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Journal of Medical Case Reports Mar 2024Myxomas are the most common primary cardiac tumor and typically originate in the left atrium. Atrial myxomas may present following complications of obstruction and...
BACKGROUND
Myxomas are the most common primary cardiac tumor and typically originate in the left atrium. Atrial myxomas may present following complications of obstruction and emboli. If an atrial myxoma goes untreated, complications such as congestive heart failure, embolic stroke, and sudden death can occur.
CASE PRESENTATION
A 58-year-old Caucasian male presented following a cardiac arrest. He was taken emergently to the cardiac catheterization lab and received two drug eluting stents. Following the procedure, he was found to have a left atrial mass that was intermittently obstructing the mitral valve on echocardiography. After leaving the cardiac catheterization lab, he was hypotensive and placed on multiple intravenous medications for hemodynamic support as well as an Impella device. Following medical optimization, he underwent one vessel coronary artery bypass graft as well as surgical excision of the left atrial mass, which pathology had shown to be an atrial myxoma.
CONCLUSION
This patient's case of cardiogenic shock following revascularization was complicated by the identification of an atrial myxoma, which, when large enough, can obstruct blood flow through the mitral valve leading to acute mitral dynamic stenosis. This condition results in circulatory collapse due to obstruction of the left ventricle in diastole as the myxoma occludes the mitral valve.
Topics: Humans; Male; Middle Aged; Shock, Cardiogenic; Myocardial Infarction; Echocardiography; Heart Atria; Heart Neoplasms; Myxoma
PubMed: 38462621
DOI: 10.1186/s13256-024-04420-7 -
Heart, Lung & Circulation Apr 2024
Topics: Humans; Dyspnea; Echocardiography; Heart Atria; Heart Neoplasms; Myxoma
PubMed: 38461107
DOI: 10.1016/j.hlc.2024.01.037 -
Medicine Mar 2024Conjunctival myxoma is a rare benign tumor, which can mimic more common conjunctival lesions such as a cyst, lymphangioma, amelanotic nevus, neurofibroma, amelanotic...
RATIONALE
Conjunctival myxoma is a rare benign tumor, which can mimic more common conjunctival lesions such as a cyst, lymphangioma, amelanotic nevus, neurofibroma, amelanotic melanoma, or lipoma. We describe a patient with the conjunctival myxoma, who was initially misdiagnosed as a conjunctival cyst. This case report includes intraoperative photographs and various immunohistochemical staining images.
PATIENTS CONCERNS
A 55-year-old woman presented with a painless mass in the superotemporal conjunctiva of the left eye, which she had noticed 1 month ago. The patient had no previous history of trauma or eye surgery. Slit-lamp examination revealed a well-circumscribed, freely movable, pinkish, semi-translucent mass on the temporal bulbar conjunctiva, suggestive of a conjunctival cyst.
DIAGNOSES
Histopathological analysis showed stellate- and spindle-shaped cells within the loose myxoid stroma, confirming a diagnosis of conjunctival myxoma.
INTERVENTIONS
The conjunctival lesion was completely excised under local anesthesia.
OUTCOMES
After 4 months of follow-up, the patient remained in good health without recurrence of the conjunctival lesion and no evidence of any systemic abnormality.
LESSONS
Myxoma is an extremely uncommon benign tumor derived from primitive mesenchyme. Considering the rarity of the tumor and its similarity to other conjunctival tumors, diagnosis can be challenging. Ophthalmologists should consider myxoma as a possible differential diagnosis when encountering conjunctival lesions. Surgical excision is essential to confirm the diagnosis and careful systemic evaluation is required to prevent potentially life-threatening underlying systemic conditions.
Topics: Female; Humans; Middle Aged; Conjunctival Neoplasms; Myxoma; Conjunctiva; Cysts; Skin Neoplasms
PubMed: 38457580
DOI: 10.1097/MD.0000000000037342 -
Cureus Feb 2024Cardiac myxoma is the most common primary heart tumor in adults. Although biologically benign, they can be life-threatening by obstructing heart function. They typically...
