Atypical localization of a left atrial myxoma at the free edge of mitral valve

Myxomas represent more than 50% of benign cardiac neoplasm and are the most frequent cardiac tumors (1). Recent studies showed these neoplasms are commonly located in the left atrium (>90%), usually as a pedicled mass arising from the inter-atrial septum at the border of the fossa ovalis (2). Intra-cardiac masses should be differentiated as they could potentially represent a primary or secondary metastatic mass or endocarditis vegetations. We present a case of an exceedingly rare myxoma location, arising from the free-edge of the posterior mitral valve (MV) leaflet, which was incidentally identified in a 20-year-old female investigated for recent onset shortness of breath.