scholarly journals The Question of Relapse of a Cardiac Myxoma: an Unusual Case from Practice

2021 ◽  
pp. 35-41
Author(s):  
R. M. Vitovskiy ◽  
V. V. Isaіenko ◽  
O. A. Pishchurin ◽  
I. G. Jakovenko ◽  
V. F. Onishchenko
Keyword(s):  
Left Atrium ◽  
Unusual Case ◽  
Thoracoscopic Surgery ◽  
Cardiac Myxoma ◽  
Carney Complex ◽  
Left Ventricular ◽  
Surgical Removal ◽  
Cardiac Tumors ◽  
Careful Study ◽  
Heart Tumors

Various studies demonstrate that recurrence of cardiac myxoma (CM) occurs in 2.1–5.3% of cases. In cases of treatment of familial myxoma, the need for reoperations can reach 20–25%. It should be taken into account that among all benign cardiac tumors, CM is detected in up to 80% of cases, and the need for its surgical removal is beyond doubt. The aim. To present a case that is of particular interest due to an unusual multiple myxomas lesion of the heart of multi-chamber localization. Material and methods. This article presents an unusual case of detecting multiple myxomas of multi-cameral heart lesions 6 years after removal of myxoma of the left atrium of typical localization. The distinguishing feature of the course of the disease lies in the fact that in this case, a careful study of the life history did not reveal the characteristic signs of familial myxomas and Carney complex which is most often characteristic of multi-chamber lesions of the heart by a tumor process. At the same time, during the surgical removal of the myxoma of the left ventricle, the myxomas of the left and right atrium were revealed, which began to grow. A technical feature of the removal of the left ventricular myxoma of the apical localization was the use of video cameras and instruments for thoracoscopic surgery, which greatly facilitated revi-sion and removal of the hard-to-reach neoplasm. Our experience in surgical treatment of CM equals to 868 operations. Wherein, repeated operations performed in 12 patients were due to recurrence or appearance of a tumor in place other than the primary localization. Conclusions. CM recurrence is one of infrequent complications in the postoperative period, which, however, requires some vigilance and annual Echo monitoring. In the vast majority of cases, CM was represented by the so-called sporadic myxomas, which are more often localized in the left atrium, and rarely recur. If CM is suspected, it is necessary to exclude the possibility of “myxoma syndrome”, which has the frequency of 0.8%, according to our data. The use of the instruments for thoracoscopic surgery can greatly facilitate the removal of hard-to-reach heart tumors localization.

Atypical Left Ventricular Myxoma: Unusual Echocardiographic and Histopathological Features

2018 ◽  
Vol 11 (4) ◽  
pp. NP129-NP131
Author(s):  
Sushil Azad ◽  
Nilanjan Dutta ◽  
Kuntal Roy Chowdhuri ◽  
Tarun Raina Ramman ◽  
Nishit Chandra ◽  
...  
Keyword(s):  
Hydatid Cyst ◽  
Histopathological Examination ◽  
Cardiac Myxoma ◽  
Surgical Excision ◽  
Interatrial Septum ◽  
Left Ventricular ◽  
Cardiac Tumors ◽  
Complete Surgical Excision ◽  
Vascular Proliferation ◽  
Cardiac Myxomas

Cardiac myxomas are the most common primary cardiac tumors and are typically attached to the interatrial septum. Left ventricular myxomas are exceedingly rare and presentation in children is all the more uncommon. We report a case of left ventricular myxoma with very atypical cystic appearance raising an initial suspicion of a hydatid cyst. Subsequently, cardiac magnetic resonance imaging was done, which ruled out the diagnosis of hydatid cyst. Complete surgical excision was done through transaortic and transmitral route. Histopathological examination revealed it to be a cardiac myxoma with vascular proliferation, which on echocardiography had appeared as a polycystic lesion. This is a very unusual histopathological presentation of cardiac myxoma.

scholarly journals P841 Case report of cardiac myxoma presenting with palpitations in young female

