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Left Atrial Mass with Stalk: Thrombus or Myxoma?

  • Jang, Kyeong-Hee (Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine) ;
  • Shin, Dae-Hee (Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine) ;
  • Lee, Chang-Kun (Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine) ;
  • Jang, Jin-Kun (Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine) ;
  • Cheong, Sang-Sig (Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine) ;
  • Yoo, San-Yong (Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine)
  • Published : 2010.12.27

Abstract

A 63-year-old female was presented to emergency room with an abdominal pain. The patient had moderate mitral valve stenosis and atrial fibrillation. Abdominal computed tomography revealed right renal infarction. Transthoracic echocardiography showed a large mobile mass in the left atrium. Transesophageal two-and three-dimensional echocardiography showed a large mobile ovoid mass with a narrow stalk attached to the left atrial septum. It was thought to be a myxoma rather than thrombus. Anticoagulation with heparin was continued. When the operation was performed, there was no mass in the left atrium. It must be a thrombus and melt away.

Keywords

References

  1. Alam M, Sun I. Transesophageal echocardiographic evaluation of left atrial mass lesions. J Am Soc Echocardiogr 1991;4:323-30. https://doi.org/10.1016/S0894-7317(14)80442-2
  2. Feinglass NG, Reeder GS, Finck SJ, Shine TS, Maniu CV. Myxoma of the left atrial appendage mimicking thrombus during aortic valve replacement. J Am Soc Echocardiogr 1998;11:677-9. https://doi.org/10.1016/S0894-7317(98)70046-X
  3. Araoz PA, Mulvagh SL, Tazelaar HD, Julsrud PR, Breen JF. CT and MR imaging of benign primary cardiac neoplasms with echocardiographic correlation. Radiographics 2000;20:1303-19. https://doi.org/10.1148/radiographics.20.5.g00se121303
  4. Fang YM, Dean R, Figueroa R. Right atrial myxoma mimicking an atrial thrombus in the third trimester of pregnancy. J Matern Fetal Neonatal Med 2007;20:77-8. https://doi.org/10.1080/14767050601131229
  5. Feinglass NG, Reeder GS, Finck SJ, Shine TS, Maniu CV. Myxoma of the left atrial appendage mimicking thrombus during aortic valve replacement. J Am Soc Echocardiogr 1998;11:677-9. https://doi.org/10.1016/S0894-7317(98)70046-X
  6. Park HS, Park JH, Jeong JO. Intracoronary catheter aspirarion can be an adequate option in patient with acute myocardial infarction caused by left atrial myxoma. J Cardiovasc Ultrasound 2009;17:145-7. https://doi.org/10.4250/jcu.2009.17.4.145
  7. Burke A, Jeudy J Jr, Virmani R. Cardiac tumours: an update: Cardiac tumours. Heart 2008;94:117-23. https://doi.org/10.1136/hrt.2005.078576
  8. Restrepo CS, Largoza A, Lemos DF, Diethelm L, Koshy P, Castillo P, Gomez R, Moncada R, Pandit M. CT and MR imaging findings of benign cardiac tumors. Curr Probl Diagn Radiol 2005;34:12-21. https://doi.org/10.1067/j.cpradiol.2004.10.002
  9. Hesse B, Murphy RT, Myles J, Huang J, Sabik EM. Images in cardiovascular medicine. A left atrial appendage thrombus mimicking atrial myxoma. Circulation 2006;113:e456-7. https://doi.org/10.1161/CIRCULATIONAHA.105.565903
  10. Heitner JF, Klem I, Alexander K, Thomson L, Meine TJ, Patel MR, Haq SA, Shah DJ, Kim RJ. The case of the disappearing myxoma. J Cardiovasc Magn Reson 2005;7:841-3. https://doi.org/10.1080/10976640500288156
  11. Kim SE, Park DG. Tentatively diagnosed as myxoma: Transit thrombus entrapped in patent foramen ovale. J Cardiovasc Ultrasound 2007;15:19- 22.
  12. Alam M. Pitfalls in the echocardiographic diagnosis of intracardiac and extracardiac masses. Echocardiography 1993;10:181-91. https://doi.org/10.1111/j.1540-8175.1993.tb00029.x
  13. Sim EK, Lim YT, Ng WL, Goh JJ, Reebye S. Co-existing left atrial thrombus and myxoma in mitral stenosis--a diagnostic challenge. Singapore Med J 1999;40:46-7.
  14. Scheffel H, Baumueller S, Stolzmann P, Leschka S, Plass A, Alkadhi H, Schertler T. Atrial myxomas and thrombi: comparison of imaging features on CT. AJR Am J Roentgenol 2009;192:639-45. https://doi.org/10.2214/AJR.08.1694

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