Herniated Liver Mimicking Right Atrial Mass

In a newborn that underwent surgery due to omphalocele, postoperative echocardiography revealed an accidental finding of a right atrial (RA) mass. Echocardiography prior to surgery was inconspicuous. Applying color Doppler, a pulsatile flow exiting the mass could be depicted and a tubular structure lancing through the mass. Thrombus formation was suspected. However, sonographic tissue texture of this formation equaled liver tissue. Abdominal ultrasound revealed protrusion of hepatic tissue through a diaphragmatic hernia indenting the RA mimicking a thrombus.