Unusual aspects of cardiac myxoma

Cardiac myxoma is an uncommon diagnosis but presents with common manifestations. There is a wide range of symptomatology from non-specific fever and weight loss to stroke-like symptoms. It is also one of the rare causes of cardiac syncope and thromboembolic events. We present a case of a 67-year-old female who presented with seemingly benign vertigo symptoms which she ignored for years before seeking medical attention. An echocardiogram revealed a 3.5 x 3.0 x 1.0 cm atrial myxoma which was surgically excised. Her symptoms have resolved entirely with no recurrence since surgery.

Section: Discussionmentioning

confidence: 99%

“…A CT or MRI can be used to demarcate the mass further [14]. Cardiac biopsy is not usually needed, but if malignancy is suspected, then the biopsy should be done after surgical excision [12].…”

Section: Discussionmentioning

confidence: 99%

Atrial Myxoma Presenting as Positional Vertigo: A Case Report

Jupalli¹,

Mubarik²,

Iqbal³

et al. 2019

“…Recurrence has been observed at the original implantation site, at adjacent locations such as the lungs, and at distant sites as a result of embolization. Malignant transformation has also been described [ 1 ].…”

Section: Discussionmentioning

confidence: 99%

“…Cardiac myxomas (CMs) are the most common primary cardiac neoplasms, accounting for 50% of all cardiac tumors. These benign tumors are rare, with reported incidences of less than 0.03% [ 1 ]. The vast majority (80%) of CMs are left atrial myxomas (LAMs), although CMs can occur in any cardiac chamber [ 2 - 3 ].…”

Section: Introductionmentioning

confidence: 99%

Left Atrial Myxoma Embolization Presenting as Acute Limb Ischemia: An Unusual Presentation

Mohamed¹,

Tawil²,

Salihi³

et al. 2018

Cardiac myxomas are rare with reported incidences of less than 0.03%. Cardiac myxomas are most commonly observed in the left atrium. Their clinical manifestations vary and most are non-specific to the diagnosis. The most common extra-cardiac manifestations are thrombo-embolic infarcts from tumor embolization. A previously healthy 55-year-old man presented with findings suggestive of acute arterial limb ischemia. Following surgical treatment of his acute presentation, a left atrial mass was found on echocardiography suggesting that the embolization was secondary to a cardiac myxoma. The patient was discharged without complication. Embolic myxoma should be included in the differential in younger, previously healthy patients presenting with acute arterial limb ischemia without obvious cause. Our patient’s dramatic presentation with a single acute event, however, prompted immediate treatment and resulted in a functional recovery with minimal complications.

“…Although cardiac myxoma is histologically a benign tumor, it has well-known malignant behaviors such as local relapse, local invasiveness, and distant metastasis. The potential for malignant transformation is controversial, but malignant sarcomas arising from cardiac myxoma recurrences have been reported in the literature [3,[16][17][18].…”

Section: Treatment and Prognosismentioning

confidence: 99%

Unusual Cause of Stroke

Borcheni

Kandah

Abdelazeem

et al. 2020

Every year, more than 795,000 people in the United States have a stroke, the vast majority of which are ischemic. Cardiac myxoma is an unusual cause of stroke and accounts for less than 1% of ischemic strokes. We present a case of a 56-year-old male with a history of hypertension, dyslipidemia, and type 2 diabetes mellitus, who presented with altered mental status, tinnitus, double vision, and diaphoresis. Due to concern for a cerebral vascular accident, a CT scan of the brain was obtained and showed no acute intracranial process. Brain MRI revealed multiple small acute infarcts involving bilateral posterior cerebral artery distribution. Further evaluation included transthoracic echocardiography that showed a large mobile mass in the left atrium measuring 3.5 x 2 cm intermittently projecting through the mitral valve. The patient underwent successful surgical resection of the left atrial mass. The pathology report confirmed the diagnosis of atrial myxoma. This case further highlights the importance of complete evaluation of stroke, including echocardiography, as well as the importance of careful surgical resection to prevent recurrence of systemic embolization and other complications of atrial myxoma.