A Giant Right Atrial Mass with Concomitant Pulmonary Embolism

Myxomas are the most common primary cardiac tumors. They are mostly located in the left atrium, but 15% to 20% of them arise from the right atrium (RA). We herein describe a 22-year-old man with a giant RA mass and simultaneous pulmonary embolism. The mass was detected accidentally on transthoracic echocardiography in preoperative workup for an elective noncardiac surgery and was confirmed with multimodality imaging. The patient underwent surgical removal of the mass and concomitant pulmonary artery embolectomy. Histopathological examination confirmed the diagnosis of an RA myxoma. He had an uneventful recovery and was asymptomatic after 24 months of follow-up. This case is a villous RA myxoma, which is a very rare subtype with a high tendency to pulmonary embolism. We report this case as an unusual location of a very large myxoma and emphasize the role of multimodality imaging in the preoperative management of this patient as cardiac computed tomography angiography confirmed the associated pulmonary embolism..