Atrial myxoma: National incidence, diagnosis and surgical management

Abstract

Despite being the most common benign intracardiac tumour with an excellent prognosis after surgical excision the incidence of atrial myxoma (except at autopsy) is unknown. We reviewed all patients admitted to the National Cardiac Surgery Unit (n = 26) with an atrial myxoma over a fifteen year period (1977-1991) to compile national incidence data and assess pre-operative diagnosis, management, surgical technique, and outcome. Preoperative symptoms were: congestive cardiac failure (12 patients), embolism (8 patients), constitutional (3 patients), asymptomatic (2 patients) and tachyarrhythmia (1 patient). The diagnosis was confirmed by 2D echocardiography alone in thirteen patients and by a combination of echocardiography and angiography in thirteen patients. At operation the site of the tumour was left atrial in 24 patients and bi-atrial in two patients. All cases were confirmed by histology. All patients made a good post-operative recovery, although one patient survived a pulmonary embolus and one patient developed a deep venous thrombosis. There has been one late death (five months after surgery) from a cerebrovascular accident. Serial echocardiography has revealed one recurrence to date (8 years after surgery). The surgical incidence of these tumours in the Republic of Ireland over the study period was 0.5 atrial myxomas/million population/year. Although rare atrial myxomas are the most important cardiac tumours to diagnose as the results from surgery are excellent.

An Unusual Presentation of Left Atrial Myxoma in an Adolescent

“…There are case reports and case series on pediatric patients presenting with LA myxoma but with wide age of presentation varying from 2 years to 17 years of age [9][10][11][12][13][14][15][16]. Even lab parameters were also unusually normal in our case except for only high ESR value, whereas there are studies where laboratory abnormalities (e.g., anemia and elevations in the ESR, C-reactive protein, or globulin level) were present in 35% of cardiac myxoma cases with systemic symptoms [3].…”

Left Atrial Myxoma: Report of A Case Observed in A Child Six Years of Chu Brazzaville

“…Cardiac myxoma is rare, it is the most common cardiac tumors in adults in whom they represent more than half of benign primary tumors intra cardiac [1], they are rarely found in children [2,3]. They represent 0.5 to 1% of soft tissue tumors, and are constituted by mucosal tissue [4].…”

Left Atrial Myxoma in a Child: An Uncommon Presentation of a Rare Tumour in Early Age

“…The usual origin of the stalk of the tumor in our patient from the inter atrial septum makes it easy to define the extent of endocardial resection, because recurrences have been reported to occur more commonly in "extraseptal" myxomas. 1 In contrast to the situation in adults, rhabdomyomas, fibromas, and teratomas are more common in children than myxomas. 2 The first successful removal of a myxoma in an infant was in 1967.…”

“…Primary heart tumors are uncommon in patients of pediatric age, 1 with a reported incidence of 0.2% in children referred for cardiac disease, 2 whereas only 14.2% of all cardiac tumors occur in patients aged less than 16 years. 3 Although cardiac myxoma is by far the most common primary heart tumor in adults, 4,5 rhabdomyoma is the most frequently encountered heart tumor in infancy and childhood.…”