An atypical radiographic appearance of a cardiac myxoma: case report and review of the literature

Cardiac myxomas are the most common primary cardiac tumors in adults. They usually present as a solitary, solid mass in the left atrium. Their most common radiographic appearance is that of a hypodense lesion on computed tomography (CT) and inhomogeneous lesion (hypo to isointense on T1 sequences and hyperintense on T2 sequences) on magnetic resonance (MR) with some contrast enhancement. However, different patterns are recognized due to secondary changes within the tumor. We present a case of a 60-year-old man with a hypervascular myxoma. The lesion was a sessile mass located in the left atrium and rigidly attached to the interatrial septum. On CT and MR, it showed vivid contrast enhancement due to intratumoral flush of arterial blood form branches of dominant left circumflex artery and a possible fistula to the left atrium. Furthermore, we review the literature for different atypical radiographic appearances of myxomas

Double superior vena cava and left brachiocephalic vein agenesis: a rare systemic vein anomaly and potential source of CIED and CVC placement complications

Abnormal systemic vein development produces anomalous veins, which—in the case of persistent left superior vena cava and/or left brachiocephalic vein (BCV)—exhibit considerable topographic and morphometric differences in comparison with their usual anatomy. The nature and extent of those developmental anomalies—detected during intravenous procedures, such as cardiac implantable electronic device (CIED) lead insertion or central venous catheter (CVC) placement—may hinder the procedure itself and/or adversely affect its outcome, both at the stage of cardiac lead advancement through an abnormally shaped vessel and lead positioning within the heart. This may lead to problems in achieving optimal sensing and pacing parameters and in ensuring that the patient cannot feel the pacing impulses. These events accompanied a de novo CIED implantation procedure in the patient with a double SVC and left BCV agenesis, who ultimately required reoperation