PMC10427500_01
Preoperative echocardiography, coronary CTA, and cardiac MRI. (A) Echocardiography showed a medium echogenic mass attached to the upper part of the interatrial septum in the left atrium, with a wide base, regular shape, and fixed position. (B) Coronary CTA demonstrated a spherical lesion in the left atrium with right coronary artery blood supply. (C) LGE imaging depicted a spherical mass having a size of approximately 2.5 cm x 2.6 cm x 2.7 cm in the left atrium, with an abnormal signal showing a clear edge and patchy and uneven delayed enhancement.
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Preoperative echocardiography showed an intracardiac mass with medium-level echogenicity attached to the upper part of the interatrial septum in the left atrium, with a wide base, regular shape, and fixed position (Figure 1A). CTA showed a spherical lesion of equal density in the left atrium, closely related to the upper part of the interatrial septum, with right coronary artery blood supply (Figure 1B). Cardiac magnetic resonance imaging (MRI) depicted a spherical lesion with mixed isointense T1 and hyperintense T2 signal in the left atrium, with a clear edge and a size of approximately 2.5 cm x 2.6 cm x 2.7 cm. Late gadolinium-enhanced (LGE) imaging demonstrated patchy and uneven delayed enhancement in the left atrial mass (Figure 1C).
Characterization of the left atrial mass and its blood supply on coronary angiography. Preoperative coronary angiography detected a tumor-like mass in the left atrium and blood supply from the distal right coronary artery to the mass.
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Coronary angiography prior to surgery revealed the blood perfusion from the distal right coronary artery to the left atrial mass (Figure 2).
Gross pathological specimen and histopathology of the left atrial mass. (A) The mass resected from the left atrium. (B) Histopathology showed cavernous hemangioma with vascular dilation and congestion based on background of cardiac myxoma. The magnifications in (B) are x40 (left) and x200 (right).
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The lesion was completely excised along with a portion of the interatrial septum and posterior wall of the left atrium (Figure 3A). Postoperative histopathology demonstrated that the lesion tissue was a left atrial myxoma, presenting with partial cavernous hemangioma showing vascular dilation and congestion (Figure 3B).
Postoperative echocardiography showed no residual tumor tissue and a normal cardiac chamber structure.
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Postoperative echocardiography did not detect any residual tumor tissue, and cardiac chamber structure and function were normal (Figure 4).