CTICasesRight Atrial Myxoma extending into SVC
Imaging findings
Imaging revealed a large, enhancing mass originating with a posterior stalk from a very high location in the right atrium and extending into the superior vena cava (SVC). Unlike most left atrial myxomas, this mass was not associated with the fossa ovalis. Delayed contrast imaging showed slow, progressive enhancement within the lesion, confirming its vascularized nature and differentiating it from thrombus.
Key takeaways
While left atrial myxomas typically arise from the fossa ovalis, right atrial myxomas can originate from various locations within the right atrium, including high up, and may extend into the SVC. Right atrial myxomas tend to be larger than left atrial myxomas at presentation because they often cause less immediate symptomatic obstruction. Slow, heterogeneous enhancement on delayed imaging is characteristic of myxomas and helps distinguish them from bland thrombus.
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