Pulmonary Embolism Following Incomplete Surgical Resection of a Right Ventricular Myxoma: A Case Report and Review of the Literature

Assaf, Yazan; Nasser, Maher; Jneid, Hani; Ott, David A.

doi:10.1007/s40119-018-0109-y

Cited by 3 publications

(3 citation statements)

References 20 publications

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“…A recurrence of right ventricle myxoma with pulmonary embolization was reported also in a 28-years-old patient because of an incomplete resection due to the adherence of the tumor to the tricuspid valve [33].…”

Section: Narrative Review Of Literature and Discussionmentioning

confidence: 83%

New Onset Cardiac Murmur and Exertional Dyspnea in an Apparently Healthy Child: A Rare Localization of Obstructive Myxoma in the Right Ventricle Outflow Tract without Pulmonary Embolization—A Case Report and Literature Review

D’Anna

Villani

Ammirati

et al. 2022

IJERPH

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Myxomas are slowly growing benign neoplasms which are rare in children. Up to 80% can be located in the left atrium and generate symptoms such as embolism, cardiac failure, fever and weight loss. Rarely, myxomas can be detected in the right ventricle outflow tract, causing arrhythmias, pulmonary emboli and sudden death. We report the case of a 13-year-old healthy child brought to the Emergency Department (ED) of the Children’s Hospital Bambino Gesù, Rome, for recent dyspnea, chest pain on exertion and new onset cardiac murmur. Patient underwent medical examination and echocardiogram with the finding of a rounded and lobulated voluminous mass in the right ventricle outflow tract (RVOT) which caused severe obstruction. The contrast computed tomography (CT) scan confirmed the presence of a heterogeneously enhancing soft-tissue mass occupying the RVOT with no evidence of pulmonary embolization. The mass was surgically excised, and the pathologic examination confirmed our suspicion of myxoma. Our experience suggests that myxoma can have mild clinical symptoms, the presentation may be non-specific, and diagnosis can be a challenge Careful examination and a diagnostic imaging workup, primarily with the transthoracic echocardiogram, are needful to make a rapid differential diagnosis and to better manage surgical treatment and follow-up.

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Section: Narrative Review Of Literature and Discussionmentioning

confidence: 83%

New Onset Cardiac Murmur and Exertional Dyspnea in an Apparently Healthy Child: A Rare Localization of Obstructive Myxoma in the Right Ventricle Outflow Tract without Pulmonary Embolization—A Case Report and Literature Review

D’Anna

Villani

Ammirati

et al. 2022

IJERPH

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“…However, there is no clear guideline for treating pulmonary embolisms combined with right ventricular tumors. One study reported the use of warfarin to treat a pulmonary embolism following incomplete surgical resection of a right ventricular myxoma, with no recurrence of emboli after 20 months [ 5 ]. Another case study reported resection of a right ventricular myxoma of 9.5 × 5.0 cm.…”

Section: Discussionmentioning

confidence: 99%

Choledochoscope-guided treatment of pulmonary embolism caused by ventricular myxoma

Mao

Wang

Wei

et al. 2023

J Cardiothorac Surg

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A 33-year male patient presented with a 6-month history of cough and shortness of breath upon physical activity. Echocardiography demonstrated right ventricular space-occupying lesions. Contrast-enhanced computed tomography of the chest showed multiple emboli in the pulmonary artery and its branches. Right ventricle tumor (myxoma) resection, tricuspid valve replacement, and clearance of the pulmonary artery thrombus were performed under cardiopulmonary bypass. Minimally invasive forceps and balloon urinary catheters were used to clear the thrombus. Clearance was confirmed by direct visualization using a choledochoscope. The patient recovered well and was discharged. The patient was prescribed oral warfarin 3 mg/day, and the international normalized ratio for prothrombin time was maintained between 2.0 and 3.0. Pre-discharge echocardiogram showed no lesion in the right ventricle or pulmonary arteries. The 6-month follow-up echocardiography indicated that the tricuspid valve was functioning well and showed no thrombus in the pulmonary artery.

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“…Yazan Assaf et al . reviewed 12 patients with pulmonary infarcts caused by cardiac tumors and pulmonary tumor emboli . Approximately 10% of patients with metastatic cardiac tumors develop cardiac dysfunction.…”

Section: Discussionmentioning

confidence: 99%

Successful surgical treatment of cardiac metastasis from uterine leiomyosarcoma: A case report and literature review

Maebayashi

Nagaishi

Nakajima

et al. 2020

J of Obstet and Gynaecol

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Uterine leiomyosarcoma is a malignant soft tissue tumor resembling uterine fibroma clinically and is difficult to diagnose preoperatively. Since metastatic cardiac tumors are very rare and asymptomatic, most cardiac metastases are detected at autopsy after death due to other diseases. A 49-year-old woman presented with menorrhagia and anemia, and a uterine tumor. Total hysterectomy was performed for the uterine tumor. Histopathological examination revealed the tumor to be a leiomyosarcoma. Postoperative computed tomography showed multiple lung metastases and a metastatic cardiac tumor. The cardiac tumor, which was located within and almost entirely occluded the right ventricle, was 49 × 26 mm. To prevent sudden death, cardiac tumorectomy was performed semi-emergently. Chemotherapy was initiated in the early postoperative period, and the patient currently maintains a complete response. Cases with lung and cardiac metastases rarely undergo surgical resection of metastatic tumors. However, emergent surgical resection of cardiac metastatic tumors should be considered to prevent sudden death.

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Pulmonary Embolism Following Incomplete Surgical Resection of a Right Ventricular Myxoma: A Case Report and Review of the Literature

Cited by 3 publications

References 20 publications

New Onset Cardiac Murmur and Exertional Dyspnea in an Apparently Healthy Child: A Rare Localization of Obstructive Myxoma in the Right Ventricle Outflow Tract without Pulmonary Embolization—A Case Report and Literature Review

New Onset Cardiac Murmur and Exertional Dyspnea in an Apparently Healthy Child: A Rare Localization of Obstructive Myxoma in the Right Ventricle Outflow Tract without Pulmonary Embolization—A Case Report and Literature Review

Choledochoscope-guided treatment of pulmonary embolism caused by ventricular myxoma

Successful surgical treatment of cardiac metastasis from uterine leiomyosarcoma: A case report and literature review

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