Asymptomatic Giant Right Atrial Myxoma Masking Severe Tricuspid Regurgitation

Background: Cardiac myxomas are the most common primary cardiac tumor and are predominantly found in the left atrium. They are biologically benign but carry the risk of embolization. Case Summary: A 46-year-old man had an incidental finding of a giant right atrial mass. Despite being asymptomatic, the cardiac mass measured 8.6 cm × 5.7 cm and masked severe tricuspid regurgitation. Diagnosis was confirmed on transesophageal echocardiography, and surgical removal of the mass with tricuspid valve repair was performed. Pathologic analysis confirmed the mass to be a cardiac myxoma. Discussion: Right atrial myxomas can vary in size and can be quite large, with a mean size of about 5 to 6 cm. Larger myxomas typically present with signs and symptoms related to tricuspid valve obstruction. Take-Home Message: This case reports a giant right atrial cardiac myxoma, presenting without hemodynamic compromise and demonstrating the importance of recognizing the mass effect on cardiac valves.