Abstract
BackgroundAtrial myxomas are the most common primary cardiac tumors. They are usually small or moderate in size by the time of the diagnosis, exhibiting non specific cardiac or systemic symptoms, and are most frequently soft and friable without microscopic signs of ossification. We describe herein an extremely rare case of an asymptomatic giant left atrial myxoma with angiographic neovascularization and ossification.Case presentationAn asymptomatic 58-year-old male with a giant left atrial tumor, was transferred to our Unit for surgical treatment. The tumor was an incidental finding during a work-up for hemoptysis due to bronchectasis. The coronary angiogram showed tumor vessels originating from the RCA. The tumor macroscopically did not resemble a myxoma, considering its dimensions (12 × 10 cm) and its solid substance. The mass was excised together with the interatrial septum and the right lateral LA wall close to the right pulmonary veins orifices. The defect was closed with Dacron patches in order to prevent malformation of both atria. The pathology study revealed a benign myxoma with excessive osteoid (mature bone) content.ConclusionWe consider our case as extremely rare because of the asymptomatic course despite the large size of the tumor, the blood supply from the right coronary artery and the bone formation.
Highlights
Atrial myxomas are the most common primary cardiac tumors
We describe an extremely rare case of an asymptomatic giant left atrial myxoma with angiographic neovascularisation and mature bone elements
A 58-year-old male was referred for evaluation of a calcified left atrial mass that was found in a thoracic CT scan performed during the course of haemoptysis investigation and was attributed to lung bronchiectasis after pulmonary
Summary
Atrial myxomas are the most common primary cardiac tumors. Further evaluation with transesophageal echocardiography revealed a sessile lesion measuring 10 × 12 cm in diameter arising from the interatrial septum in an otherwise normal-sized left atrium. The macroscopic appearance of the lesion intraoperatively was a soft, glistening, multi-lobulated mass with pale gray-white surface and a broad base attached near the fossa ovalis of the left atrium by a stalk. His postoperative course was uneventful except the need for temporary external pacing. He was discharged on the 10th postoperative day in sinus rhythm and remains well and asymptomatic two years after surgery.
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