Positive calretinin stain with immunohistochemistry in a 49 year-old female with cardiac myxoma: A case report

I Gusti Ayu Sri Mahendra Dewi

doi:10.15562/ism.v11i3.824

Abstract

Background: Primary tumors of the heart are scarce. Cardiac myxoma is a primary benign heart tumor most often found with an incidence of 0.5-1.0 cases per million population per year and 90% diagnosed in the fourth to seventh decades of life, rarely found in children. Cardiac myxoma is three times more common in women than in men. These tumors are mostly found in the left atrium.Case description: Female, a 49-year-old patient, came with palpitations, shortness of breath, and weakness since the previous six months. On echocardiography, found a mass in the left atrium suspected of a left atrial myxoma. Surgery was performed, and the specimen was sent for histopathological examination. Macroscopically, the tumor mass shows an irregular shape, brownish color, and spongy consistency. Microscopic examination shows the tumor consisting of proliferation of spindle-shaped and stellate cells, with oval to round nuclei, eosinophilic cytoplasm, mostly scattered, some of which are arranged cord and nest, infiltrative between the myxoid stroma and partially surround small blood vessels to form a vasoformative ring. The specimen also contains the proliferation of blood vessels, extravasation of erythrocytes, and the distribution of inflammatory cells and hemosiderophages. The result of the immunohistochemical examination with calretinin was positive.Conclusion: This case was concluded as cardiac myxoma based on clinical features, echocardiography, macroscopic, routine histopathological, and immunohistochemical examinations.

Highlights

Tumors in the heart are rare and are divided into primary tumors originating from the heart, and secondary or metastatic tumors from elsewhere
Other benign primary tumors found in the heart include papillary fibroelastoma (PFE) (26%), fibroma (6%), lipoma (4%), rhabdomyoma, hemangioma, and atrio ventricular node tumors
We found visible erythrocyte extravasation, and distribution of lymphoplasmacytic inflammatory cells, neutrophil polymorphonuclear cells, and hemosiderophage (Figure 1)

Summary

INTRODUCTION

Tumors in the heart are rare and are divided into primary tumors originating from the heart, and secondary or metastatic tumors from elsewhere. Cardiac myxoma is the most common benign primary heart tumor. These tumors are three times more common in women than men in the fourth to seventh decades of life and are rarely found in children. The following reports a case of cardiac myxoma in the left atrium of a 49-y ear-old woman based on clinical features, radiological, macroscopic, microscopic, and immunohistochemical examinations. This case is reported because of its rare incident. Based on the clinical finding, echocardiography, macroscopic, microscopic, and immunohistochemical examinations, the patient was diagnosed as cardiac myxoma in the left atrium. The cardiac myxoma was a benign tumor without oncological stagging

DISCUSSION

Findings

CONCLUSION