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
A Nalmpantis
Keyword(s):  
Case Report ◽  
Mitral Valve ◽  
Cardiac Function ◽  
Left Atrium ◽  
Cardiac Myxoma ◽  
Young Female ◽  
Normal Function ◽  
Atrial Myxoma ◽  
Surgical Removal ◽  
Common Symptom

Abstract Funding Acknowledgements none Introduction Atrial myxoma is a benign tumor of the heart , most commonly found in left atrium. The tumor must be surgically removed, because if remain untreated can lead to embolism, to arrhythmia and/or obstruction of mitral valve. Case report A 29 years old female presented due to palpitations and fatigue In the last two-three months. From recent blood tests she had a normal hematocrit and normal function of the thyroid gland. From the physical examination she had a blood pressure of 95/55 mmHg, S1S2 without any murmur, ECG with sinus rhythm and rsr" pattern. A bedside transthoracic echocardiography has performed and the findings were normal left systolic cardiac function, normal right systolic cardiac function, a large mass in left atrium without obstruction of mitral valve and a mild mitral regurgitation. The young female has been submitted for surgical removal of the cardiac mass and the anatomopathological examination has confirmed the benign nature of the atrial myxoma. Conlusion A common symptom such as palpitations are , has lead the young female to us in order to evaluate her and finally to reveal a benign cardiac tumor . Abstract P841 Figure. myxoma

scholarly journals Thymic pathology and cardiac myxomas: Coincidence or a closer relationship?

2018 ◽  
Vol 88 (1) ◽  
Author(s):  
Sotirios D. Moraitis ◽  
Apostolos C. Agrafiotis ◽  
Dimitrios Pappas ◽  
Chrysovalantis Pothitakis ◽  
Maria Stergianni ◽  
...  
Keyword(s):  
Left Atrium ◽  
Cardiac Myxoma ◽  
Anterior Mediastinum ◽  
Thymus Gland ◽  
Thymic Hyperplasia ◽  
Cardiac Tumors ◽  
Cardiac Myxomas ◽  
Thymic Tumors

Myxomas are the most common benign cardiac tumors and are located more frequently in the left atrium. In the literature there are cases describing the coexistence of thymic tumors and cardiac myxomas. In the case reported herein, during the resection of a cardiac myxoma, an enlarged thymus gland was encountered and resected. The histological exam revealed a thymic hyperplasia. The aim of this case study is to assess the need of conducting further studies in order to identify a common histological pathway between thymic lesions and cardiac myxomas. The diagnosis of a cardiac myxoma could justify a further workup of the anterior mediastinum in order not to overlook a lesion of thymic origin.

Unusual presentation during childhood of left ventricular myxoma

1998 ◽  
Vol 8 (1) ◽  
pp. 126-127 ◽  
Author(s):  
A. Kapoor ◽  
S. Radhakrishnan ◽  
N. Sinha
Keyword(s):  
Left Ventricle ◽  
Left Atrium ◽  
Febrile Illness ◽  
Left Ventricular ◽  
Unusual Presentation ◽  
Cardiac Tumors ◽  
History Of ◽  
Primary Cardiac Tumors

AbstractAmongst all primary cardiac tumors, myxomas are the commonest, and their commonest site of origin is the left atrium. Myxomas originating in the left ventricle are rare. When seen, they usually present with a history of systemic embolisation and/or syncopal episodes, with constitutional symptoms being absent. We report here a child with left ventricular myxoma who presented with a prolonged febrile illness.

scholarly journals Left Atrial Myxoma with Tricuspid Regurgitation: Pathophysiology, Diagnostic Approach, and Management

2015 ◽  
pp. 28-3
Author(s):  
Prima Almazini ◽  
Bambang Budi Siswanto ◽  
Nani Hersunarti ◽  
Rarsari Soerarso ◽  
Amiliana M Soesanto
Keyword(s):  
Cardiac Myxoma ◽  
Clinical Manifestations ◽  
Definitive Treatment ◽  
Surgical Removal ◽  
Cardiac Tumors ◽  
Gold Standard Method ◽  
Left Atrial Myxoma ◽  
Associated Conditions ◽  
Cardiac Myxomas ◽  
Primary Cardiac Tumors

