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Annals of Cardiac Anaesthesia 2021Cardiac myxomas are the most common benign tumors of the heart. They are most commonly found in the left atrium, followed by a right atrium and rarely in the left...
Cardiac myxomas are the most common benign tumors of the heart. They are most commonly found in the left atrium, followed by a right atrium and rarely in the left ventricle. Herein, we report a rare case of left ventricular myxoma in a patient who had twice undergone removal of left atrial myxoma. Complete removal of the tumor through aortotomy, without causing fragmentation led to the uneventful recovery of the patient.
Topics: Heart Atria; Heart Neoplasms; Heart Ventricles; Humans; Myxoma
PubMed: 34747762
DOI: 10.4103/aca.ACA_7_20 -
Clinical Cardiology Feb 2011We report on a family of 4 members, all of whom have had multifocal, recurrent atrial myxomas associated with skin pigmentation, melanotic schwannomas, mucocutaneous... (Review)
Review
We report on a family of 4 members, all of whom have had multifocal, recurrent atrial myxomas associated with skin pigmentation, melanotic schwannomas, mucocutaneous myxomas, and tumors of the ovary and pituitary, adrenal, and thyroid glands. Immunochemistry of the myxoma cells is positive for calretinin, confirming their neuroendocrine origin. Genetic studies confirmed mutations in the gene coding protein kinase A, regulatory subunit 1-α (PRKAR1α). This is Carney's complex, characterized by multiple, mucocutaneous myxomas; pigmented lesions over the lips, conjunctiva, and genitalia; adenomas of the breast and thyroid; schwannomas; and endocrinal abnormalities including Cushing syndrome and acromegaly. Members of the family require vigorous screening, including urinary free cortisol, plasma transforming growth factor-β(1) and thyrotropin-releasing hormone, testicular ultrasound, routine echocardiographic screening, searches for cardiac and mucocutaneous myxomas in multiple locations, and genetic studies for the PRKAR1α gene sequence.
Topics: Adult; Aged; Carney Complex; Cyclic AMP-Dependent Protein Kinase RIalpha Subunit; Female; Heart Atria; Heart Neoplasms; Humans; Middle Aged; Mutation; Myxoma; Recurrence; Risk Factors
PubMed: 21298650
DOI: 10.1002/clc.20845 -
European Journal of Surgical Oncology :... Feb 2024Cardiac myxoma is the most common primary cardiac tumor. However, existing literature mainly consists of single-center experiences with limited subjects. This systematic... (Meta-Analysis)
Meta-Analysis Review
Cardiac myxoma is the most common primary cardiac tumor. However, existing literature mainly consists of single-center experiences with limited subjects. This systematic review aimed to provide data on clinical characteristics and surgical outcomes of cardiac myxoma. We performed a thorough literature search on May 23, 2023 on PubMed, ProQuest, ScienceDirect, Scopus, and Web of Science. The inclusion criteria were English full-text, observational studies, and included >20 subjects. From the search, 112 studies with a total of 8150 patients were included in the analysis. The mean age was 51 years (95 % confidence interval [95%CI] = 49.1-52.3), and the majority were females (64.3 % [95 % CI = 62.8-65.8 %]). The most common clinical manifestation was cardiovascular symptoms. Echocardiography can diagnose almost all cases (98.1 % [95 % CI = 95.8-99.6 %]). Cardiac myxoma was mostly prevalent in left atrium (85.3 % [95%CI = 83.3-87 %]) and predominantly with pedunculated morphology (75.6 % [95%CI = 64.1-84.3 %]). Post-tumor excision outcomes were excellent, with an early mortality of 1.27 % (95 % CI = 0.8-1.8 %), late mortality rate of 4.7 (95 % CI = 2.5-7.4) per 1000 person-years, and recurrence rate at 0.5 (95 % CI = 0.0-1.1) per 1000 person-years. Tumor excision is warranted in a timely manner once the cardiac myxoma diagnosis is established.
