Huge myxoma in the right atrium

We describe the case of a patient in whom two-dimensional echocardiography, performed due to dissociated cholestasis and jugular ingurgitation, demons trated a huge mass in the right atrium which prolapsed in the right ventric le. Intraoperative transesophageal echocardiography was performed to furthe r assess the dimension and characteristics of the mass and to discard the i nvolvement of associated structures. The patient underwent a cardiopulmonar y bypass surgery and the mass (12 x 5 cm) was removed without complications . Histologic examination confirmed the diagnosis of myxoma. This case is of interest because of the size of the mass, and is centered in the diagnosis following clinical suspicion due to the pattern of dissociated cholestasis and jugular ingurgitation leading to surgery to prevent the potential embo lic complications.