A giant right atrial villous myxoma with simultaneous pulmonary embolism

Abstract

Introduction: Primary cardiac tumors are rare and approximately three quarters of them are benign and up to half of the benign tumors are myxomas. Right atrial villous myxoma with pulmonary embolism is an unusual apparition.

Presentation of case: A 29 year-old male was admitted to our outpatient clinic with progressive exertional dyspnea, chest pain and intermittent feeling faint. A giant right atrial villous mobile mass was detected by means of transthoracic echocardiography. To exclude possible pulmonary embolism, chest computed tomography scan was performed and showed filling defects in the branch of the pulmonary artery. The mass was totally resected.

Discussion: RA villous myxoma is a rare subtype in an unusual location with high potential of pulmonary embolism. Early surgery for villous myxoma has a great importance in order to reduce the risk of pulmonary embolism.

Conclusion: 3D TEE should be a sufficient technique for diagnosis and evoluation of shape, size and origin of the cardiac mass an adequate guide to surgical treatment.

Keywords: Pulmonary embolism; Villous myxoma.

Fig. 1

Right atrial mass on 2D-transesophageal echocardiography. A bicaval view showing a giant villous mass in the right atrium.

Fig. 2

Right atrial mass on 3D-transesophageal echocardiography. 3D full volume image reconstruction better defined the mass real shape, size and its attachment in the interatrial septum.

Fig. 3

An image of a chest computed tomography scan with intravenous contrast shows filling defects in the branch of pulmonary artery.

Fig. 4

Photograph of the right atrial myxoma resection.