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Right Atrial Myxoma: An Uncommon Presentation
S K Shah1, M Acharya, S I Alam
1Dr Sanjeet Kumar Shah, MS Resident (Phase-B), Department of Cardiac Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh.
Mymensingh Medical Journal : MMJ
|September 19, 2017
Summary
This case report highlights a rare right atrial myxoma, a cardiac tumor, co-occurring with hepatomegaly and Hepatitis B virus infection. The unusual combination presented diagnostic challenges due to atypical echocardiographic findings.
Area of Science:
- Cardiology
- Hepatology
- Oncology
Background:
- Primary cardiac tumors are rare, with myxomas accounting for 29% of these, predominantly in the left atrium.
- Right atrial myxomas are exceptionally uncommon, posing diagnostic difficulties due to their location and atypical presentations.
Observation:
- A 52-year-old patient presented with dyspnea, fever, and weakness, exhibiting hepatomegaly, jaundice, and positive Hepatitis B surface antigen (HBsAg).
- Echocardiography revealed a large right atrial myxoma (14.3cm²) extending into the inferior vena cava, with mild inferior vena cava dilation.
- Abdominal ultrasound confirmed hepatomegaly (17.6cm) with coarse hepatic parenchyma.
Findings:
- The study details a rare case of right atrial myxoma coexisting with hepatomegaly and Hepatitis B virus infection.
- The large size of the myxoma and its unusual right atrial location complicated diagnosis.
- Atypical echocardiographic findings further contributed to the diagnostic challenge.
Implications:
- This case underscores the importance of considering rare cardiac tumors in patients with unexplained hepatomegaly and jaundice, especially with concurrent viral infections.
- It highlights the need for comprehensive cardiac and abdominal evaluations for atypical presentations.
- The report emphasizes the diagnostic challenges and emphasizes the rarity of this specific clinical triad.
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