Systemic Inflammation in the Setting of Cardiac Myxomas: an Overview of Clinical and Practical Considerations

Yalta, Kenan; Öztürk, Cihan; Yalta, Tülin; Yetkın, Ertan

doi:10.4070/kcj.2021.0241

Cited by 4 publications

(12 citation statements)

References 9 publications

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“…Infected myxoma: Occasionally, myxomas get infected, presenting with high fever and multiple embolic events[ 85 - 88 ] (Figure 8 ).…”

Section: Introductionmentioning

confidence: 99%

Cardiac myxomas: A narrative review

Islam¹

2022

WJC

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Cardiac myxomas are common primary neoplasms of the heart. They are biologically benign but “functionally malignant” because of the potential for embolization. They arise most commonly from the left atrium, but no chambers of the heart are immune. They may be sporadic in the majority but also familial as a part of the Carney complex. Two morphological forms exist: polypoid and papillary. Polypoid myxomas often present with obstructive features, while the papillary forms are more prone to embolization. Histogenesis is still controversial; the current view centres around origin from the primitive pluripotent mesenchymal cells. They may be of giant proportion, be calcified or get infected. Clinical presentation typically involves the triad of intracardiac obstruction, embolic events and constitutional symptoms. Precordial examination findings may simulate those of mitral or tricuspid stenosis. The presence of tumour plop and change of the physical findings with changing position may help differentiation between the two. Echocardiography is the investigation of choice. Echogenic polypoid or papillary mobile mass within the atrial cavity remaining attached to the interatrial septum through a stalk are the tell-tale echocardiographic features. Cardiac magnetic resonance and computed tomographic scanning may have incremental diagnostic value. Histopathological examination reveals abundant loose myxoid stroma with scattered round, polygonal or stellate cells with dense irregular nuclei. Genetic testing may detect mutations in the PRKAR1A gene in the familial form of cardiac myxoma, i.e. the Carney complex. Surgical excision is the mainstay of treatment with low operative mortality, excellent postoperative survival and low recurrence rate. The current trend favours minimal-access surgery with or without robotic assistance. Physicians should have appropriate preparedness to make a timely diagnosis and enthusiastic treatment to avoid potentially fatal complications.

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“…Infected myxoma: Occasionally, myxomas get infected, presenting with high fever and multiple embolic events[ 85 - 88 ] (Figure 8 ).…”

Section: Introductionmentioning

confidence: 99%

Cardiac myxomas: A narrative review

Islam¹

2022

WJC

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“…First, frequent recurrences in this case may be largely due to its genetic origin associated with the Carney complex (presenting with dermatological and endocrinological abnormalities). 1 , 3 , 5 However, persistent systemic inflammation may not only account for constitutional (fever, etc.) and embolic findings in patients with cardiac myxoma but may also play a dominant role in tumor recurrences (local or systemic).…”

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confidence: 99%

“…and embolic findings in patients with cardiac myxoma but may also play a dominant role in tumor recurrences (local or systemic). 3 , 5 , 6 Moreover, the impact of systemic inflammation on clinical recurrences might be even higher in the setting of myxomas with a genetic origin. 3 , 5 In this context, systemic inflammation may originate from the neoplastic tissue itself or other co-existing inflammatory sources (chronic infections, etc.).…”

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confidence: 99%

“… 3 , 5 , 6 Moreover, the impact of systemic inflammation on clinical recurrences might be even higher in the setting of myxomas with a genetic origin. 3 , 5 In this context, systemic inflammation may originate from the neoplastic tissue itself or other co-existing inflammatory sources (chronic infections, etc.). 3 , 5 Mechanistically, certain cytokines including interleukin-6 (IL-6) were previously suggested to have a strong link with cardiac myxoma recurrences.…”

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confidence: 99%

“… 3 , 5 In this context, systemic inflammation may originate from the neoplastic tissue itself or other co-existing inflammatory sources (chronic infections, etc.). 3 , 5 Mechanistically, certain cytokines including interleukin-6 (IL-6) were previously suggested to have a strong link with cardiac myxoma recurrences. 3 , 5 , 6 In particular, persistent elevation of inflammation markers following myxoma resection may indicate 2 relevant implications: (1) a substantial tumoral burden and (2) consequent stimulation of growth factors, both of which may impact tumor recurrences in time.…”

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confidence: 99%

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