Multimodality Imaging of a Right Atrial Myxoma Mimicking Pancreatitis

Right atrial myxomas are rare and may present with nonspecific systemic or gastrointestinal manifestations, leading to diagnostic delay.

A 51-year-old woman presented with severe epigastric pain that was initially treated as pancreatitis after abdominal computed tomography demonstrated interstitial pancreatic edema with peripancreatic fluid collection. Serum amylase and lipase levels were normal, raising diagnostic uncertainty; hence, subsequent evaluation was performed after transfer to our institution. Repeat abdominal imaging demonstrated hepatomegaly with a "nutmeg" pattern, suggestive of hepatic congestion. During emergency department evaluation, transthoracic echocardiography was requested to evaluate unexplained systemic findings and revealed a large right atrial mass nearly obstructing right ventricular inflow. Urgent surgical excision confirmed cardiac myxoma, and the patient recovered without complications.

Right atrial myxomas may mimic extracardiac disease through venous congestion and inflammatory effects, resulting in misleading gastrointestinal presentations.

Multimodality imaging, particularly echocardiography, is essential for timely diagnosis and lifesaving surgical management.