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Interconnected Biatrial Myxoma Spanning the Fossa Ovalis: Management Based on Multimodality Imaging
Jonathan Cayo Urdiales Herrera1, Heleutério da Conceição Nicolau Madogolele1, Rafael Ruas Nastari1
1Cardiomyopathies Unit of the Heart Institute (InCor) of the Hospital das Clínicas, Faculty of Medicine, University of São Paulo, São Paulo, Brazil.
Background:
Biatrial myxomas are exceptionally rare; an even more unusual variant is a single tumor that straddles the interatrial septum through the fossa ovalis, forming 2 synchronous masses.
Case Summary:
A 74-year-old woman undergoing routine echocardiography displayed mobile lesions (3.1 × 1.4 cm left, 3.6 × 1.7 cm right) arising from a common pedicle traversing the fossa ovalis. Transesophageal echocardiography, cardiac magnetic resonance, and computed tomography confirmed a biatrial myxoma with a continuous stalk crossing the septum. Surgery achieved complete en bloc resection; recovery was uneventful aside from transient sinus bradycardia.
Discussion:
This case illustrates the diagnostic value of multimodality imaging in defining a myxoma that bridges the atrium-a configuration predisposing to both systemic and pulmonary embolization-and demonstrates the excellent prognosis with prompt surgical excision.
Take-Home Messages:
Multimodality imaging guides precise surgical planning. Early complete resection prevents dual-chamber embolic complications.
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