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World Journal of Surgical Oncology Mar 2023Cardiac myxoma is the most common type of primary cardiac tumor, with the majority located in the atrial wall. The tumor is attached to valvular structures in a few... (Review)
Review
BACKGROUND
Cardiac myxoma is the most common type of primary cardiac tumor, with the majority located in the atrial wall. The tumor is attached to valvular structures in a few cases, of which the pulmonary valve is the least affected. Pulmonary valve myxoma may have different clinical manifestations from the more common cardiac myxomas because of its vital position. A misdiagnosis of these types of cardiac myxoma may be detrimental to the care and well-being of patients. Therefore, this systematic review aims to define the clinical characteristics of pulmonary valve myxoma and how this differs from a more common cardiac myxoma.
METHODS
Employed literature was obtained from PubMed, ScienceDirect, Scopus, Springer, and ProQuest without a publication year limit on August 23, 2022. The keyword was "pulmonary valve myxoma." Inclusion criteria were as follows: (1) case report or series, (2) available individual patient data, and (3) myxoma that is attached to pulmonary valve structures with no evidence of metastasis. Non-English language or nonhuman subject studies were excluded. Johanna Briggs Institute checklists were used for the risk of bias assessment. Data are presented descriptively.
RESULTS
This review included 9 case reports from 2237 articles. All cases show a low risk of bias. Pulmonary valve myxoma is dominated by males (5:4), and the patient's median age is 57 years with a bimodal distribution in pediatric and geriatric populations. The clinical manifestation of pulmonary valve myxoma is often unspecified or asymptomatic. However, systolic murmur in the pulmonary valve area is heard in 67% of cases. Echocardiography remains the diagnostic modality of choice in the majority of cases. Tumor attached to the pulmonary cusps or annulus and extended to adjacent tissues in all cases. Therefore, valve replacement or adjacent tissue reconstructions are required in 77% of cases. The recurrence and mortality are considerably high, with 33% and 22% cases, respectively.
CONCLUSIONS
Pulmonary valve myxoma is more common in males with a bimodal age distribution, and its outcomes seem worse than usual cardiac myxomas. Increasing awareness of its clinical symptoms, early diagnosis, and complete myxoma resection before the presence of congestive heart failure symptoms are important in achieving excellent outcomes. A firm embolization blockade is needed to prevent myxoma recurrence.
Topics: Male; Humans; Child; Aged; Middle Aged; Pulmonary Valve; Echocardiography; Heart Neoplasms; Myxoma; Heart Atria
PubMed: 36941612
DOI: 10.1186/s12957-023-02984-0 -
Portuguese Journal of Cardiac Thoracic... Oct 2022Cardiac myxomas are the most common primary cardiac tumours in adults. Clinical presentation is variable, with few cases of infected myxomas reported in the literature....
Cardiac myxomas are the most common primary cardiac tumours in adults. Clinical presentation is variable, with few cases of infected myxomas reported in the literature. We describe a rare case of a 63-year-old patient who presented with splenic abscesses and a left atrial mass suggestive of emboligen myxoma. The patient underwent a successful emergency sur- gical excision of the atrial mass followed by splenectomy. Blood cultures were positive for Fusobacterium nucleatum, whereas the histopathological examination of the excised mass confirmed the presence of a myxoma with a marked inflammatory infiltrate. All these findings allowed us to confirm the diagnosis of definite infected myxoma. Some aspects related to the aetiology, diagnosis and management of this entity are discussed.
Topics: Adult; Fusobacterium nucleatum; Heart Neoplasms; Humans; Middle Aged; Myxoma; Respiratory Tract Neoplasms; Splenic Diseases
PubMed: 36197820
DOI: 10.48729/pjctvs.287 -
Canadian Journal of Ophthalmology.... Aug 2021
Topics: Cornea; Corneal Diseases; Humans; Myxoma
PubMed: 33358992
DOI: 10.1016/j.jcjo.2020.11.010 -
BMJ Case Reports Feb 2019Myxoma is a common benign tumour found in the heart. On reviewing literature, we found some left atrial myxomas receive blood supply from the right coronary artery.... (Review)
Review
Myxoma is a common benign tumour found in the heart. On reviewing literature, we found some left atrial myxomas receive blood supply from the right coronary artery. Performing a coronary angiogram in a cardiac tumour has the following uses: (1) it shows the vascularity that can be ligated by the surgeon at operation; (2) if there is a blood supply visible, it may not be an intracardiac thrombus; (3) the coronary angiogram may detect a myxoma even before an echocardiogram does so; (4) some myxomas may bleed into the right atrium or left atrium and this may be seen on coronary angiography. We show here the neovascularity of a left atrial myxoma and its blood supply from the right coronary artery. We recommend that all routine coronary angiograms be reviewed carefully for any signs of tumour vascularity or tumour blush as this would prevent missing early myxomas. Echocardiography is the gold standard for detection of myxomas but literature has a number of intracardiac tumours that were detected only by the tumour blush. Some left atrial tumours have been treated by occluding their blood supply.The absence of a blood supply on coronary angiography could rule out a benign cardiac tumour that usually has a blood supply.
