We present a case of a 67-year-old female with cerebrovascular accident and newly diagnosed atrial fibrillation where cardiac workup including echocardiogram demonstrated a 1.8 cm × 2 cm sessile left atrial mass with internal vascularity, attached to the posterior wall and adjacent to and partially invading the left upper pulmonary vein [[Figure 1] and [Figure 2], Videos 1 and 2]. Coronary angiogram showed a large vascular mass supplied by atrial branches from the left circumflex artery and right coronary artery and extensive contrast flow from the mass into the left atrium [Figure 3] and [Figure 4]. Thereafter, the patient underwent surgical resection where histology demonstrated a benign myxoma requiring extensive patch reconstruction of the left atrium. She was discharged home after an unremarkable postoperative course.
Left atrial myxoma blood supply is usually from the left circumflex artery and occasionally from the right coronary artery; left and right coronary arteries supplying myxoma are an uncommon finding. Cardiac myxomas commonly demonstrate some vascularity and benign appearance; however, highly vascular cardiac tumors are usually malignant, making this case of extensively vascular atrial myxoma rare.
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