Left atrial myxoma arising from the Coumadin ridge

A male in his 70s had an incidental finding of a mass located within the left atrium on staging CT, following a new diagnosis of prostate cancer. The patient was asymptomatic; however, he was admitted for further investigations of a suspected thrombus.Cardiac MRI described a focal, mobile lesion measuring 17 × 12mm, within the ostium of the left atrial appendage. The lesion displayed cystic features on MRI consistent with a possible pseudocystic myxoma. Transoesophageal echocardiography demonstrated a moderately large, probable atrial cystic myxoma attached to the Coumadin ridge. He underwent surgical excision of a histologically confirmed atrial myxoma.Herein, we describe a rare finding of a cardiac myxoma arising from the Coumadin ridge, highlighting the importance of considering myxoma in the differential diagnosis of a left atrial mass and the role of multi-modality imaging in the evaluation and management of cardiac masses.