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A 40-year-old female presented with a year's history of atrial fibrillation. Transthoracic echocardiography identified the presence of a biatrial mass and transoesophageal echocardiography delineated its extent. At surgery, a huge myxoma originating from the fossa ovalis and straddling the inter-atrial septum was removed and the atrial septum repaired. This report highlights the role of transthoracic and transoesophageal echocardiography in the diagnosis and management of this extremely rare cardiac tumour.

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