A right atrial mass - But where is it coming from?

摘要

We present a case of a 70-year-old male who attended our emergency department with prolonged weight loss and a 3-week history of progressive swelling of his lower limbs and scrotum with haema-turia. On examination there was pitting oedema up to his sacral area, with significant scrotal enlargement. The abdomen was distended with a large left-sided abdominal mass extending across the midline. This was in addition to 5 cm of hepatomegaly. On auscultation a pansystolic murmur was noted, which was loudest over the cardiac apex, with bibasal lung crepitations.