Cardiac myxomas are the most common primary cardiac tumors. Myxoma are more common in women. Clinical manifestations can mimic many cardiac and noncardiac conditions. Transthoracic echocardiography (TTE) is the gold standard method in the diagnosis of cardiac myxoma. The management of cardiac myxoma are medical therapy for the treatment of associated conditions and surgical removal as the definitive treatment.

scholarly journals Echocardiographic characteristics of cardiac myxoma

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
P Koritnik ◽  
N Pavsic ◽  
M Bervar ◽  
K Prokselj
Keyword(s):  
Left Atrium ◽  
Tumor Size ◽  
Cardiac Tumor ◽  
Imaging Modality ◽  
Cardiac Computed Tomography ◽  
Cardiac Myxoma ◽  
Clinical Manifestations ◽  
Cardiac Tumors ◽  
Number Of Patients ◽  
Cardiac Masses

Abstract Background Accurate imaging differentiation of various cardiac masses is pivotal due to differences in clinical management and treatment. The most common primary cardiac tumor is cardiac myxoma (CM), which is typically located in the left atrium attached to the interatrial septum. Although benign, serious clinical manifestations may occur and surgical treatment of CM is warranted in most cases. Echocardiography is the most common imaging modality, with a reported sensitivity of 90–96%, however accurate diagnosis can be challenging due to the heterogeneous morphological presentation of CM. Purpose The aim of this study was to determine the utility of echocardiography in CM diagnosis. Methods We retrospectively analyzed the echocardiographic and pathohistological findings of all consecutive patients admitted to our cardiology department for possible CM between 2005 and 2020. Results During the 15-year period, 73 patients were admitted for diagnostic evaluation of a possible CM. Subsequently, 54 patients (74%) were diagnosed with CM or another non-myxomal (NM) cardiac tumor, while in others cardiac masses of other etiologies (thrombus, infective endocarditis, etc.) were diagnosed (Figure 1). All but one patient with CM or NM cardiac tumor were treated surgically at our institution and pathohistological specimens were obtained from the resected tumor. There was a significant female preponderance (n=34, 63%) and the mean age at the time of surgery was 64±14 years. Based on the preoperative echocardiographic findings, 45 (85%) tumors were diagnosed as CM and 8 as NM cardiac tumors (Figure 1). Evaluation of pathohistological specimens revealed CM in 39 of 53 (74%) operated patients. Patohistiologically, a NM cardiac tumor was diagnosed in 7 patients who were preoperatively classified as CM. The sensitivity and specificity of preoperative echocardiography for the detection of CM were 97% and 50%, respectively (Figure 1). The echocardiographic characteristics of pathohistologically confirmed CM were compared to cases of NM cardiac tumors. The comparison between the two groups revealed statistically significant differences in localization and tumor size. All NM cardiac tumors were located in an atypical position and 72% of CM were found in a typical position within the left atrium (p<0.001). NM cardiac tumors were also significantly smaller than CM (25.1±12.6 mm vs. 37.5±18.5 mm, p=0.029). Conclusion Our single-center study confirms the excellent sensitivity of echocardiography for CM diagnosis. The specificity of echocardiography was modest, thus caution is warranted due to a wide differential diagnosis of CM. The diagnosis of CM seems to be less likely with atypical tumor location and small tumor size. Other non-invasive imaging modalities such as cardiac computed tomography or magnetic resonance imaging should be considered in such cases. FUNDunding Acknowledgement Type of funding sources: None. Figure 1. Flow chart showing the number of patients diagnosed with CM on preoperative echocardiography.

scholarly journals Surgical Treatment of Heart Mixomas: the Analysis of 10 Years’ Experience

