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Myxoma is a common benign tumour found in the heart. On reviewing literature, we found some left atrial myxomas receive blood supply from the right coronary artery. Performing a coronary angiogram in a cardiac tumour has the following uses: (1) it shows the vascularity that can be ligated by the surgeon at operation; (2) if there is a blood supply visible, it may not be an intracardiac thrombus; (3) the coronary angiogram may detect a myxoma even before an echocardiogram does so; (4) some myxomas may bleed into the right atrium or left atrium and this may be seen on coronary angiography. We show here the neovascularity of a left atrial myxoma and its blood supply from the right coronary artery. We recommend that all routine coronary angiograms be reviewed carefully for any signs of tumour vascularity or tumour blush as this would prevent missing early myxomas. Echocardiography is the gold standard for detection of myxomas but literature has a number of intracardiac tumours that were detected only by the tumour blush. Some left atrial tumours have been treated by occluding their blood supply.The absence of a blood supply on coronary angiography could rule out a benign cardiac tumour that usually has a blood supply.

Lipoleiomyomas account for approximately 0.03-0.2% of all uterine leiomyomas and are comprised of a mixture of variable amounts of mature adipocytes and smooth muscle cells. [1][2][3] Lipoleiomyomas typically occur in older post-menopausal women, whereas leiomyomas occur mostly in women of reproductive age and usually regress after menopause.2,3 The most common location of a lipoleiomyoma is the uterus, while other reported sites include the cervix, ovaries and, on occasion, the retroperitoneum.2-4 However, lipoleiomyomas on the broad ligament-a peritoneal fold that connects the uterus to the pelvis-are extremely uncommon, with only seven cases reported in the literature to date. 2,[5][6][7][8][9][10] Broad ligament lipoleiomyomas are difficult to diagnose preoperatively upon radiology and may be mistaken for an ovarian carcinoma.11 However, it is important to distinguish between these entities as broad ligament lipoleiomyomas can be treated conservatively with a lumpectomy.6 This report describes two cases of broad ligament lipoleiomyoma in which both patients were initially diagnosed with a solid malignant adnexal mass. Case OneA 15-year-old girl was admitted to the Lok Nayak Jai Prakash Hospital (LNJPH), New Delhi, India, in 2016 with lower abdominal discomfort and an abdominal mass of three months' duration. The patient's past medical history was insignificant. She had first undergone menarche at the age of 12 years. A physical examination revealed a hard movable mass in the lower abdomen of a size similar to a pregnancy of 20 gestational weeks. There was no evidence of lymphadenopathy or organomegaly. Magnetic resonance imaging (MRI) showed a well-defined, large, solid, cystic abdominopelvic mass measuring 26 x 26 x 14.5 cm. The mass was abutting the posterior wall of the urinary bladder, uterus, anterior wall of the rectum and the retroperitoneal structures, displacing the uterus and reaching up to the lower margin of the liver [ Figure 1]. Laboratory tests revealed raised levels of serum thyroid-stimulating hormone (14.74 µIU/mL) and total triiodothyronine (T3; 60 ng/dL), although her thyroxine (5.42 µg/dL) and free T3 (2.2 ng/dL) levels were normal. Based on these clinical and radiological features, the patient was diagnosed with an ovarian tumour. Lipoleiomyomas are an extremely rare form of uterine leiomyoma; moreover, the occurrence of this type of tumour on the broad ligament is even rarer. We report two cases of broad ligament lipoleiomyomas in 15-and 38-year-old female patients who presented to the Lok Nayak Jai Prakash Hospital in New Delhi, India, between 2016 and 2017. In both cases, the preoperative diagnosis was of a solid ovarian malignancy. Most broad ligament tumours are mistaken for ovarian masses as they are difficult to diagnose radiologically.

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