Left Atrial Rhabdomyosarcoma

A 27-year-old man complained of frequent chest pain and recurrent syncope for 3 months. He was in mild respiratory distress with a respiratory rate of 20/min and a heart rate of 94 bpm, regular in rhythm. His blood pressure was 120/70 mm Hg. Cardiac auscultation revealed a distinct early diastolic click followed by a grade 2/5 diastolic decrescendo murmur at the apex that was variable in character with postural changes. A grade 2/6 systolic ejection murmur was heard at the left lower sternal border.Transthoracic echocardiography revealed a large pedunculated mass within the left atrial chamber, protruding into the left ventricular cavity and obstructing mitral inflow (Figure 1). Computed tomography of the chest showed a large mass in the dilated left atrium.Figure 1. A , Echocardiography (parasternal long-axis view) showed a huge mass occupying most of the left atrium (LA), with blood flow within the tumor on color Doppler examination. B , Modified 4-chamber view showed the mass protruding into the left ventricle (LV) during diastole. RA indicates right atrium; and RV, right ventricle.In view of severe mitral valve obstruction by the atrial mass, surgical removal of the tumor was recommended. During operation, an irregular tumor …