Images in Clinical Medicine
Left Atrial Myxoma
N Engl J Med 2008; 358:728February 14, 2008
- Article
A 63-year-old man who was a retired truck driver had undergone four-vessel coronary-artery bypass grafting and was well, with no recurrent symptoms. However, on follow-up stress echocardiography to assess left ventricular function 14 months later, mild dilatation of the left atrium was noted, and a mass (3.2 by 1.6 cm) adhering to the left atrial septum and extending into the left atrial lumen, suggestive of a myxoma, was also found. Contrast-enhanced computed tomography confirmed the presence of the left atrial mass (indicated by an arrow in this coronal view of the heart). The mass was consistent with the diagnosis of myxoma, although other possible diagnoses were thrombus, malignant mesenchymal tumors, sarcoma, and metastases. Given the possibility of a tumor and the risk of systemic embolization, especially to the central nervous system, the patient underwent resection of the mass. Pathological evaluation revealed a benign myxoma. The patient had an unremarkable postoperative course and was discharged on the sixth postoperative day. At 1 year, the patient continued to be well and had no symptoms or evidence of recurrence on echocardiography.
Ritu Gill, M.D.
Sary F. Aranki, M.D.
Brigham and Women's Hospital, Boston, MA 02115
rgill@partners.org
