The vanishing tumor: A right atrial myxoma with unusual aspects

We describe an 80-year-old woman who presented with acute pulmonary edema. Laboratory evaluation revealed an increased erythrocyte sedimentation rate, anemia, and hyperglobulinemia. Revision of a transthoracic two-dimensional echocardiogram performed several months before revealed a right atrial myxoma, which was not present on a repeat study during the present hospital admission. Radionuclide pulmonary perfusion showed multiple small defects, an observation compatible with tumor embolization. Right atrial myxoma is a rare condition, especially in the elderly. Nevertheless, atypical presentations of pulmonary emboli, particularly in conjunction with unexplained systemic manifestations, should focus attention on the diagnostic possibility of a right atrial myxoma.