Incidental right atrial mass in a patient with secondary pancreatic cancer: A case report and review of literature

Table 2 Timeline of clinical history

Date	Event
2011	Breast cancer (right mastectomy and lymphadenectomy + adjuvant chemotherapy with cyclophosphamide, methotrexate, 5-fluorouracil + hormone therapy with tamoxifen)
2020	Pancreatic cancer with hepatic metastases (chemotherapy with nab-paclitaxel and gemcitabine)
February 2021	Second-line treatment with 5-fluorouracil, folic acid, oxaliplatin, irinotecan
May 2021	Deep vein thrombosis (right external iliac vein and both common femoral veins) and pulmonary embolism
	Start LMWH
June 2021	Persistence of deep vein thrombosis and pulmonary embolism
	LMWH replaced with edoxaban for inefficacy and patient’s preference
August 2021	Chemotherapy with carboplatin for worsening of liver metastases
September 2021	Dyspnea at rest and fatigue
	Echocardiogram: Incidental large right atrial mass, highly mobile and not vascularized, close to the ICV orifice
	Edoxaban replaced with LMWH due to thrombocytopenia and anemia
October 2021	Halved LMWH dose due to further platelet count decrease
November 2021	Marked decline of clinical general condition
	Discontinuation of anticancer drugs for severe disease progression
	Discontinuation of LMWH for severe thrombocytopenia
	Start palliative care

LMWH: Low molecular weight heparin; ICV: Inferior cava vein.