Incidental finding of a giant asymptomatic right atrial tumor

Abstract

Primary cardiac tumors are very rare, atrial myxoma being the most common benign tumor of the heart. They may present with a great variety of incidental asymptomatic masses to severe life-threatening cardiovascular complications necessitating emergency surgery. Here we report the diagnostic evaluation and successful surgical resection of such a giant cardiac tumor which was found on a routine medical check-up in a 62-year-old patient. Histology confirmed diagnosis of unusually huge myxoma. This article demonstrates it's necessary to include cardiac tumors in the differential diagnosis of subtle and non-specific cardiothoracic symptoms.

Keywords: Cardiac tumors; echocardiography; myxoma; pathology; surgery.

Figure 1

A: Transthoracic echocardiography revealed a large mobile mass (41 x 46 m) attached to the lateral wall of the right atrium. B: Intraoperative photograph showing the giant right atrial heterogeneous mass. The tumor also infiltrates parts of the inferior wall. C: Glistening cut surface of the tumor with predominantly deep red and sometimes pale yellow color. D: The tumor cells occasionally formed ring-like structures around primitive vessels. E: The macroscopically paler areas corresponded to heavily collagenized and inflamed stroma. F: Especially at the base of the tumor a prominent lymphofollicular reaction with admixed siderophages was seen.