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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 -
Chang Gung Medical Journal 2011Cardiac myxoma, the most common primary tumor of the heart, has variable clinical presentations and an immunohistochemical profile. Survivin, an antiapoptosis protein,...
BACKGROUND
Cardiac myxoma, the most common primary tumor of the heart, has variable clinical presentations and an immunohistochemical profile. Survivin, an antiapoptosis protein, may play an important role in the causes of cardiac myxoma. This investigation will report the expression pattern of survivin in cardiac myxomas.
METHODS
This study included 40 patients with cardiac myxoma, who were treated with surgical excision of the lesion. Detailed clinical parameters were reported and the expression of survivin was studied by immunohistochemical staining.
RESULTS
The patient population was comprised of 24 (60%) women and 16 (40%) men. The mean age of the patients was 42 years, with an age range of 30 to 63 years. All study cases were sporadic myxomas rather than familial myxoma. Patients were asymptomatic (20%), or had dyspnea (40%), stroke (15%), chest pain (12%), and fever (12%) on presentation. All lesions were located in the left atrium. The location of the myxoma and clinical events did not differ in terms of pathological changes, such as vascular proliferation, inflammation, cellularity, hyaline, calcification and thrombosis. Cardiac myxoma was characterized by a survivin dependent pathway with 100% immunohistochemical staining in the cytoplasm and the distribution in scoring system of survivin expression were 1 case (2.5%) in score 1; 12 cases (30%) in score 2; 12 cases (30%) in score 3 and 15 (37.5%) in score 4.
CONCLUSION
Cardiac myxomas demonstrate strong expression of survivin in the cytoplasm. This implies survivin may play an important role in the apoptosis pathway in cardiac myxomas.
Topics: Adult; Female; Heart Neoplasms; Humans; Immunohistochemistry; Inhibitor of Apoptosis Proteins; Male; Middle Aged; Myxoma; Survivin
PubMed: 21880190
DOI: No ID Found -
Turk Patoloji Dergisi 2020Myxomas are rare in the vocal cords. A 69-year-old man was admitted with one-year history of progressive dysphonia. Laryngoscopy revealed a polypoid mass on the right... (Review)
Review
Myxomas are rare in the vocal cords. A 69-year-old man was admitted with one-year history of progressive dysphonia. Laryngoscopy revealed a polypoid mass on the right vocal cord. The diagnosis was cellular myxoma. A review of the literature including the present case revealed eleven reported cases of myxoma. Ten cases were classic myxoma. To the best of our knowledge, cellular myxoma has not been previously reported in the vocal cord. Hypercellularity does not affect the behavior of cellular myxoma. However, its recognition is important to prevent confusion with the group of low-grade myxoid sarcomas. Cellular myxoma should be considered in the differential diagnosis of any vocal cord mass.
Topics: Aged; Humans; Laryngeal Neoplasms; Male; Myxoma; Treatment Outcome; Vocal Cords
PubMed: 29235612
DOI: 10.5146/tjpath.2017.01417