Cardiac myxoma the great imitators: Comprehensive histopathological and molecular approach

Tricuspid valve obstruction and right heart failure due to a giant right atrial myxoma arising from the superior vena cava

“…Besides nonspecific constitutional symptoms such as fevers, arthralgia and erythematous rash, patients with CMs generally present with hemodynamic derangement due to intra-cardiac obstruction and signs of systemic or pulmonary embolization caused by mass fragmentation [1,5,8]. Atrioventricular valve obstruction with corresponding-sided heart failure, as demonstrated in our case, is the major cause of acute presenting symptoms of CMs that facilitate their initial diagnosis.…”

“…Myxomas are the most common primary cardiac tumors in adults, constituting up to 50-85% of all benign lesions [1,2,8,12]. As reported by literatures, CMs are more common in women and occur much more frequently between the third and sixth decades of life [1-4].…”

“…Actually, majority of CMs occur in the atria with only 3-10% identified in either the left or right ventricle. The left atrium is the most common site with greater than 75% of all myxomas arising from here, and the right-sided location accounts for only 20% of cases [1,8]. Only a few such tumors are reported to have arisen from atrio-ventricular valves, pulmonary vessels and inferior vena cava [7-11,14,15].…”

“…Recurrence after surgical resection of primary lesions has been observed in 1-4% of sporadic and 12-22% of familial cases [1,2,7]. The possible explanations for the CMs recurrence are familial predisposition, unrecognized multifocal origin of primary lesion, incomplete resection or intraoperative dissemination of tumor cells [2,8,12,19]. Therefore, considering the rare origin of this myxoma and the experience learned from Teixido’s report [18], we decided to excise the myxoma and its attachment site (a part of the anterior wall of the SVC) completely, trying to minimize the risk of intra-cardiac recurrence.…”

Left atrial cardiac myxoma. Two unusual cases studied by 3D echocardiography

“…Cardiac myxomas develop in any of the cardiac cavities, but up to 90% of them are located in the left atrium, mainly adhered to the atrial septum near the fossa ovalis2; however, some of them have atypical localisation such as the right atrium (18% of cases)3 and, more rarely, the aorta, pulmonary artery, ventricles and vena cava; they are also, though very rarely, found in the roof of the left atrium;4 5 they exhibit a strong preference for women aged 40–60 years 1…”