The patient was a 27-year-old woman (weight = 48 kg, height = 171 cm) admitted to a general hospital with primary diagnosis of acute abdomen because of acute epigastric pain, nausea, and vomiting. She had a history of activity-induced dyspnea and chest discomfort for 18 months. Anorexia, weight loss (approximately 10 kg), and episodes of flushing and syncope while standing were added to her symptoms at the past 3 months. In spite of a few medical visits at the past year, there was not any definitive diagnosis. Episodic epigastric pain referred to the right shoulder lasted for 15 min; nausea and vomiting were reported as the main symptoms in the last two weeks. In the physical examination, she was cachectic, acyanotic, ill, and tachypneic with respiratory distress. Her vital signs were as follows: a regular heart rate 100 beat/min, blood pressure 80/45 mmHg, axillary temperature 36.7 C, and respiratory rate 24 per minute. Respiratory sounds decreased in the lower half of the lungs. There was a muffled first heart sound with a moderate holosystolic murmur in the apex. There was not either guarding or tenderness on abdomen or abdominal organomegaly. Laboratory data were normal except for a mild increase in ESR. The chest X-ray revealed increased chest/thoracic ratio and bilateral plural effusion. A thoracic and abdominal CT scan revealed cardiomegaly with a large mass (45*32 mm) in LV and bilateral pleural effusion without any pathologic findings in the abdomen. Transthoracic echocardiography (TTE) was done as a final diagnostic modality and reported a completely occupied LV with a large nonhomogenous mass protruding into aortic valve and severely compromised ejection fraction (0.15), limited valve opening, and flow through mitral and aortic valves. Preoperative lab tests were showing the normal values for blood, renal, and hepatic function tests. She was transferred to our heart hospital for an emergency surgery. With invasive arterial blood pressure monitoring, anesthesia was induced using midazolam 10 mg, ethomidate 10 mg, fentanyl 100 mug, and cisatracurium 10 mg. Intraoperative transesophageal echocardiography (TEE) revealed severely decreased LV function; LV chamber was totally filled with a large mass (76*44 mm), compromised mitral valve opening (moderate regurgitation), and a systolic protrusion of the mass to the aorta (approximately 1.5-2 cm). On the TEE, it seemed that the mass was pedunculated, originating from the LV lateral wall (Figure 1). Using cardiopulmonary bypass (CPB) and a transmitral and aortic root approach, the huge multilobulated jelly-like mass was resected piece-by-piece. It had been attached to the apical-lateral wall. After deairing of the heart, CPB discontinued using dobutamine infusion 10 mug/kg/min with a sinus rhythm. Postbypass TEE revealed a moderate MR with severe LV systolic dysfunction (ejection fraction 0.10-0.15). Postoperative period was without any complication, and almost all the complaints were resolved rapidly. Renal, hepatic, and routine blood tests were within normal limits postoperatively. A blood sample was prepared and sent to a referral regional lab in order to measure the serum IL-6 concentration, in the second postoperative day. The patient left the ICU and hospital on the third and seventh postoperative days, respectively, in a good clinical condition. TTE on the third postoperative day showed a moderate eccentric mitral regurgitation (MR) with LVEF of 0.30. Pathologic examination confirmed myxoma diagnosis. Three months later, TTE showed a normal heart (LVEF 0.45) with only mild MR. Lab report presented the postoperative serum IL-6 concentration (assayed by Bender MedSystem, Austria) as a normal value (2.98 pg/mL).