Primary lung sarcoma mimicking left atrial myxoma

Area of Science:

• Cardiology
• Radiology
• Oncology

Background:

• A patient presented with symptoms initially suggestive of a left atrial myxoma.
• Initial diagnosis was made via echocardiography in the emergency department.
• Referral for open-heart surgery was recommended based on the initial findings.

Purpose of the Study:

• To investigate a suspected left atrial myxoma.
• To accurately diagnose a mass in the right hemithorax with suspected atrial involvement.
• To determine the appropriate management pathway and avoid unnecessary surgical intervention.

Main Methods:

• Chest X-ray review revealed a right lower lobe whiteout.
• Computed tomography (CT) of the chest was performed for further evaluation.
• Imaging analysis focused on the mass characteristics, location, and relationship with the left atrium.

Main Results:

• CT revealed a heterogeneously hypodense mass in the right hemithorax.
• The mass demonstrated ill-defined planes with the left atrium.
• Extension into the left atrium via the right inferior pulmonary vein was observed.
• Imaging suggested a sarcomatous/malignant vascular mass of pulmonary origin.

Conclusions:

• Computed tomography (CT) chest imaging is crucial for differentiating cardiac from pulmonary masses.
• Accurate radiological diagnosis averted unnecessary open-heart surgery.
• The patient was appropriately referred to the oncology department for further management of a presumed malignant pulmonary mass.