Multimodal Advanced Imaging Assessment of Atypical Presentation of Cardiac Myxoma with Incidental Pulmonary Finding: A Case Report

Cardiac myxomas are benign tumors representing approximately 50% of all benign cardiac neoplasms. However, atypical presentations with unusual imaging characteristics and incidental findings remain diagnostically challenging. This case report presents a unique instance of cardiac myxoma with unusual superior vena cava involvement and concurrent pulmonary findings detected through multimodal imaging integration. A 62-year-old female presented with nonspecific constitutional symptoms initially misinterpreted as thromboembolic disease. Comprehensive multimodal imaging including transthoracic echocardiography (TTE), computed tomography (CT), and cardiac magnetic resonance (CMR) imaging with advanced diffusion-weighted imaging (DWI) sequences revealed the diagnosis. This case demonstrates the critical value of multimodal imaging correlation, standardized reporting using RECIST 1.1 criteria for lesion characterization, and the importance of recognizing incidental findings that may impact overall patient management. We discuss the diagnostic pearls, imaging pitfalls, and novel quantitative imaging parameters that enhanced diagnostic confidence. This case contributes to the growing literature on atypical cardiac presentations and provides practical guidance for radiologists encountering complex cardiac masses.