Ectopic Liver Presenting as Right Atrial Mass: A Case Report and Literature Review

Ectopic liver, commonly found within the abdomen, seldom extends above the diaphragm, with documented cases occurring among younger individuals. However, this manifestation is exceptionally rare in adults. We present a case of a 45-year-old male who is obese with obstructive sleep apnea, presented with worsening exertional dyspnea and a past episode of syncope. The electrocardiogram (EKG) showed a normal sinus rhythm. A Transthoracic echocardiogram revealed a 2.7 cm × 1.6 cm mass at the junction of the right atrium and inferior vena cava, along with a patent foramen ovale (PFO) and an ejection fraction of 55%–60%. Cardiac surgery successfully removed a presumed atrial myxoma, closed the PFO, and confirmed partially encapsulated liver parenchyma through histological examination. The postoperative course was uneventful, and resolution of dyspnea was observed during follow-up. Discovering right atrial masses is typically an unintentional finding during echocardiography. Nevertheless, surgical removal frequently remains the primary option due to the embolic and carcinogenic risks associated with ectopic masses.