Multidisciplinary Single Stage Surgical Management of Advanced Breast Carcinoma With Concomitant Left Atrial Myxoma.
Shriya Haval, Anurag Garg, Ranjit Pawar et al.
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Case in brief
A 58-year-old woman with locally advanced invasive mucinous breast carcinoma had a progressive fungating mass despite neoadjuvant chemotherapy and radiotherapy. Routine echocardiography incidentally identified a large left atrial mass attached to the interatrial septum. Cardiac MRI and FDG PET-CT suggested a cardiac neoplasm but could not rule out metastasis. A multidisciplinary team performed toilet mastectomy, atrial mass excision with septal reconstruction, and split-thickness skin grafting during one anaesthetic. Histopathology identified the cardiac lesion as a glandular atrial myxoma.
What made this case unusual
The intracardiac mass was discovered during management of advanced breast cancer, and imaging could not distinguish a primary cardiac tumour from metastasis. Both conditions were treated in a single operation.
Diagnostic / clinical pearl
In a patient with malignancy, an intracardiac mass should not be assumed to represent metastasis; imaging may remain indeterminate, and histopathology can establish the diagnosis.
Why it matters
The report illustrates that coordinated single-stage surgery may be considered in carefully selected patients when oncologic urgency and embolic risk make treatment delay a concern.