Pericardial effusion simulating a tumor. The value of Doppler color echocardiography for its differentiation

We describe the case of a patient aged 64 with aortic valve disease and pericardial effusion. Echocardiographic evaluation showed an intrapericardial mass of about 7 cm of diameter with clotted appearance, adhered to the visceral leaf, at the level of the atrio-ventricular function. Because of this finding we performed color codified Doppler echocardiography, observing that this mass acquired a blue hue during diastole and mosaic hue at the end of the systole, realizing that this phenomenon was due to fluid retention. There are many publications about the value of echocardiography for the identification of pericardial masses and some of them show how an effusion can hide a tumor. The interest of this particular case lies in that the effusion simulated a tumor and by means of the color codified Doppler we could demonstrate that it corresponded to the stream of the pericardial fluid. During the surgical procedure the absence of the mass was corroborated.