2021 ◽  
Vol 10 (2) ◽  
pp. 385-392
Author(s):  
V. V. Vladimirov ◽  
A. I. Kovalev ◽  
A. V. Redkoborody ◽  
V. V. Sokolov ◽  
N. M. Bikbova ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Well Being ◽  
Surgical Removal ◽  
Cardiac Tumors ◽  
Heart Neoplasms ◽  
Results Of Treatment ◽  
Heart Tumors

Introduction. Primary cardiac tumors are rare, and the autopsy detection rate does not exceed 0.003%. Approximately 80% of primary heart tumors are benign, 50% of them are myxomas. Diagnosis of cardiac tumors at present in the presence of transesophageal echocardiography is not difficult in most cases. Surgical treatment of mixomas became possible after the introduction of open-heart surgery under cardiopulmonary bypass into clinical practice. After verification of the tumor, its surgical removal is indicated. In the practice of large cardiac surgery clinics, the experience of radical treatment of heart neoplasms is relatively small; therefore, the analysis of tactical approaches and results of operations in this pathology is of absolute interest.Aim of study. To present an analysis of 10 years’ experience in surgical treatment of cardiac mixomas. Material and methods The results of treatment of 58 patients with myxomas who underwent surgical removal of the neoplasm of the heart are presented.Results. Hospital mortality after surgical removal of myxoma was 1.7%, 1 patient died. All patients, we have the long-term period data about, noted a significant improvement in well-being, a decrease or disappearance of dyspnea at rest and/or during exertion, and no recurrence of myxoma was noted. Conclusion. The data obtained indicate, on the whole, good immediate results and high quality of life of patients in the long-term period operated on for heart mixomas. 

Giant Left Atrial Myxoma Misdiagnosed As Schizophrenia: A Case Report

2020 ◽  
Author(s):  
Hongfei Xu ◽  
Wei Si ◽  
Yiran Zhang ◽  
Yiming Ni ◽  
Weidong Li
Keyword(s):  
Left Atrium ◽  
Left Atrial ◽  
Tumor Resection ◽  
Cardiac Myxoma ◽  
Health Department ◽  
Cardiac Tumors ◽  
Left Atrial Myxoma ◽  
Giant Tumor ◽  
Atrial Enlargement ◽  
Mental Health Department

Abstract Background: Primary cardiac tumors are rare. Myxoma is the most common cardiac tumor and presents in the left atrium. Improvements tend to occur with early diagnosis, and with the help of high-resolution imaging technology, such as transesophageal echocardiography (TEE). Patients typically present with tightness of the chest, fatigue and lassitude. There are also cases of misdiagnosis and missed diagnosis. Case presentation: A 59-year-old Chinese woman complained of tightness in her chest, fatigue and lassitude for eight years. She had been misdiagnosed with schizophrenia by the local rural hospital. Computed tomography (CT) confirmed a giant mass in the left atrium, and transthoracic echocardiography (TTE) revealed left atrial enlargement with an occupying lesion. For this patient, we performed tumor resection surgery with a cardiopulmonary bypass. The giant tumor was partially detached during the operation, and the thrombus was removed successfully. After the operation, the mental health department of our hospital thought that the patient's diagnosis of schizophrenia was misdiagnosed. The patient recovered well and appeared rejuvenated after the operation. A two-year follow-up found no adverse events since the operation. Conclusions: When making a diagnosis for a patient who presented with tightness of the chest, we need to administer a cardiac physical examination and echocardiography. The physician diagnosing schizophrenia needs to first rule out any organic diseases. A careful and complete resection of the cardiac myxoma is a vital operation, due to the risk of thromboembolism.

scholarly journals Carney Complex

2014 ◽  
Vol 6 (1) ◽  
pp. 1-6 ◽  
Author(s):  
Surendra Kumar Agarwal ◽  
Shantanu Pande ◽  
Bipin Chandra
Keyword(s):  
Skin Pigmentation ◽  
Cardiac Myxoma ◽  
Large Cell ◽  
Carney Complex ◽  
Regulatory Subunit ◽  
Surgical Removal ◽  
Endocrine Gland ◽  
Autosomal Dominant Disorder ◽  
Complete Evaluation ◽  
Cardiac Neoplasms

