A rare case of a primary atrial myxoma with metaplastic ossification and its multimodal imaging features

Abstract

Introduction: Cardiac myxomas are rare, benign intracardiac tumors that arise from pluripotent mesenchymal stem cells. The vast majority of myxomas consist of mesenchymal stem cells suspended within a mucoid, gelatinous material.

Presentation of case: A 55-year-old woman presented with progressive chest pain due to a left atrial myxoma with unusual calcification. A complete resection was performed and pathology confirmed the diagnosis of myxoma with metaplastic ossification.

Discussion: This case represents the diagnostic challenges of atypical myxomas and emphasizes the importance of multimodal anatomic and functional imaging for accurate preoperative assessment.

Conclusions: This case showcases the heterogeneity of cardiac myxomas, the typical natural history, and the value of multimodal imaging in managing these rare intracardiac tumors.

Keywords: Calcification; Cardiac myxoma; Multimodal imaging; Ossification.

Fig. 1

Left atrial myxoma with metaplastic ossification (A) sagittal section of chest CT with contrast showing rounded filling defect in left atrium with dystrophic calcification (white arrow) (B) parasternal long axis view from TTE demonstrating a 2.8 × 2.9 cm mass within the left atrium above the anterior mitral leaflet (C) T1 axial MRI slice with mass originating from the interatrial septum that is isointense to the myocardium (D) yellow/white mass post-resection, with arrow indicating the point of septal attachment.