Ventricular Myxoma Research Articles

Recurrent left ventricular myxoma with Carney complex

Recurrent left ventricular myxoma with Carney complex

Large ventricular myxoma causing inflow and outflow obstruction of the right ventricle; A Case Report

BackgroundMyxomas are the most common primary benign heart tumors, typically found in the left atrium, with only 2–4% occurring in the right ventricle. Clinical presentations vary widely, including congestive heart failure and systemic embolic phenomena. This case report describes a rare right ventricular myxoma causing both inflow and outflow obstruction, presenting as progressive exertional dyspnea.Case PresentationA 23-year-old male presented with two weeks of worsening exertional dyspnea. He was stable but tachypneic with a systolic murmur over the tricuspid area. Elevated erythrocyte sedimentation rate (ESR) and C-Reactive protein (CRP) were noted, while other lab tests were normal. Imaging, including echocardiography and chest tomography scan (CT) revealed a 4 × 3.8 × 4.6 cm mass in the right ventricle extending to the pulmonary trunk. Surgical resection via right ventriculotomy was performed, and histopathology confirmed myxoma. The patient recovered uneventfully.ConclusionRight ventricular myxomas, though rare, can cause significant obstruction and present with diverse symptoms. Timely diagnosis using imaging techniques like echocardiography is crucial. Surgical resection remains the definitive treatment, offering excellent outcomes and low recurrence rates. Early intervention is vital to prevent serious complications and ensure favorable patient prognosis.

Pulmonary embolism from right ventricular myxoma in a child with undiagnosed Carney complex.

Pediatric pulmonary embolism occurs in 8.6-57 per 100,000 hospitalised children. We report a novel case of bilateral pulmonary emboli in a child presenting with dyspnoea who was found to have large right ventricular myxoma and subsequent diagnosis of Carney complex. After resection of the right ventricular myxoma and bilateral pulmonary embolectomy, she had a full recovery and an excellent outcome.

A case study on right ventricular-myxoma: An unusual presentation

Myxomas originating from the right ventricle are even less common in pediatric patients. It's important to note that right ventricular myxomas are rare, and the symptoms and complications can vary from person to person. Prompt diagnosis and treatment are crucial to prevent potentially life-threatening complications. Treatment typically involves surgical removal of the tumor, and in some cases, additional measures may be necessary to address any associated complications or damage caused by the tumor. Objective: This case study aims to present a rare and noteworthy case of right ventricle myxoma in a 15-year-old boy, emphasizing the challenges in diagnosis, treatment, and the successful outcome achieved. Methods: Detailed clinical, imaging, and surgical data were collected and analyzed for a 15-year-old male patient presenting with atypical cardiac symptoms. Diagnostic procedures included 2D ECHO, X-RAY, HRCT-Thorax along with pulmonary Angio leading to the identification of a right ventricle myxoma. Incidences: Primary tumors of the heart are rare with an incidence of 0.02–0.05%. Cardiac MYXOMAS are rare BENIGN TUMORS that account for nearly 50% of all adult primary Cardiac tumors. Approximately 75–80% of myxomas are in the LEFT ATRIUM,10–20% are in the RIGHT ATRIUM, and 5–10% are in both ATRIA or either VENTRICLE. Myxomas arising from the RIGHT-VENTRICLE are extremely rare and characterized by the presence of a gelatinous mass in the right ventricle. The exact incidence of right ventricular myxoma is not well established, as it is a rare condition and limited data is available. The condition is often diagnosed incidentally during investigations for other cardiac conditions or when patients present with symptoms such as chest pain, shortness of breath, palpitations, or heart murmurs. Results: The patient, initially presenting with palpitation, underwent successful surgical excision of the right ventricle myxoma. Postoperative recovery was uneventful, and the patient demonstrated significant improvement in symptoms. Conclusion: Right ventricle myxomas are exceptionally rare in pediatric patients, posing unique diagnostic challenges. This case underscores the importance of considering cardiac tumors even in younger populations when presented with unexplained cardiac symptoms. Timely diagnosis and surgical intervention contributed to a favorable outcome, highlighting the successful management of right ventricle myxoma in adolescents.

