DOI: https://doi.org/10.36347/sjmcr.2026.v14i06.023

Pages: 1415-1418

Primary cardiac tumors are extremely rare and often present with non-specific symptoms. Among them, cardiac angiosarcomas are the most common malignant subtype, typically arising from the right atrium and frequently associated with pericardial effusion. Differentiating them from atypical myxomas can be challenging, particularly on imaging. We report the case of a 58-year-old male with recurrent pericardial effusions, progressive chest pain, dyspnea, and cough. Contrast-enhanced chest CT demonstrated a large pericardial effusion associated with a thickened, irregular right atrial wall. Cardiac MRI revealed a poorly defined, irregular tissue mass centered on the posterior and lateral walls of the right atrium, protruding into the atrial lumen. Cardiac MRI findings were highly suggestive of a right atrial angiosarcoma, although an atypical myxoma could not be excluded. This case underscores the pivotal role of MRI in characterizing cardiac masses and assessing their extension, which is essential for diagnosis and management planning.