Abstract

The Silent Giant : Incidental Discovery of a Large Left Atrial Myxoma

Author(s): Fadoua Lachhab*, Rime Fagouri, Ahmed Maghraoui, Jamal Eddine Filal, Abdou Louali, Amal Drissi, Said Moughi

Primary cardiac tumors are uncommon, with atrial myxomas constituting the most prevalent benign subtype and predominantly arising in the left atrium. Although traditionally associated with obstructive, embolic, and constitutional manifestations, their clinical presentation is highly heterogeneous. Tumor size is often presumed to correlate with symptom severity; however, this association remains inconsistent and appears to be influenced by additional factors such as tumor mobility, site of attachment, and degree of valvular interference. We report the incidental diagnosis of a giant left atrial myxoma with a surface area of 37 cm² in a 54-year-old man presenting with non-specific symptoms and no evidence of significant hemodynamic compromise. Despite its remarkable size and diastolic prolapse through the mitral valve, the tumor was not associated with severe obstruction or embolic events. T his case underscores the potentially silent yet life-threatening nature of large atrial myxomas and highlights the importance of early imaging-based diagnosis and prompt surgical resection, even in patients with minimal or absent symptoms.