Multidisciplinary single stage surgical management of advanced breast carcinoma with concomitant left atrial myxoma

Primary cardiac tumors are rare, with atrial myxomas accounting for approximately 50% of benign cardiac tumors. In patients with malignancy, intracardiac masses pose a diagnostic challenge because distinguishing primary tumors from metastases directly influences management.

A 58-year-old woman with locally advanced invasive mucinous breast carcinoma developed a progressive fungating breast mass despite neoadjuvant chemotherapy and radiotherapy.Routine echocardiography incidentally revealed a large left atrial mass attached to the interatrial septum. Cardiac MRI and FDG PET-CT suggested a cardiac neoplasm but could not exclude metastasis.Given the embolic risk and urgent need for oncologic surgery,a multidisciplinary team performed single-stage toilet mastectomy,atrial mass excision with interatrial septal reconstruction and split-thickness skin grafting under one anaesthetic. Histopathology confirmed glandular atrial myxoma.

Single-stage multidisciplinary surgery may safely reduce treatment delay, embolic risk, repeated anaesthesia, and hospitalization in carefully selected patients.