An exceptionally giant left atrial myxoma: a case report and literature review

Figure 1. Electrocardiogram, on admission, showing normal regular sinus rhythm, bifid p waves (P mitrale), and no ischaemic changes.

Figure 2. PA view chest X-ray showing bilaterally accentuated hilar vascular markings ‘arrowhead’, associated with diffuse reticular peripheral and basal lines (Kerley B lines), bilaterally.

Figure 3. (A) A midoesophageal four-chamber view of the transoesophageal echocardiography showing a huge left echogenic mass filling the left atrium (asterisk) with a moderate degree of mitral and tricuspid regurgitation evident by the presence of mosaic blood flow (arrow). (B) Postoperative transoesophageal echocardiography midoesophageal four-chambers view revealing minimal systolic mitral regurgitation. ‘P’ an indicator of the probe site.

Figure 4. (A) As shown in the picture, the resected specimen measuring 10 × 8 × 6 cm. The outer surface is smooth and covered with punctate haemorrhage. (B) On a digital weighing scale, the mass weighs 119 g. (C) Intraoperative photographs revealing a huge left atrial tumour mass (asterisk). (D) A cut section of the specimen showing a yellow–brown gelatinous and haemorrhagic areas.

Figure 5. A histopathologic view of haematoxylin and eosin stained sections confirms the presence of low cellular myxoid growth with numerous cords, nests, rings, and glandular pattern stellate to spindled cells that have a pink cytoplasm surrounding a small round benign nucleus. No nucleoli or mitotic figure are seen. Background rich in small-sized capillaries with occasional hemosiderin pigments suggests stromal haemorrhage. Multiple cystic formations with vascular differentiation along with calcifications are also seen.