Long-term survival after extended resection of primary atrial myxosarcoma

Abstract

The vast majority of adult primary cardiac tumours (75%) are benign. The differentiation between malignant and benign lesions based on imaging is often difficult. Furthermore, it is challenging to distinguish between a cardiac myxoma and a myxosarcoma histologically. We report the case of a 48-year-old female who underwent resection of myxoma. Fourteen months postoperatively, she developed dyspnoea and evidence of local recurrence was observed. An open biopsy was performed and compared with the initially resected specimen. A primary cardiac myxosarcoma was diagnosed. Extended resection of the tumour including a part of the left atrium and the left lung was performed. Follow-up at 4 years shows no radiological evidence of any further recurrence and the patient is satisfied with a good quality of life. Despite the infrequent nature and particularly in view of the poor prognosis of cardiac myxosarcoma with a median overall survival of ∼12–17 months, we were able to demonstrate in our case that, with an extensive medical and surgical therapy and an interdisciplinary approach, a long-term disease-free survival can be achieved.

Hypoxia: The “Invisible Pusher” of Gut Microbiota

“…In hypoxia environment, hepatoma cells activate target genes containing a hypoxia response element (HRE) through HIF-1 transcription (in human tumor cells, these gene products are greatly increased) to cause a series of tumor cells to respond to hypoxia ( Kaneoka et al, 2003 ). HIF-1 can also enhance the ability of glycolysis to make tumor adapt to hypoxia environment quickly ( Kakaty et al, 2015 ). Tumor cells have stronger survival ability than normal tissue cells in hypoxia environment, thus enhancing the ability of tumor invasion and metastasis.…”

Total thoracoscopic surgery for biatrial cardiac myxoma: a case report

“…The risk of recurrence increases linearly in the first 4 years after resection of myxoma, and the risk of recurrence afterwards is very low (17). (II) Malignant transformation: the biological behavior of cardiac myxoma is benign, but a very small number of patients have malignant transformation (18). There are reports suggesting that patients with malignant transformation have genetic abnormalities.…”

Differential diagnosis of cardiac tumors: General consideration and echocardiographic approach

“…In fact, several cases of malignant tumors diagnosed at surgery or after recurrence after a misdiagnosis of myxoma have been reported. [101][102][103] F I G U R E 1 8 Pulmonary artery sarcoma. (A).…”

“…TTE is the first diagnostic tool for patients with a suspected cardiac mass because of its ubiquitous availability but other more advanced echocardiographic techniques are often required to better define the cardiac mass, mostly for intraatrial masses. In fact, several cases of malignant tumors diagnosed at surgery or after recurrence after a misdiagnosis of myxoma have been reported 101–103 …”