Giant Myxoma of the Right Atrium a Rare Location: A Case Report at the Festoc Center in Bamako

Right ventricular myxoma is a very rare location of cardiac myxomas. The most common complications are pulmonary embolism and tumor obstruction of the pulmonary valve. We report the case of a 63-year-old woman admitted to Cardiology for recurrent syncope and progressively worsening dyspnea. Echocardiography revealed right atrial myxoma. Surgical excision was performed under extracorporeal circulation, with favorable postoperative outcomes. Histological examination of the specimen confirmed the diagnosis of myxoma. The 2-month follow-up does not show any tumor recurrence.

Choledochoscope-guided treatment of pulmonary embolism caused by ventricular myxoma

A 33-year male patient presented with a 6-month history of cough and shortness of breath upon physical activity. Echocardiography demonstrated right ventricular space-occupying lesions. Contrast-enhanced computed tomography of the chest showed multiple emboli in the pulmonary artery and its branches. Right ventricle tumor (myxoma) resection, tricuspid valve replacement, and clearance of the pulmonary artery thrombus were performed under cardiopulmonary bypass. Minimally invasive forceps and balloon urinary catheters were used to clear the thrombus. Clearance was confirmed by direct visualization using a choledochoscope. The patient recovered well and was discharged. The patient was prescribed oral warfarin 3 mg/day, and the international normalized ratio for prothrombin time was maintained between 2.0 and 3.0. Pre-discharge echocardiogram showed no lesion in the right ventricle or pulmonary arteries. The 6-month follow-up echocardiography indicated that the tricuspid valve was functioning well and showed no thrombus in the pulmonary artery.

Huge right ventricular myxoma in a 15-year-old female patient: a case report and literature review

BackgroundMyxomas represent about 5–10% of primary cardiac tumors in children, and only about 2.5–4% of cardiac myxomas originate from ventricular chambers. Symptoms and signs of right ventricular tumors depend mainly on the size and the site of the tumor and its effect on the inflow and outflow of the blood.Case presentationA 15-year-old female patient presented with syncope on exertion and symptoms and signs of congestive heart failure. She had a history of dyspnea and palpitation on exertion for 2 years before admission. Echocardiography and cardiac magnetic resonance imaging (MRI) diagnose a huge right ventricular mobile mass (9 × 4.6 × 3.7 cm) prolapsing during systole into the main pulmonary artery and severe tricuspid regurgitation. The mass showed no contrast enhancement in early dynamic and delayed gadolinium images, suggestive of a thrombus. The mass was safely excised and tricuspid annuloplasty repair was done using right atriotomy and vertical right ventriculotomy approaches. The patient was discharged in a well condition on postoperative day 6. Pathologically, the mass was confirmed as cardiac myxoma with old extensive hemorrhage inside.ConclusionsEarly echocardiography is essential for patients complaining of unexplained cardiac symptoms for early diagnosis and management of rare cases. Multimodality imaging is needed for the diagnosis and planning of the surgical procedure of right ventricular masses. Hemorrhage inside myxoma may lead to no contrast enhancement of the tumor.

Right ventricular myxoma in a child causing right ventricular outflow tract obstruction.

Primary cardiac tumours are uncommon in the paediatric population, accounting for fewer than 0.5% of paediatric cases of cardiac disease. Right ventricular tumours, including myxomas, are particularly rare and may be asymptomatic or demonstrate varying degrees of cardiac dysfunction based on the location and size of the tumour, inducing conduction abnormalities, syncope, embolism, and potentially, sudden death. We report a rare case of right ventricular myxoma causing severe right ventricular outflow tract obstruction and surgical intervention in a paediatric patient.

