Large intracardiac mass revealed by cerebrovascular accident: a case report

Intracardiac masses may be revealed by an ischemic cerebrovascular accident (stroke). They are sometimes difficult to differentiate by echocardiography. Determining their nature is a crucial aspect of patient management. We here report the case of a 58-year-old man with untreated hypertension, active smoking, a history of psoriasis, chronic obstructive pulmonary disease (COPD) and a nodule in the left upper lobe suspected to be lung cancer. He was hospitalized for an ischemic stroke which was treated with thrombolysis, resulting in hemorrhagic transformation. Routine echocardiography revealed a large mass in the left atrium suggestive of intra-atrial myxoma. Histological examination of the surgical specimen confirmed the diagnosis. Left atrial myxomas can remain asymptomatic for a long time and may be revealed by systemic embolic complications. Echocardiography guides the diagnosis and anatomopathological examination confirms it. Management should be multidisciplinary.