CTICasesCarney Complex with Right Atrial Myxoma and Pulmonary Tumor Embolization
Imaging findings
Chest CT angiogram shows multiple low-attenuation filling defects within the main and segmental pulmonary arteries bilaterally, displaying irregular, lobulated contours and low-attenuation mixoid density rather than typical thromboemboli. A large, lobulated, mobile filling defect is noted within the right atrium, prolapsing through the tricuspid valve. Pathological examination confirms a gelatinous, villous right atrial myxoma.
Key takeaways
Carney complex is an autosomal dominant syndrome characterized by cardiac and cutaneous myxomas, spotty skin pigmentation, and endocrine overactivity. Right-sided atrial myxomas are highly friable and prone to fragmentation, leading to recurrent pulmonary tumor embolization. The embolized tumor fragments can mimic acute or chronic thromboembolic disease on CT but typically display lower attenuation and more irregular margins.
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