P680 Aortic arch myxoma with multiple peripheral embolism.

Abstract

Abstract We report an unusual localisation of myxoma, the most common primary cardiac neoplasm. A 58-year-old woman was admitted to surgery department with exacerbation of abdominal discomfort and symptoms of lower limb claudication.The abdominal CT showed embolism in the upper mesenteric artery arms with intestinal ischemia, in the minor renal arteries with kidney infarcts and in the minor arteries of lower extremities. She was urgently, succesfully operated and partial resection of the small intestine was performed. The chest angio-CT conducted three days after the operation revealed additional structure in the aortic arch. Local aortic arch dissection with a thrombus was initially suspected. Echocardiography showed homogenous tumor on the minor curvature of the aortic arch, with a base of 11 mm of width, reaching down with the blood stream towards the descending aorta. The aortic wall was linear, with no signs of dissection or atherosclerotic lesions, echogenicity indicated rather solid mass. The patient was operated cardiosurgically and tumor of a myxoma type was confirmed intraoperatively. Another, small tumor of the same type was found below isthmus, in a descending aorta. Partial resection of aortic arch, alloplasty of aortic arch with the use of a dacron prosthesis were performed. The tumor below the isthmus was removed, without resection of aortic wall, due to the high risk associated with the widening of the procedure. Multimodality imaging with the essential role of echocardiography is useful especially in differential diagnostics of the atypically localized tumors causing diffuse peripheral embolization. Abstract P680 Figure. Aortic arch myxoma tumor