Abstract
IntroductionLeft atrial myxomas are rare benign tumors of the heart. They vary widely in size, and very little is known about their growth rate. The reported growth rates of left atrial myxomas from several published case reports appears to vary from no growth, to between 1.3 to 6.9 mm/month in diameter within patients with established myxoma who have not undergone surgery.Case presentationWe present the case of a rapidly growing pedunculated left atrial myxoma in a 62-year-old asymptomatic Caucasian woman found incidentally during routine transthoracic echocardiography. Our patient was attending her annual valve clinic assessment for moderate aortic regurgitation, and her two previous consecutive transthoracic echocardiography scans performed 12 and 24 months prior to this appointment had demonstrated a clear left atrium and aortic regurgitation of moderate severity.ConclusionsTo the best of our knowledge, our case is the first to provide images of absence and presence of myxoma from transthoracic echocardiography scans taken a year apart, with estimated growth rate of 2.2 mm/month. Rapidly growing myxoma may be mistaken for thrombus, and may require urgent surgical excision to reduce the risk of associated complications such as thrombo-embolic events, sudden cardiac death and removal of a possibly malignant tumor. The potential for rapid growth should be considered if there is a plan to delay surgery. Furthermore, it would be pertinent to consider annual echocardiography in patients presenting with clinical features suggestive of cardiac myxoma such as constitutional symptoms, as these tumors may be rapid growing and may only become apparent on subsequent echocardiography.
Highlights
Left atrial myxomas are rare benign tumors of the heart
Growing myxoma may be mistaken for thrombus, and may require urgent surgical excision to reduce the risk of associated complications such as thrombo-embolic events, sudden cardiac death and removal of a possibly malignant tumor
The potential for rapid growth should be considered if there is a plan to delay surgery
Summary
To the best of our knowledge, our case report is the first to present images of absence and presence of myxoma from TTE scans taken a year apart, with an estimated growth rate of 2.2 mm/month. The major differential diagnosis of myxoma is thrombus, which often has a rapid growth rate. Caution is required in using rapid growth rate as a diagnostic criterion to differentiate between thrombus and myxoma. It would be pertinent to consider annual echocardiography in patients presenting with clinical features suggestive of cardiac myxoma such as constitutional symptoms, as these tumors may be rapidly growing, and may only become apparent on subsequent echocardiography. Consent Written informed consent was obtained from the patient for publication of this case report and any accompanying images. Remained asymptomatic for two years after surgery, with no recurrence of myxoma on TTE
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