Right ventricular myxoma: An incidental finding on CT chest lung screen

With the rise in screening modalities, incidental findings increase. We present a case of a computed tomography (CT) chest lung cancer screen that resulted in the diagnosis of a right ventricular (RV) myxoma. Echocardiogram and cardiac magnetic resonance imaging (CMR) led to this diagnosis.

Rare Right Ventricular Obstructing Myxoma: An Incidental Finding for a Common Symptom

Background: Palpitations are a common clinical manifestation within the general population and are often associated with conduction abnormalities within the heart. Structural causes account for only 3% of palpitations. As such, they are often investigated with cardiac event/Holter monitoring. Presented here is a case of palpitations secondary to intracardiac mass. Case summary: A 58-year-old female patient presented with palpitations. The electrocardiogram was unremarkable. Transthoracic echocardiography revealed a large, mobile mass visualised in the right ventricular outflow tract. Further investigations, including cardiac CT and cardiac MRI, confirmed a right ventricular myxoma, which was successfully surgically excised. There has been no evidence of recurrence or long-term morbidity. Discussion: Myxomas are extremely rare and most commonly present with signs of heart failure, thromboembolic events, or constitutional symptoms. Palpitations are a usual presentation of cardiac masses. Myxomas carry a high risk of sudden death through thromboembolic events or dysrhythmias, therefore immediate intervention is essential. From the findings, patients presenting with palpitations are recommended to undergo a transthoracic echocardiogram to identify the possibility of palpitations secondary to structural variants or abnormalities. Learning Points: If there are no haematological or biochemistry abnormalities, and no risk factors for palpitations were ascertained, patients presenting with palpitations should ideally have a transthoracic echocardiogram, in addition to Holter monitoring, to rule out a structural cause for their clinical manifestation. Structural abnormalities noticed on echocardiography are better characterised with cardiac MRI as it provides both structural and possible tissue characterisation.

The Question of Relapse of a Cardiac Myxoma: an Unusual Case from Practice

Various studies demonstrate that recurrence of cardiac myxoma (CM) occurs in 2.1–5.3% of cases. In cases of treatment of familial myxoma, the need for reoperations can reach 20–25%. It should be taken into account that among all benign cardiac tumors, CM is detected in up to 80% of cases, and the need for its surgical removal is beyond doubt.
 The aim. To present a case that is of particular interest due to an unusual multiple myxomas lesion of the heart of multi-chamber localization.
 Material and methods. This article presents an unusual case of detecting multiple myxomas of multi-cameral heart lesions 6 years after removal of myxoma of the left atrium of typical localization. The distinguishing feature of the course of the disease lies in the fact that in this case, a careful study of the life history did not reveal the characteristic signs of familial myxomas and Carney complex which is most often characteristic of multi-chamber lesions of the heart by a tumor process. At the same time, during the surgical removal of the myxoma of the left ventricle, the myxomas of the left and right atrium were revealed, which began to grow. A technical feature of the removal of the left ventricular myxoma of the apical localization was the use of video cameras and instruments for thoracoscopic surgery, which greatly facilitated revi-sion and removal of the hard-to-reach neoplasm. Our experience in surgical treatment of CM equals to 868 operations. Wherein, repeated operations performed in 12 patients were due to recurrence or appearance of a tumor in place other than the primary localization.
 Conclusions. CM recurrence is one of infrequent complications in the postoperative period, which, however, requires some vigilance and annual Echo monitoring. In the vast majority of cases, CM was represented by the so-called sporadic myxomas, which are more often localized in the left atrium, and rarely recur. If CM is suspected, it is necessary to exclude the possibility of “myxoma syndrome”, which has the frequency of 0.8%, according to our data. The use of the instruments for thoracoscopic surgery can greatly facilitate the removal of hard-to-reach heart tumors localization.

Imaging features of Carney complex with external auditory canal myxoma.

