Unusual-Appearing Calcified Left Atrial Myxoma

Abstract

Background

Cardiac myxoma is a rare tumor with variability in clinical presentation, imaging, and histopathologic findings.

Case summary

An 82-year-old woman presented with fatigue, dizziness, and declining exercise tolerance. Work-up included echocardiogram notable for an atrial mass. Further imaging diagnosed left atrial myxoma for which she underwent open surgical resection.

Discussion

Cardiac myxomas with gross calcifications are uncommon and are usually seen in right rather than left atrial tumors. The pathogenesis of their formation is largely unknown. We present a rare case of a left atrial myxoma with large, dystrophic calcifications that affected both preoperative and intraoperative evaluation of the tumor.

Take-Home Messages

Cardiac myxoma tumor characteristics are quite variable, with gross calcifications generally uncommon and more frequently seen in the right rather than the left atrium. Supplemental imaging such as cardiac magnetic resonance may be necessary in preoperative evaluation of heavily calcified cardiac tumors owing to limitations in echocardiographic images regarding sufficient diagnostic detail.