Images in Cardiovascular CT Left atrial myxoma Nicholaos Kakouros, BSc, MRCP*, Eric McWilliams, MD, FACC, John Giles, FRCP, FRCR Conquest Hospital, The Ridge, St Leonards-on-Sea, TN37 7RD United Kingdom KEYWORDS: Atrial myxoma; Cardiac CT; Cardiac tumor A 56-year-old woman presented with sudden onset right arm weakness and was diagnosed with a small left internal capsule stroke. Transesophageal echocardiogram showed a 3.5 cm  3.0cm pedunculated, lobulated mass of heteroge- neous echogenicity in the left atrium (Fig. 1A and B) with Doppler flow acceleration along the edge of the mass sug- gestive of dynamic mitral valve obstruction (Fig. 1C and D). The presumptive diagnosis was of an atrial myxoma. A 64-slice electrocardiography-gated multidetector CT coro- nary angiogram was performed (Fig. 2). The calcium score was zero, and the coronary arteries were normal. The scan further showed an irregular, lobulated mass with a pedun- culated stalk attachment to the interatrial septum (Supple- mentary Video; see supplementary material online at www. CardiacCTJournal.com). The patient required no invasive coronary assessment before surgical removal of the tumor. A lobulated, gelatinous mass was removed by a transeptal approach (Fig. 3). Histopathology confirmed the diagnosis of myxoma. Cardiac myxomas are readily detected during contrast- enhanced cardiac CT angiography. 1 The diagnosis of atrial myxoma is suggested by the absence of calcification and attachment of the mass to the interatrial septum. 2 Preoper- ative planning for resection is aided by additional data from the multidetector CT, including delineation of the anatom- ical relations of the mass, and the exclusion of coronary artery disease, thus obviating the need for preoperative invasive coronary angiography. 2 References 1. Butany J, Nair V, Naseemuddin A, Nair GM, Catton C, Yau T: Cardiac tumours: diagnosis and management. Lancet Oncol. 2005;6(4):219 –28. 2. Ragland MM, Tak T: The role of echocardiography in diagnosing space-occupying lesions of the heart. Clin Med Res. 2006;4(1):22–32. Conflict of interest: The authors report no conflicts of interest. * Corresponding author. E-mail address: nkakouros@gmail.com Submitted December 24, 2007. Accepted for publication February 27, 2008. 1934-5925/$ -see front matter © 2008 Society of Cardiovascular Computed Tomography. All rights reserved. doi:10.1016/j.jcct.2008.02.013 Journal of Cardiovascular Computed Tomography (2008) 2, 188 –190