Left atrial myxoma presenting with erythematous macules and loss of memory

Abstract

Left atrial myxoma was diagnosed in a 42-year-old woman who had cutaneous and neurological manifestations without cardiac symptoms or signs. A two-dimensional echocardiogram revealed an orange-sized mobile mass in the left atrium. Magnetic resonance imaging showed multiple cerebral infarctions. Cardiac surgery for removal of the left atrial myxoma was successful and histopathology confirmed myxoma. Cutaneous and neurological manifestations were improved after the operation. Early surgical intervention may prevent the onset of severe neurological deficits in such patients.

The Role of Echocardiography in Diagnosing Space-Occupying Lesions of the Heart

“…Cutaneous findings include telangiectasia, livedo reticularis, tender, blanching or nonblanching erythematous macule or papule, and serpiginous or ulcerating lesions on extremities. 10 Knowledge of the various cutaneous findings associated with myxomas may help in the early recognition of these cardiac masses. 10 Two-dimensional echocardiography is the imaging modality of choice, classically revealing a mobile tumor connected to the interatrial septum by a narrow stalk.…”

“…10 Knowledge of the various cutaneous findings associated with myxomas may help in the early recognition of these cardiac masses. 10 Two-dimensional echocardiography is the imaging modality of choice, classically revealing a mobile tumor connected to the interatrial septum by a narrow stalk. 5 Myxomas usually have heterogeneous echogenecity and occasional calcifications.…”

“…5 These constitutional symptoms are due to release of vasoactive products from the tumor or an autoimmune response invoked by tumor products or production of cytokine interleukin-6 (IL-6) by cardiac myxomas. 10 The gross appearance of cardiac myxoma is variable. 11 However, they are generally polypoid, mostly pedunculated, round or oval with a smooth surface and often covered with thrombi.…”

“…12 Due to the friability of the left atrial myxoma, systemic emboli are estimated to occur in approximately 40% to 50% of the cases. 10 The most frequent site of myxomatous emboli is the cerebral vessels, including the retinal arteries. 10 The extremities are the next most common sites of embolic Familial myxomas constitute 10% or less of all myxomas.…”

“…10 The most frequent site of myxomatous emboli is the cerebral vessels, including the retinal arteries. 10 The extremities are the next most common sites of embolic Familial myxomas constitute 10% or less of all myxomas. 5 In contrast to sporadic myxomas, which typically present at an older age, patients with familial myxoma tend to present earlier (median age, 20 years) and are more likely to have myxomas in atypical locations, to have multiple tumors, are more likely to develop recurrent tumors, and have associated dermatological and endocrine abnormalities.…”