Topics: Adult; Coronary Angiography; Evidence-Based Medicine; Female; Heart Atria; Heart Neoplasms; Humans; Myxoma; Sensitivity and Specificity
PubMed: 30804157
DOI: 10.1136/bcr-2018-225900 -
Oral Surgery, Oral Medicine, Oral... Feb 2021Myxomas are rare benign mesenchymal soft tissue tumors that seldom affect the head and neck area. The present report describes a rare case of intramuscular myxoma of the... (Review)
Review
OBJECTIVE
Myxomas are rare benign mesenchymal soft tissue tumors that seldom affect the head and neck area. The present report describes a rare case of intramuscular myxoma of the oral cavity and briefly reviews the literature regarding the occurrence of these lesions in the maxillofacial area.
STUDY DESIGN
A 59-year-old patient was referred for the development of a slow-growing tumefaction in the right buccal mucosa in the previous 12 months. Magnetic resonance imaging was performed to characterize the lesion's dimensions and its relationship with the surrounding structures, and it revealed intramuscular localization in correspondence with the medial pterygoid muscle. Incisional biopsy was carried out to aid in the final diagnosis.
RESULTS
Histology revealed the presence of an intramuscular myxoma, characterized by discontinuous margins and locally infiltrating muscular fibers. A second surgery was performed to totally remove the lesion. Follow-up at 6 months did not show any signs of recurrence. A literature search was performed to retrieve data on the incidence of oral intramuscular myxomas.
CONCLUSIONS
To the best of our knowledge, this is the first case of intramuscular myxoma of the medial pterygoid muscle reported in the literature. Although rarely encountered, intramuscular myxomas should be considered when performing differential diagnoses of soft tissue masses at the level of the masticatory muscles.
Topics: Biopsy; Diagnosis, Differential; Humans; Magnetic Resonance Imaging; Middle Aged; Muscle Neoplasms; Myxoma; Neoplasm Recurrence, Local
PubMed: 32499151
DOI: 10.1016/j.oooo.2020.03.053 -
Archivio Italiano Di Urologia,... Oct 2020Myxomas are rare tumours that can be found in many anatomical locations. There are only 17 cases of renal involvement documented. Our case is an 85 year-old man followed...
Myxomas are rare tumours that can be found in many anatomical locations. There are only 17 cases of renal involvement documented. Our case is an 85 year-old man followed in our consultation with recurrent hematuria after a transurethral resection of a bladder tumour. Evaluation with CT showed a solid lesion with 23 x 18 mm partially obliterating the left inferior calyx. The patient underwent a left nephroureterectomy. Microscopic examination showed a mass within renal parenchyma adjacent to the renal pelvis composed of plump mildly atypical spindle cells distributed in a copious myxoid matrix. Immunohistochemical staining for Vimentine, Pankeratin (AE1/AE3-), CD34, CD31 and smooth muscle actin were negative. With these histopathological and immunohistochemical findings, the case was diagnosed as renal myxoma.
Topics: Aged, 80 and over; Humans; Kidney Neoplasms; Male; Myxoma
PubMed: 33016063
DOI: 10.4081/aiua.2020.3.273 -
Veterinary Pathology Jul 2020This report describes the clinical and pathologic characteristics of cystic and myxomatous lesions of synovial joints in 16 cats. The average age was 13.4 years. The...
This report describes the clinical and pathologic characteristics of cystic and myxomatous lesions of synovial joints in 16 cats. The average age was 13.4 years. The elbow was most commonly affected (12/16), and all lesions were unilateral. Degenerative joint disease was a frequent concurrent but bilateral condition. The lesions consisted of fluid-filled cysts lined by synoviocytes (3 cases), solid foci of stellate cells in a myxomatous matrix (2 cases), or a combination of the two (11 cases). In some cases there were areas of transition between the cystic and myxomatous lesions. Mitoses and other features of malignancy were rare to nonexistent. In the 13 cats with follow-up information, the lesion gradually increased in size over a period of years. None of the cats died or were euthanized because of this lesion. We propose that some cats with degenerative joint disease develop synovial cysts, which have the potential to transform to a synovial myxoma.
