LAUSR

A 75-year-old woman was admitted for further evaluation of an incidentally detected mass in the right atrium (RA) on transthoracic echocardiography (TTE) during a medical check-up. She complained of not having chest pain or dyspnea and had been on medication for hypertension and dyslipidemia for 30 years. TTE showed a small hyperechoic mass-like structure just below the tricuspid valve (TV) in the RA (Figure 1A, Video 1), which appeared to be linear and extended into the right ventricle (RV) with rotation of the ultrasound transducer (Figure 1B, Video 2). Additional history taking revealed that she had undergone percutaneous vertebroplasty (PVP) for a lumbar compression fracture 7 months ago. Based on her history, the echogenic structure in the right heart was regarded as migrated bone cement. TTE showed no signs suggesting cardiac perforation such as pericardial effusion. Cardiac computed tomography demonstrated a highly attenuated, L-shaped material located in the RA and RV across the TV (Figure 1C). Because of the risk of perforation, urgent cardiac surgery was performed and a 67-mm long, bent foreign body penetrating the septal leaflet of TV was successfully removed (Figure 2).