Retinal artery occlusion by left atrial myxoma misdiagnosed as thrombus

Left atrial mass has been known to have a benign course.

A 55-year-old Asian woman visited to our hospital because of right sided hemiparesis and sudden vision loss in her left eye. She diagnosed as acute cerebral infarction and central retinal artery occlusion by several studies. We detected a large mass in the left atrium and thought this mass as thrombus causing multiple emboli. But her neurologic symptom was aggrevated during therapy and coronary computed tomography angiogram suggested a left atrial myxoma, not thrombus. She underwent the resection of the myxoma.

Sometimes it could be fatal because it could be source of systemic embolization. Moreover, when the mass is located at unusual site, it is difficult to differentiate thrombus and other benign mass.

We report a patient with a left atrial mass initially presented as multiple embolic infarction. Our case will let ophthalmologists know about the possibility of retinal artery occlusion by cardiac myxoma.