Topics: Animals; Cat Diseases; Cats; Joint Diseases; Joints; Myxoma; Synovial Cyst
PubMed: 32436816
DOI: 10.1177/0300985820926483 -
Journal of Cardiothoracic Surgery Jun 2024Cardiac myxomas are the most common type of primary cardiac tumors in adults, but they can have variable features that make them difficult to diagnose. We report two...
BACKGROUND
Cardiac myxomas are the most common type of primary cardiac tumors in adults, but they can have variable features that make them difficult to diagnose. We report two cases of atrial myxoma with calcification or ossification, which are rare pathological subgroups of myxoma.
CASE PRESENTATION
A 47-year-old woman and a 35-year-old man presented to our hospital with different symptoms. Both patients had a history of chronic diseases. Transthoracic and transesophageal echocardiography revealed a mass in the left or right atrium, respectively, with strong echogenicity and echogenic shadows. The masses were suspected to be malignant tumors with calcification or ossification. Contrast transthoracic echocardiography(cTEE) showed low blood supply within the lesions. The patients underwent surgical resection of the atrial mass, and the pathology confirmed myxoma with partial ossification or massive calcification.
CONCLUSION
We report two rare cases of atrial myxoma with calcification or ossification and analyze their ultrasonographic features. Transthoracic echocardiography and cTEE can provide valuable information for the diagnosis and management of such mass. However, distinguishing calcification and ossification in myxoma from calcification in malignant tumors is challenging. More studies are needed to understand the pathogenesis and imaging characteristics of these myxoma variants.
Topics: Humans; Myxoma; Heart Neoplasms; Male; Middle Aged; Calcinosis; Heart Atria; Female; Adult; Ossification, Heterotopic; Echocardiography; Echocardiography, Transesophageal
PubMed: 38926775
DOI: 10.1186/s13019-024-02876-8 -
Cardiovascular Pathology : the Official... 2021Cardiac myxomas are rare tumors of incompletely elucidated pathogenesis. The aim of this study is to explore the possible presence of a senescence phenotype in cardiac...
AIMS
Cardiac myxomas are rare tumors of incompletely elucidated pathogenesis. The aim of this study is to explore the possible presence of a senescence phenotype in cardiac myxomas, associated with an inflammatory and vasculogenic tumor microenvironment.
METHODS AND RESULTS
This is a retrospective study of 29 cardiac myxomas with immunohistochemical detection of various inflammatory, vascular, and senescence markers. We show that all myxomas contain tumor cells in senescence overexpressing p16, and a fraction of senescent endothelial cells. Macrophages are the principal inflammatory cell population, followed by cytotoxic T cells, with fewer plasma cells, mastocytes, and B lymphocytes. These populations are found in different intratumoral localizations. Larger tumor volume is associated with a lower percentage of myxoid matrix, higher cellularity, higher macrophage, and lower number of mast cells as well as higher PD-L1 expression by inflammatory cells. Higher vascular density is associated with higher percentage of B cells, a lower number of macrophages and higher number of mastocytes, and lower PD-L1 expression by inflammatory cells. Tumors with higher vascular density and higher cellularity show higher amounts of p16 senescent endothelial cells.
CONCLUSIONS
Myxoma tumor cells are in senescence and reside inside a tumor microenvironment with a distinct inflammatory profile rich in macrophages and cytotoxic T cells, and a rich vasculature, probably attributed to a senescence-associated secretory phenotype.
Topics: B7-H1 Antigen; Endothelial Cells; Heart Neoplasms; Humans; Myxoma; Neovascularization, Pathologic; Retrospective Studies; Senescence-Associated Secretory Phenotype; Tumor Microenvironment
PubMed: 33762213
DOI: 10.1016/j.carpath.2021.107335 -
The Annals of Thoracic Surgery Apr 2021Myxomas are common benign cardiac tumors that can cause life-threatening events. Urgent surgical excision is needed. Therefore, little is known about their growth rate....
Myxomas are common benign cardiac tumors that can cause life-threatening events. Urgent surgical excision is needed. Therefore, little is known about their growth rate. We present a peculiar case of an incidental left atrial myxoma offering calculation of a growth curve over more than 6 years. The myxoma was incidentally seen retrospectively on computed tomography scans in follow-up for bladder carcinoma in a 71-year-old patient. The patient underwent surgical resection of the myxoma. The authors emphasize that myxoma can be unnoticed on non-electrocardiogram-gated computed tomography scans. In the presented case, cardiac myxoma appears to grow linearly over time.
Topics: Aged; Cardiac Surgical Procedures; Disease Progression; Echocardiography, Transesophageal; Heart Atria; Heart Neoplasms; Humans; Male; Myxoma; Tomography, X-Ray Computed
PubMed: 32890493
DOI: 10.1016/j.athoracsur.2020.06.088