Topics: Female; Humans; Middle Aged; Male; Echocardiography; Heart Atria; Heart Neoplasms; Myxoma; Treatment Outcome
PubMed: 38219702
DOI: 10.1016/j.ejso.2023.107940 -
BMC Cardiovascular Disorders Dec 2022Atrial myxomas account for approximately 50% of all primary cardiac tumors. The size, location, risk of embolic event, and involvement of other cardiac structures, are...
BACKGROUND
Atrial myxomas account for approximately 50% of all primary cardiac tumors. The size, location, risk of embolic event, and involvement of other cardiac structures, are all factors that contribute to the wide range of presentation for cardiac myxomas. Patients with myxomas may remain asymptomatic, while others may report symptoms such as fatigue and fever, dyspnea, and syncope. It is important to recognize arrhythmias as an uncommon symptom of myxomas.
CASE PRESENTATION
We report a rare case of a 67-year-old man who presented with pre-syncopal episodes, symptomatic bradycardia, and night sweats found to have a 5.5 × 5.1 × 3 cm myxoma in the left atrium. During diastole the mass caused dynamic flow obstruction across the mitral valve. The patient underwent surgical resection of the mass given his symptomatology and risk of embolic events. Removal of the myxoma resulted in resolution of both pre-syncopal episodes and the patient's sinus bradycardia.
CONCLUSION
Atrial myxomas are a rare cause of pre-syncope and symptomatic bradycardia. It is important to have a clinical suspicion for atrial myxomas given early diagnosis and surgical intervention are key in improving the prognosis of these patients. This case also highlights the importance of taking into account the source of the myxoma's blood supply in relationship to other cardiac structures, and further correlating these findings with clinical symptoms.
Topics: Male; Humans; Aged; Bradycardia; Atrial Fibrillation; Heart Atria; Heart Neoplasms; Syncope; Myxoma
PubMed: 36585613
DOI: 10.1186/s12872-022-03018-5 -
Deutsches Arzteblatt International Jul 2021
Topics: Heart Neoplasms; Heart Ventricles; Humans; Myxoma
PubMed: 34491165
DOI: 10.3238/arztebl.m2021.0099 -
European Review For Medical and... Feb 2017The purpose of this study is to compare the effectiveness and safety of thoracoscopic surgery and traditional median sternotomy. (Comparative Study)
Comparative Study
OBJECTIVE
The purpose of this study is to compare the effectiveness and safety of thoracoscopic surgery and traditional median sternotomy.
PATIENTS AND METHODS
64 patients with atrial myxoma and 114 patients with atrial septal defect were collected from Mar 2012 to Aug 2015. 40 atrial myxoma and 77 atrial septal defect (ASD) patients underwent totally thoracoscopic surgery technique, while 24 atrial myxoma and 37 ASD patients underwent traditional median sternotomy. The baseline characteristics and perioperative data were recorded and analyzed from all cases. Follow-up data were obtained from outpatient clinics.
RESULTS
All patients had successful resections or repairs. Compared with the traditional median sternotomy, the patients with atrial myxoma who underwent thoracoscopic surgery had longer operation time (208.08 ± 23.98 vs. 170.00 ± 16.58 min) while shorter intensive care unit (ICU) stay time (17.67 ± 4.95 vs. 49.88 ± 3.21 h), less blood drainage (127.87 ± 48.84 vs. 275.00 ± 59.01 ml) and shorter hospitalization days (9.97 ± 3.54 vs. 15.13 ± 1.06 days). For patients underwent ASD repair, longer operation time (232.92 ± 61.02 vs. 183.40 ± 54.63 min), shorter mechanical assistant ventilation time (4.82 ± 2.10 vs. 6.02 ± 2.50 h) and shorter ICU stay time (18.54 ± 5.80 vs. 39.68 ± 18.44 h) were detected in the thoracoscopic surgery group. There was no postoperative embolism events or death in all participated patients. Neither residual shunt nor atrioventricular blocks were detected in all ASD patients.
