Abstract
BACKGROUND: Abdominal aortic embolization is an exceptionally rare event. While some case reports have noted abdominal aortic aneurysms and occlusions caused by malignancy, abdominal aortic embolism due to a cardiac tumor is unusual. We present a case of infrarenal abdominal aortic embolization resulting from a left atrial myxoma. CASE PRESENTATION: A 37-year-old man presented with acute bilateral lower limb symptoms. Imaging revealed occlusion of the infrarenal abdominal aorta and both common iliac arteries. Surgical exploration identified and removed a gelatinous mass consistent with a myxoma. Histopathology confirmed the diagnosis. Postoperative echocardiography initially revealed a small residual stalk in the left atrium, which did not demonstrate further growth on follow-up imaging for up to four years. The patient demonstrated a successful recovery and exhibited no signs of recurrence during subsequent follow-up evaluations. CLINICAL DISCUSSION: This case underscores the diagnostic challenges in atypical aortic occlusion without ischemic signs and highlights the importance of early cardiac imaging in suspected embolic events. The presence of collateral circulation may obscure classical symptoms. n instances where a residual stalk is observed in the left atrium, close monitoring with serial echocardiography may represent a feasible and appropriate strategy. CONCLUSIONS: Abdominal aortic embolization secondary to atrial myxoma is rare but life-threatening. Prompt diagnosis using CT angiography and echocardiography, followed by timely surgical management, is critical for survival. Long-term follow-up is essential due to the risk of recurrence.