CTICasesVillous Left Atrial Myxoma with Embolic Brain Infarcts
Imaging findings
MRI of the brain showed multiple areas of infarction, evidenced by bright signal on ADC maps and dark signal on diffusion-weighted imaging. A gated cardiac CT revealed a large, villous mass in the left atrium, situated along the posterior wall and notably not attached to the interatrial septum, confirmed pathologically as a myxoma.
Key takeaways
Left atrial myxomas are typically attached to the interatrial septum, often at the fossa ovalis, but can occur in atypical locations such as the posterior wall. A villous morphology makes them prone to fragmentation and embolization, which can present with systemic embolic events, including brain infarcts leading to symptoms like dizziness. Surgical resection is the definitive treatment.
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