A 59-year-old woman was diagnosed with breast cancer in 1989. In 2002, she was diagnosed with ovarian carcinoma.

A left ventricular mass was incidentally noted on a breast magnetic resonance imaging scan for routine screening. Transthoracic echocardiogram showed a large pedunculated echo-dense “finger-like” mass attached to the apex and protruding toward the base, measuring 6.4 × 2.4 cm. The mass appeared to be attached to the apex, and it did not thicken during systole (A, Online Video 1).

On the cardiac magnetic resonance study, the mass was nearly isointense with myocardium and revealed attachment of the mass to the apex, with absence of systolic thickening (B, Online Video 2). Inversion recovery imaging sequence confirmed the mass to be a thrombus. Delayed enhancement showed an anterolateral-apical scar consistent with distal left anterior descending artery infarction (C). The patient had no history of a prior myocardial infarction or previous ischemic cardiac workup, and her 12-lead electrocardiogram was unremarkable (Online Videos 1 and 2).