En bloc resection of a left atrial myxoma mimicking bronchial asthma: a case report

Abstract

A 50-year-old female patient presenting with progressive dyspnea was initially diagnosed with bronchial asthma. Even after a six-month treatment period, the patient's symptoms continued to escalate. On cardiac auscultation, a diastolic murmur was noted at the apex. Transthoracic echocardiography (TTE) revealed a pedunculated mass measuring 38 × 32.5 mm, attached to the interatrial septum within the left atrium. Additionally, moderate functional mitral regurgitation was identified. With a preliminary diagnosis of atrial myxoma, urgent surgical intervention was scheduled to prevent the risk of embolism. With a transseptal atriotomy approach, the tumor was mobilized without fragmentation and resected en bloc along with its stalk. Postoperatively, the functional mitral regurgitation resolved. Histopathological examination of the resected cardiac mass confirmed the diagnosis of atrial myxoma. During the postoperative course, the patient's symptoms significantly improved, and no residual mass was detected on follow-up echocardiography at twelfth months.

Myxomas are soft, gelatinous, and highly friable tumors that pose a significant risk of intraoperative fragmentation and embolization. This case highlights a rare instance in which a left atrial myxoma, initially misdiagnosed as asthma, underscored the importance of appropriate surgical strategy to prevent embolic events and recurrence. Furthermore, the case illustrates the diverse clinical presentations of cardiac myxomas and provides valuable insights that may contribute to the existing literature.