Primary Myxoma of the Pulmonary Artery

Abstract

Cardiac myxomas are most commonly found within the left atrium. We now report a patient presenting with dyspnea, palpitation, and chest pain who was found to have myxoma arising from the pulmonary valve commissure. Urgent surgical treatment is curative and warranted for these lesions, in order to prevent outflow obstruction and thromboembolic phenomena.

Pulmonary valvular and pulmonary arterial myxomas

“…The associated disorders included patent ductus arteriosus (n = 1) [16], pulmonary valve insuffi ciency and stenosis (n = 3) [3,4,18], hypoxia (n = 2) [7,9], pulmonary artery or valve obstruction (n = 2) [10,24], pulmonary artery dilation (n = 2) [16,20], pulmonary embolism (n = 1) [9,13,20], pulmonary artery hypertension (n = 1) [13], hypertension and dyslipidemia (n = 1) [15], and complete heart bloc k (n = 1) [9], myocardial bridging (n = 1) [14], secondary polycethemia (n = 2) [6,13], and multiple emboli with kidney infarctions (n = 1) [6].…”

“…Computed tomography angiography was done in 2 (11.1%) patients with fi lling defects found in both [12,15]. Magnetic resonance imaging w as examined in 2 (9.1%) patients, and it showed a solid mass in the pulmonary artery trunk in both [5,18]. Perfusion scan showed absence of left lung perfusion in 1 (4.5%) patient [10].…”

“…Perfusion scan showed absence of left lung perfusion in 1 (4.5%) patient [10]. Cardiac catheterization was performed in 6 (27.3%) patients, revealing a fi lling defect [20], serve pulmonary stenosis [21], serve pulmonary stenosis with fi lling defect in the pulmonary valve region [7], moderate aortic valve regurgitation [15], a mobile hyperlucent mass [18], and RVO T obstruction with tumor prolapse [22] in 1 (20%) patient each. Echocardiographic examinations were reported in 13 (61.1%) patients: an attenuated moving mass seen in the pulmonary artery, pulmonary valve or RVOT in 8 (63.6%) patients [3,4,8,14,17,19,22,24], a nodular mass in the RVOT [11], a space-occupying mass in the pulmonary artery [16], a moving mass in the pulmonary artery with insuffi ciencies and stenoses of both the mitral and aortic valves [15], and abnormal fl ow in the pulmonary artery [10], si gns of pulmonary artery hypertension [13] in 1 (9.1%) patient each.…”

“…The myxoma was arising from the pulmonary valve in 12 (54.5%) [4,7,8,11,12,14,[17][18][19]21,22,24], from the pulmonary artery in 9 (40.0%) [3,5,9,10,13,15,16,20,23], and from pulmonary valve and pulmonary artery in 1 (4.5%) patient [6]. In one patient, there were two myxomas arising from the pulmonary artery [20].…”

“…The diagnostic methods depended on preoperative m edical imaging in most cases, while the diagnosis was made by surgical ex ploration in 3 (18.8%) [7,9,21], and by autopsy in 2 (9.1%) patients [6,13]. The dimension of the myxomas was 2.5 ± 1.2 (range, 1-5; median, 3) cm (n =19) [3][4][5][8][9][10][13][14][15][17][18][19][20][21][22]24]. There was no signifi cant difference between the dimensions of pulmonary valve and pulmonary artery (2.4 ± 1.0 cm vs. 3.1 ± 1.2 cm, p = 0.175).…”