CONCLUSIONS
Totally thoracoscopic surgery for atrial myxomas and atrial septal defect repair is more effective and safer. It provides another option to treat the patients with atrial myxoma and atrial septal defect.
Topics: Adult; Female; Heart Septal Defects, Atrial; Humans; Male; Middle Aged; Myxoma; Operative Time; Sternotomy; Thoracoscopy; Treatment Outcome; Young Adult
PubMed: 28239810
DOI: No ID Found -
Genetics in Medicine : Official Journal... Jan 2021Carney complex (CNC), is an autosomal dominant multiple neoplasia and lentiginosis syndrome. We aimed to identify risk factors associated with the occurrence and...
PURPOSE
Carney complex (CNC), is an autosomal dominant multiple neoplasia and lentiginosis syndrome. We aimed to identify risk factors associated with the occurrence and recurrence of cardiac myxomas, the predominant cause of death in CNC patients.
METHODS
Patients with CNC were monitored prospectively between 1995 and 2020 for the development of cardiac myxomas.
RESULTS
Of the 319 patients studied, 136 (42.6%) developed myxomas. The mean age at diagnosis was 28.7 ± 16.6 years in females and 25.0 ± 16.4 years in males. By age 30, 35% of females and 45% of males had at least one myxoma. The CNC-related lesions, lentigines, cutaneous, mucosal, or breast myxomas, thyroid nodules, pituitary adenoma, and schwannoma were significantly more frequent (all p < 0.05) among patients with myxomas. Forty-four percent of patients had recurrences; nearly all within the first 8 and 16 years for males and females, respectively. Recurrences were more common in females.
CONCLUSION
This is the largest study to date and provides the first-time risk estimates by age and gender for cardiac myxomas in CNC patients. Cardiac myxomas are common by age 30 and often recur, especially in women, but the risk drops in 10 to 20 years. These findings may guide patient counseling, screening intervals, and surgical approaches.
CLINICAL TRIAL REGISTRATION
Clinical Trial Registration: Defining the Genetic Basis for the Development of Primary Pigmented Nodular Adrenocortical Disease and the Carney complex, Registration number: NCT00001452 URL: https://clinicaltrials.gov/ct2/show/NCT00001452.
Topics: Adult; Carney Complex; Female; Heart Neoplasms; Humans; Male; Myxoma; Neoplasm Recurrence, Local; Risk Factors
PubMed: 32893266
DOI: 10.1038/s41436-020-00956-3 -
Turk Patoloji Dergisi 2012Myxoma is a rare mesenchymal tumor and it is mainly seen in heart and skin. Renal myxoma is extremely rare. To date, eleven cases of kidney myxomas have been reported in... (Review)
Review
Myxoma is a rare mesenchymal tumor and it is mainly seen in heart and skin. Renal myxoma is extremely rare. To date, eleven cases of kidney myxomas have been reported in the literature. One of them is myxoma of the renal sinus. Our case was an 82-year-old man admitted to our hospital symptoms related to the urinary tract obstruction. Abdominal computerized tomography revealed a solid, hypodense mass 9 cm in diameter infiltrating the renal parenchyma in the renal pelvis. The patient underwent nephrectomy. The resected kidney contained gelatinous tumor with indistinct borders. The tumor was composed of slender, bland, spindle-shaped cells with large amounts of mucoid material. Tumor cells were positively stained with vimentin, focally stained positive for smooth muscle actin and had negative reactivity for S-100 protein, epithelial membrane antigen and pancytokeratin. Herein we report the second case of renal myxoma arising from the renal sinus.
Topics: Aged, 80 and over; Humans; Kidney Neoplasms; Kidney Pelvis; Male; Myxoma
PubMed: 22207437
DOI: 10.5146/tjpath.2012.01102 -
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 -
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