Cardiac myxomas are rare and their location in the left atrial appendage is even rarer. Most left atrial appendage masses have been reported to be thrombus, particularly in the presence of atrial fibrillation, although asymptomatic atrial fibrillation can also present with thrombus. This report presents the case of a 69-year-old woman with a history of limited scleroderma with a 1-year history of exertional dyspnea and no history of atrial fibrillation who was found to have on transesophageal echocardiogram a 5 3 5 cm mass that was attached to the base of the left atrial appendage at its junction with the left atrium. The diagnosis was based on the transesophageal echocardiography characteristics of the mass and confirmed by histologic examination after operation. The importance of considering other possibilities with regard to left atrial appendage masses is emphasized.
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