Cardiac myxoma is the most common primary heart tumor in adults. Although biologically benign, they can be life-threatening by obstructing heart function. They typically develop in the left atrium and can be polypoid (causing more obstruction) or papillary (more likely to cause embolizations). Symptoms are nonspecific, and diagnosis is relatively rare. Echocardiography is essential for quick diagnosis, and surgical removal is the primary treatment with low mortality rates, excellent postoperative survival, and low recurrence rates. We report a 73-year-old woman presented to the emergency room with extreme fatigue and weight loss. Further investigations revealed a mass in the left atrium suggestive of an intracardiac tumor on a thoracic computer tomography scan. A subsequent transesophageal echocardiogram was performed, which showed a large, mobile, and friable hyperechogenic intra-auricular mass adhered to the atrial septum with moderate mitral regurgitation and moderate aortic stenosis. This case highlights the crucial role that the transesophageal echocardiogram plays in these patients by accelerating diagnosis, assisting with myxoma resolution, and confirming the complete removal of the myxoma.
PubMed: 38449977
DOI: 10.7759/cureus.53597 -
Asian Journal of Surgery Mar 2024Minimally invasive surgery has emerged as a favorable alternative to conventional surgery for various cardiac conditions. This study aimed to compare the perioperative...
BACKGROUND
Minimally invasive surgery has emerged as a favorable alternative to conventional surgery for various cardiac conditions. This study aimed to compare the perioperative outcomes and follow-up results of the robotic approach versus the sternotomy approach for left atrial myxoma (LAM) resection.
METHOD
We retrospectively analyzed the perioperative outcomes and follow-up results of 94 patients who underwent left atrial myxoma resection using either the sternotomy approach (n = 64) or the robotic approach (n = 30) at our center between January 2017 and April 2023. Multiple linear regressions were employed to examine the actual impact of the surgical approach on perioperative outcomes while controlling for potential confounding factors.
RESULTS
There were no in-hospital deaths or follow-up deaths in the robotic group. Univariate analyses revealed that robotic LAM resection had a longer cardiopulmonary bypass (CPB) time (99.93 ± 22.30 vs. 76.28 ± 24.92, P < 0.001), longer aortic clamping time (57.80 ± 20.27 vs. 47.89 ± 18.10, P = 0.019), reduced postoperative drainage (P < 0.001), shorter mechanical ventilation time (P = 0.005), shorter postoperative bed-stay time (P < 0.001), shorter postoperative hospitalization time (P = 0.040), and higher hospital costs (P = 0.001) compared to the sternotomy group. After adjusting for baseline characteristics in a multiple regression model, a longer CPB time (B = 28.328; CI, 18.609-38.047; P < 0.001), longer aortic clamping time (B = 11.856; CI, 4.069-19.644; P = 0.003), reduced postoperative drainage (B = -200.224; CI, -254.962- -145.486; P < 0.001), shorter mechanical ventilation time (B = -3.429; CI, -6.562- -0.295; P = 0.032), shorter postoperative bed-stay time (B = -2.230; CI, -3.267- -1.193; P < 0.001), shorter postoperative hospitalization time (B = -1.998; CI, -3.747- -0.250; P = 0.026), and higher hospital costs (B = 2096.866, P = 0.002) were found in the robotic group. Furthermore, the robotic group exhibited a faster return to exercise compared to the sternotomy group (Log-Rank χ = 34.527, P < 0.001).
CONCLUSION
Both the robotic and sternotomy approaches are viable and safe options for LAM resection. However, despite the higher costs, longer CPB time, and longer aortic clamping time associated with robotic LAM resection, this technique was correlated with reduced postoperative drainage and faster postoperative recovery compared to the sternotomy technique.
PubMed: 38443251
DOI: 10.1016/j.asjsur.2024.02.112 -
International Journal of Surgery Case... Mar 2024Extracardiac intramuscular myxomas are exceedingly rare benign tumors, necessitating well-planned management for optimal outcomes.
INTRODUCTION
Extracardiac intramuscular myxomas are exceedingly rare benign tumors, necessitating well-planned management for optimal outcomes.
CASE PRESENTATION
We report the case of a 63-year-old male with no prior medical history, presenting with a progressively enlarging mass within the adductor compartment of the right thigh. Physical examination revealed a mobile and painless mass measuring 70 mm by 50 mm at the level of the adductor compartment of the right thigh, devoid of signs of inflammation or skin lesions. The patient showed no cachexia, asthenia, or weight loss. Imaging exams confirmed the characteristic features of intramuscular myxoma, leading to the decision for complete surgical excision. Subsequent histological analysis confirmed the diagnosis, and the patient experienced no postoperative complications, showing positive long-term follow-up results.