A 46-year-old man, with Carney complex (CC) and a history of recurrent atrial and ventricular myxomas, experienced left ear fullness for 18 months. He complained of hearing difficulties, temporarily resolved by ear canal manipulation, with no vestibular symptoms, earache or ear drainage. The patient also had a family history of cardiac myxoma and biochemical evidence of adrenal cortex autonomy. Physical examination and dedicated head and neck imaging showed a nearly occlusive soft tissue nodule in the left external auditory canal (Fig. 1A and B). Surgical resection and histopathologic examination revealed a myxoma (Fig. 1C). CC is a rare genetic syndrome related to inactivating mutation, either of random occurrence or from autosomal dominant transmission, of the protein kinase A (PRKAR1A) located on chromosome 17. CC is characterized by cardiac myxoma (Fig. 2A and B), cutaneous or mucosal myxoma, lentiginosis, multiple blue nevi, endocrinopathies with dominant...

Carney Complex With Endocrine Involvement Isolated to the Thyroid Gland

Abstract Introduction: Carney complex is a rare autosomal dominant disorder characterized by pigmented lesions of skin and mucosae, endocrine neoplasms or overactivity, and myxomas of the heart, skin, and other organs. Most patients have at least two affected endocrine organs at time of diagnosis. We present a case of Carney complex with endocrine involvement limited to the thyroid gland. Case: A 48-year-old female was referred for evaluation of thyroid nodules incidentally discovered on imaging for submandibular salivary gland swelling. Ultrasound evaluation of the thyroid revealed numerous, bilateral nodules that were mostly cystic or spongiform, though some had irregular borders and microcalcifications. A brother with Carney complex had been diagnosed with papillary carcinoma, and the patient decided to undergo thyroidectomy. Fortunately, no thyroid carcinoma was found on postsurgical histopathology. Initial biochemical evaluation showed no evidence of hypercortisolemia (8 AM cortisol 1.7 mcg/dL on 1 mg dexamethasone suppression test; 24-h urine cortisol 26.1 mcg [reference: 4-50]), growth hormone excess (IGF-1 190 ng/mL [reference: 52-328]), or hyperprolactinemia (prolactin 10 ng/mL [reference: 2.74-26.72]). Imaging showed no pituitary or adrenal masses. The patient underwent total hysterectomy with bilateral salpingo-oophorectomy for endometrial cancer prior to referral. She was diagnosed with Carney complex at age 19 years, and her manifestations included atrial and ventricular myxomas, intraductal adenoma of the breast, multiple skin lesions (lentigines, blue nevi, and cutaneous myxomas), and myxomas of the external auditory canals. She is in a Carney complex kindred that includes her mother, two brothers, and a niece. Discussion: Carney complex is usually caused by inactivating mutations or large deletions in the protein kinase A type I alpha regulatory subunit (PRKAR1A) gene located on chromosome 17q22-24. Most mutations are inherited in an autosomal dominant manner, though approximately 30% of cases are due to de novo mutations. In a review of 365 cases, the median age at diagnosis was 20 years. Growth hormone adenomas or somatomammotroph hyperplasia occurs in approximately 75% of patients, and most have at least one additional endocrine abnormality including multinodular goiter, primary pigmented nodular adrenocortical hyperplasia, and testicular or ovarian masses. There is an approximately 10% chance of developing well differentiated thyroid carcinoma. Treatment for Carney complex is individualized depending on the patient’s presentation and includes excision or surgical removal of myxomas, neoplasms, and skin lesions, as well as regular evaluation for cardiac myxomas and endocrine overactivity. This case of Carney complex is unusual because the only endocrinopathy is multinodular goiter.

