An Atypical Case of Intracardiac Myxoma Fed by Extracardiac Arteries

Myxoma is the most common type of primary benign heart tumor and is usually easily identified by echocardiography. Tumor vascularity is a rare finding in atrial myxomas and reported cases of the right atrial myxomas most frequently involve feeding vessels from the right coronary artery or, less frequently, from both coronary arteries. In this case report, an echocardiographic examination of a 74-year-old male, who was admitted to hospital with chest pain revealed an echogenic solid mass in the right atrium. A coronary angiography showed an arteriocavity fistula connecting the feeding artery to the cardiac chamber. In the computed tomography angiography examination performed, a mass was observed with intense vascularity, containing feeding vessels from the left circumflex artery, the right inferior phrenic artery, and the left hepatic artery; calcifications in the right atrium were also present. The mass was completely and successfully resected. Pathology results of the mass were compatible with cardiac myxoma. This was an atypical case of a right atrial myxoma due to the presence of intense vascularization and the feed from the cardiac and extracardiac arteries.