Complete remission of immune thrombocytopenia in a 30‐year old woman after excision of a right atrial myxoma

Durand, Pauline; Furudoï, Adéline; Parrens, Marie; Lazaro, Estibaliz; Viallard, Jean‐François; Rivière, Étienne

doi:10.1111/bjh.16135

Cited by 4 publications

(4 citation statements)

References 9 publications

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“…Just like Smith et al in their review of the literature [4], we found a sample of patients who had a myxoma diagnosis that initially presented as a PS [7][8][9][10][11][12][13][14][15][16][17][18]. Some articles suggest grouping PS by the nature of the symptoms they experience, whether they are arthritic, hematologic, neurologic, respiratory, gastrointestinal, or dermatologic.…”

Section: Discussionmentioning

confidence: 86%

Cardiac Myxomas As Chameleons: A Scoping Review of Their Paraneoplastic Presentations

Gil¹,

Cross²,

Barrera³

et al. 2023

Cureus

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This scoping review aims to explore the relationship between cardiac myxomas (CMs) and paraneoplastic syndromes (PS). CMs are the most common tumors in the heart, with the majority located in the left atrium, and are often associated with a triad of obstructive, embolic, and constitutional symptoms. However, they can also present with unrelated symptoms that are part of a PS. This study performed a thorough literature search of 11 databases and included 12 papers in the final review. All of the patients were diagnosed with atrial myxoma, which initially presented as a PS. Surgery was the curative measure in all cases and resulted in remission in every case, with patients reporting resolution of symptoms at follow-up. The majority of patients in the study were female, with comorbid rheumatologic conditions often present. This study highlights the heterogeneity of presentations of CMs and their associated PS.

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Section: Discussionmentioning

confidence: 86%

Cardiac Myxomas As Chameleons: A Scoping Review of Their Paraneoplastic Presentations

Gil¹,

Cross²,

Barrera³

et al. 2023

Cureus

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show abstract

“…Cases of thrombocytopenia resolving immediately with surgical resection of primary cardiac tumours such as atrial myxoma and sarcoma have been described in the literature [4][5][6][7][8]. Proposed mechanisms of thrombocytopenia associated with cardiac tumours have included mechanical shearing via turbulent obstructed fow through the heart and platelet consumption by microthrombi formation within the tumour itself [4,6].…”

Section: Discussionmentioning

confidence: 99%

“…Patients with PCL typically present with dyspnoea and constitutional symptoms such as weight loss and anorexia [2]. Trombocytopenia has rarely been described in association with PCL [3] and other primary cardiac tumours [4][5][6][7][8] and can add substantial morbidity to the diagnosis if present. We report to our knowledge, the second case of primary cardiac lymphoma presenting with marked thrombocytopenia which subsequently resolved with chemotherapy.…”

Section: Introductionmentioning

confidence: 99%

Primary Cardiac Lymphoma Presenting with Thrombocytopenia, Right Heart Failure, and Cardiogenic Shock

Kurniawan

Mathur

Bogun

et al. 2023

Case Reports in Hematology

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Primary cardiac lymphoma (PCL) is a rare, potentially fatal subtype of non-Hodgkin’s lymphoma. Thrombocytopenia has also infrequently been reported in association with other primary cardiac tumours and can add substantial morbidity to an already life-threatening diagnosis if present. We report a rare case of a 70-year-old man who presented with thrombocytopenia (91 × 109/L) and progressive right heart failure. Transthoracic echocardiogram revealed a large 8 × 4 cm right atrial mass with severe tricuspid obstruction, confirmed as PCL on subsequent endomyocardial biopsy and immunohistochemistry. He deteriorated into cardiogenic shock precipitated by atrial fibrillation, with worsening thrombocytopenia (18 × 109/L) in the setting of ischaemic hepatitis. The patient stabilised with initiation of high dose steroids prior to tissue diagnosis and platelet counts normalised following chemotherapy. This case demonstrates the importance of considering PCL as a diagnosis and preemptive initiation of high dose steroids to improve outcomes in PCL associated with cardiogenic shock. This case also elucidates a potential pathophysiological association between PCL and thrombocytopenia.

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“…[8][9][10] While typical myxomas are easier to diagnose, some may have atypical features that make the diagnosis challenging. [11][12][13][14] A possible cause of secondary tumors in the right atrium can be the extension of an intraabdominal tumor, like a hepatocellular carcinoma or renal cell carcinoma with a direct invasion of the inferior vena cava and the right atrium. 4,15 Even though data regarding right atrial thrombosis are scarce, a review from Sweden reported a prevalence of right atrium thrombi of 7% in 23,796 autopsies.…”

Section: Diagnosis Of Cardiac Massesmentioning

confidence: 99%

Incidental Discovery of a Cardiac Thrombus Mimicking a Right Atrial Myxoma in a Young Female Patient – A Case Report

Oltean

Caloian

Irimie

et al. 2023

Journal of Cardiovascular Emergencies

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Introduction Cardiac masses are at the attention of health specialists since the development of echocardiography. Even though imaging is an excellent tool for diagnosis, the clinical presentation, risk factors, and hemodynamic status of the patients are important in establishing the diagnosis and subsequent management. The purpose of this presentation is to assess the difficulty of diagnosis in the case of an intracardiac mass and its therapeutic management. Case report A 29-year-old female with paresthesia in the left arm and a systolic tricuspid murmur underwent echocardiography, which revealed a mass of 35/20 mm in the right atrium. Due to the high embolic risk, the patient was referred to the cardiac surgery department and underwent surgical removal of the cardiac mass, which presented the macroscopical aspect of a myxoma. However, the histopathological examination revealed a right atrial thrombus. Conclusion Right heart thrombi represent a challenging diagnosis that involves a multidisciplinary team for the diagnosis and treatment of the patient.

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Complete remission of immune thrombocytopenia in a 30‐year old woman after excision of a right atrial myxoma

Cited by 4 publications

References 9 publications

Cardiac Myxomas As Chameleons: A Scoping Review of Their Paraneoplastic Presentations

Cardiac Myxomas As Chameleons: A Scoping Review of Their Paraneoplastic Presentations

Primary Cardiac Lymphoma Presenting with Thrombocytopenia, Right Heart Failure, and Cardiogenic Shock

Incidental Discovery of a Cardiac Thrombus Mimicking a Right Atrial Myxoma in a Young Female Patient – A Case Report

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