Giant Cystic Left Atrial Myxoma: Multimodal Imaging Assessment of a Rare Cardiac Mass Variant.

backgroundCystic myxoma is a rare morphological variant of atrial myxomas, with atypical imaging features mimicking other cystic cardiac masses. CASE SUMMARY: A 54-year-old woman presented with palpitations and dyspnea. Echocardiography revealed a left atrial mass with a cystic component causing moderate mitral stenosis. Cardiac computed tomography and cardiac magnetic resonance confirmed a semimobile lobulated mass attached to the interatrial septum, with heterogeneous enhancement and a central cystic cavity. Surgical excision demonstrated broad-based septal attachment, and histopathology confirmed cystic myxoma. The postoperative course was uneventful, and the patient was asymptomatic at follow-up. DISCUSSION: Cystic myxomas are exceptionally rare and can pose diagnostic challenges given their atypical presentation and broad differential diagnosis. Multimodal imaging is essential for accurate diagnosis and surgical planning, particularly in lesions with unusual morphology. TAKE-HOME MESSAGES: Multimodal imaging is pivotal in evaluating atypical cardiac masses. Early surgical excision prevents embolic and obstructive complications.