Left Atrial Mass with Stalk: Thrombus or Myxoma?

Abstract

A 63-year-old female was presented to emergency room with an abdominal pain. The patient had moderate mitral valve stenosis and atrial fibrillation. Abdominal computed tomography revealed right renal infarction. Transthoracic echocardiography showed a large mobile mass in the left atrium. Transesophageal two-and three-dimensional echocardiography showed a large mobile ovoid mass with a narrow stalk attached to the left atrial septum. It was thought to be a myxoma rather than thrombus. Anticoagulation with heparin was continued. When the operation was performed, there was no mass in the left atrium. It must be a thrombus and melt away.

Left atrial appendage myxoma masquerading as left atrial appendage thrombus

“…Most often, a left atrial myxoma is attached to the fossa ovalis of the interatrial septum. 1 Less commonly, it is attached to the atrial dome, mitral valve, pulmonary valve, aortic valve, eustachian valve, right interatrial septum, right ventricle, left ventricle or free wall. 2 In the presence of atrial fibrillation or mitral stenosis, a mass in the left atrial appendage (LAA) is a thrombus unless proven otherwise; in the absence of predisposing conditions, other rarer masses such as LAA myxoma, papillary fibroelastoma, and cardiac hemangioma should also be considered in the differential diagnosis.…”

Atypical size and location of a right atrial myxoma: a case report

“…Approximately 70% of affected patients are women, predominantly between the third and sixth decades of life, as was the case of the 35-year-old patient described in this report. 7,8 RA myxomas usually originate in the fossa ovalis or base of the interatrial septum, but in this case, the myxoma was implanted in the anterior wall of RA near IVC origin. 9 In a recent publication reporting 19 years of experience with surgical treatment of primary intracardiac myxoma, seven (17%) cases out of 41 originated from the RA.…”

Atypical location of extracardiac myxoma: a case report

“…Similarly, we present an unusual extracardiac epicardially located myxoma of right atrium, in this report. The literature states that approximately 70% of adult myxoma patients are women (5,6), predominantly between 30 and 60 years of age. Additionally most of such cases are solitary and sporadic, while some are associated with certain syndromes (7,8).…”