Right atrial tumour in a patient with acute pancreatitis

Differential diagnosis of intracardiac tumours should include i.a. thrombi, vegetations and neoplasms. We present a case of a 72-year-old male with paroxysmal atrial fibrillation, who had been previously treated with dabigatran and whose anticoagulant treatment was subsequently changed to enoxaparin during hospitalisation due to acute pancreatitis. Initially, tumour of the ampulla of Vater was suspected. Echocardiography revealed a polycyclic, balloting tumour in the right atrium, originating from the inferior vena cava. Based on computed tomography, magnetic resonance imaging and gastroscopy, carcinoma of the ampulla of Vater was ruled out. Positron emission tomography was performed, showing no signs of metabolically active neoplastic growth. Anticoagulation with acenocoumarol was initiated, leading to a complete resolution of the mass in the right atrium and inferior vena cava.