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Cardiac myxomas are mostly arising from interatrial septum, particularly from fossa ovalis, back and front atrial wall and appendix. However, 10% of myxomas arise from atypical locations. This report presents a rare case of atypical location of extracardiac myxoma in a case of sudden death. A 43-year old female suddenly dies at home. At autopsy, three masses attached each other were observed in pericardial fat tissue localized between right atrium, vena cava superior wall, and right ventricle. Three masses, as a lobulated single mass, were 7x2x1 cm, 5x5x2 cm, 3x2x0.5 cm in size, respectively. Masses were observed to surround right coronary artery for a segment of 7 cm. Cardiac dissection revealed that mass infiltrates epicardial site of right atrium and ventricle wall but not infiltrated to myocardium and heart cavities. Histopathological and immunohistochemical findings were compatible with a rarely seen atypically localized extracardiac myxoma on right atrial epicardium.

Gokmen A, Renklidag T, Yondem M. Multiple deaths due to entrapment in refrigerator.

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