ABSTRACT The complex of myxomas, spotty skin pigmentation, and endocrine over activity or Carney complex (CNC) (MIM no. 160980) is an autosomal dominant disorder that was described in 1985 by Carney. The diagnosis of CNC is made if two of the main manifestations of the syndrome are present, these need to be confirmed by histology, biochemical testing, or imaging. Alternatively, the diagnosis is made when one of the criteria is present and the patient is a carrier of a known inactivating mutation of the PRKAR1A gene. Most cases of CNC are caused by inactivating mutations in the gene encoding one of the subunits of the protein kinase A (PKA) tetrameric enzyme, namely regulatory subunit type1 alpha (PRKAR1A), located at 17q22-24. Endocrine, dermatologic, and cardiac anomalies are the main manifestations of CNC. Skin abnormalities are present in almost 77% of the CNC patients. Variety of endocrine gland tumors are observed in CNC patients, namely growth hormone secreting pituitary adenoma (acromegaly), thyroid adenomas or carcinomas, testicular tumors (large cell calcifying sertoli cell tumors), and ovarian cyst. Cardiac myxoma is the most common primary tumor affecting the heart, accounting for nearly half of cardiac neoplasms. Approximately, 30-60% of CNC patients will develop cardiac myxoma, usually at much younger ages than the sporadic tumors. A high degree of suspicion, complete evaluation, genetic counseling is important aspect of management of Carney's disease. Once confirmed, surgical removal remains the mainstay of treatment. How to cite this article Majumdar G, Agarwal SK, Pande S, Chandra B. Carney Complex. World J Endoc Surg 2014;6(1):1-6.

scholarly journals Growth hormone and risk for cardiac tumors in Carney complex

2016 ◽  
Vol 23 (9) ◽  
pp. 739-746 ◽  
Author(s):  
W Patricia Bandettini ◽  
Alexander S Karageorgiadis ◽  
Ninet Sinaii ◽  
Douglas R Rosing ◽  
Vandana Sachdev ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Cardiac Myxoma ◽  
Heart Tissue ◽  
Carney Complex ◽  
Cardiac Tumors ◽  
Gh Secretion ◽  
Albright Syndrome ◽  
Cardiac Myxomas ◽  
Gh Excess

Carney complex (CNC) is a multiple neoplasia syndrome that is caused mostly by PRKAR1A mutations. Cardiac myxomas are the leading cause of mortality in CNC patients who, in addition, often develop growth hormone (GH) excess. We studied patients with CNC, who were observed for over a period of 20 years (1995–2015) for the development of both GH excess and cardiac myxomas. GH secretion was evaluated by standard testing; dedicated cardiovascular imaging was used to detect cardiac abnormalities. Four excised cardiac myxomas were tested for the expression of insulin-like growth factor-1 (IGF-1). A total of 99 CNC patients (97 with a PRKAR1A mutation) were included in the study with a mean age of 25.8 ± 16.6 years at presentation. Over an observed mean follow-up of 25.8 years, 60% of patients with GH excess (n = 46) developed a cardiac myxoma compared with only 36% of those without GH excess (n = 54) (P = 0.016). Overall, patients with GH excess were also more likely to have a tumor vs those with normal GH secretion (OR: 2.78, 95% CI: 1.23–6.29; P = 0.014). IGF-1 mRNA and protein were higher in CNC myxomas than in normal heart tissue. We conclude that the development of cardiac myxomas in CNC may be associated with increased GH secretion, in a manner analogous to the association between fibrous dysplasia and GH excess in McCune–Albright syndrome, a condition similar to CNC. We speculate that treatment of GH excess in patients with CNC may reduce the likelihood of cardiac myxoma formation and/or recurrence of this tumor.

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