CLINICAL DISCUSSION
In the presence of an intramuscular mass, thorough questioning and meticulous clinical examination enable us to propose a diagnosis of intramuscular myxoma. MRI is the preferred imaging modality, supporting diagnostic reasoning. However, histopathological analysis remains essential to confirm the mass's nature and rule out potential malignant differential diagnoses. Complete surgical resection is considered the gold standard, ensuring favorable results with a low risk of recurrence.
CONCLUSION
Extracardiac intramuscular myxomas are exceptionally rare; MRI and histopathological analysis combined help rule out potential malignant differential diagnoses. Total surgical excision yielded good results with a low risk of recurrence.
PubMed: 38442674
DOI: 10.1016/j.ijscr.2024.109402 -
Radiology. Cardiothoracic Imaging Feb 2024Cor triatriatum sinister is a rare entity characterized by a membrane within the left atrium and posterior to the atrial appendage. This defect may cause obstructive...
Cor triatriatum sinister is a rare entity characterized by a membrane within the left atrium and posterior to the atrial appendage. This defect may cause obstructive symptoms analogous to mitral stenosis. The authors present a case of an incidentally detected enhancing mass originating from a cor triatriatum sinister membrane, with imaging characteristics most suggestive of myxoma. MR Imaging, Cardiac, Left Atrium, Congenital, CT Angiography, Echocardiography .
Topics: Humans; Cor Triatriatum; Multimodal Imaging; Heart Defects, Congenital; Computed Tomography Angiography; Heart Atria
PubMed: 38421274
DOI: 10.1148/ryct.230225 -
Frontiers in Cardiovascular Medicine 2024Primary cardiac tumors are uncommon, with the majority being benign myxomas. Cystic myxoma, a particularly rare type of benign cardiac tumor, demands cautious...
BACKGROUND
Primary cardiac tumors are uncommon, with the majority being benign myxomas. Cystic myxoma, a particularly rare type of benign cardiac tumor, demands cautious differential diagnosis from other cardiac tumors.
CASE SUMMARY
A 43-year-old male patient presenting with intermittent dyspnea was referred to our department for surgical evaluation. Transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) unveiled an intra-left atrial cyst, which was subsequently found to be blood-filled during a video-assisted microinvasive heart surgery. Pathological examination depicted a cyst wall filled with small stellate and fat spindle cells, along with a mucoid matrix, indicating a diagnosis of cystic myxoma.
CONCLUSIONS
We herein presented a rare case of an adult patient with cystic myxoma, initially misdiagnosed as an intracardiac blood cyst (CBC) prior to surgery, and ultimately verified via pathological findings.
PubMed: 38420261
DOI: 10.3389/fcvm.2024.1323890 -
Cardiology 2024The aim of the study was to investigate the clinical characteristics, surgical treatment, and long-term efficacy of primary right heart tumors.
INTRODUCTION
The aim of the study was to investigate the clinical characteristics, surgical treatment, and long-term efficacy of primary right heart tumors.
METHODS
This study is retrospective analysis of the clinical data of 70 patients with primary right heart tumors admitted to our department between 1980 and 2022 (observation group) and 70 patients with left heart tumors during the same period (control group). The surgical treatment was performed under cardiopulmonary bypass after differential diagnosis by echocardiography, cardiac CTA, and PET-CT before the surgery. The perioperative characteristics, recurrence rate, and long-term survival rates of right heart tumor versus left heart tumor were compared.
RESULTS
The most common pathological types of right heart tumors were myxoma (60%), lipoma (8.57%), and papillary elastofibroma (7.14%). During the perioperative period, there were 1 case of systemic embolism in the observation group, compared with 6 in the control group (p = 0.026), 13 cases of malignant tumor in the observation group versus 1 in the control group (p = 0.01). During the follow-up period, there were 15 cases of tumor recurrence and 17 cases of death in the observation group versus 4 (p = 0.002) and 7 in the control group (p = 0.006), comparatively.
CONCLUSION
Compared with left heart tumors, primary right heart tumors had a higher incidence of malignant tumors and a lower risk of systemic embolism during perioperative period. During the follow-up period, primary right heart tumors had a higher rate of tumor recurrence and a lower long-term survival rate.
Topics: Humans; Neoplasm Recurrence, Local; Retrospective Studies; Positron Emission Tomography Computed Tomography; Heart Neoplasms; Embolism
PubMed: 38417418
DOI: 10.1159/000535656