Giant right ventricular myxoma presenting as right heart failure with systemic congestion: a rare case report

BackgroundMyxoma is an uncommon disease and its symptoms vary greatly depending on size, location and mobility. Right-sided myxoma, especially right ventricular myxoma, is much rarer, and the symptoms are alien and uncharacteristic. The lack of understandings poses challenges to prompt diagnosis and timely treatment.Case presentationA 44-year-old female patient was diagnosed with giant right ventricular tumor. Right heart failure and systemic congestion caused by right ventricular outflow tract obstruction were observed on this case. Surgery was performed to excise the mass which was measured at 9.5 * 5.0 cm and confirmed as myxoma pathologically.ConclusionsRight-side myxoma is easy to be unnoticed due to its low incident rate and atypical symptoms. Delay in surgical intervention might cause unrecoverable complications. More comprehensive understanding of the symptoms is expected to help improving the diagnose and treat of right-sided myxoma.

Multidisciplinary Approach to Right Ventricular Myxoma.

Right ventricular (RV) myxoma that obstructs the RV outflow tract is rare. Multimodality imaging is crucial due to the curved and triangular shape of the RV anatomy. Incomplete resection by the right atrial approach in cardiac myxomas may be prevented by preoperative imaging with echocardiography, computed tomography and magnetic resonance imaging to provide detailed visualization. Right ventriculotomy may be an alternative approach to the isolated atrial approach to get complete resection of RV myxoma in suitable patients. The preferred surgical treatment is not well defined for ventricular myxomas and careful preoperative planning is essential. Surgical resection should be performed as soon as possible to avoid outflow tract obstruction, which might result in sudden death. The collaboration between cardiologist and heart surgeon and the effective use of imaging tools are essential for successful treatment. In this article, diagnosis and treatment and the heart team approach to RV myxoma are discussed with a demonstrative patient.

A case of left ventricular myxoma with acute basilar artery occlusion detected by mechanical thrombectomy

A case of left ventricular myxoma with acute basilar artery occlusion detected by mechanical thrombectomy

Heart myxoma develops oncogenic and metastatic phenotype

Heart myxomas have been frequently considered as benign lesions associated with Carney's complex. However, after surgical removal, myxomas re-emerge causing dysfunctional heart. To identify whether cardiac myxomas may develop a metastatic phenotype as occurs in malignant cancers, a profile of several proteins involved in malignancy such as oncogenes (c-MYC, K-RAS and H-RAS), cancer-associated metabolic transcriptional factors (HIF-1α, p53 and PPAR-γ) and epithelial-mesenchymal transition proteins (fibronectin, vimentin, β-catenin, SNAIL and MMP-9) were evaluated in seven samples from a cohort of patients with atrial and ventricular myxomas. The analysis was also performed in: (1) cardiac tissue surrounding the area where myxoma was removed; (2) non-cancer heart tissue (NCHT); and (3) malignant triple negative breast cancer biopsies for comparative purposes. Statistical analysis applying univariate (Kruskal-Wallis and Dunn's tests) and multivariate analyses (PCA, principal component analysis) revealed that heart myxomas (7-15 times) and myxoma surrounding tissue (22-99 times) vs. NCHT showed high content of c-MYC, p53, vimentin, and HIF-1α, indicating that both myxoma and its surrounding area express oncogenes and malignancy-related proteins as occurs in triple negative breast cancer. Based on ROC (receiver operating characteristics) statistical analysis, c-MYC, HIF-1α, p53, and vimentin may be considered potential biomarkers for malignancy detection in myxoma.

Rare Cause of Chest Pain in Young Patient: Left Ventricular Myxoma

Rare Cause of Chest Pain in Young Patient: Left Ventricular Myxoma

Inverted Yoga and Near Syncope: An Unusual Diagnosis of Right Ventricular Myxoma

Primary cardiac tumors are extremely rare and are difficult to diagnose. Although usually benign in nature, myxomas require surgical resection due to their increased risk of embolic and cardiac complications, with the timing of resection dependent on the presentation and size of the tumor. However, if diagnosed early, patients with primary benign cardiac tumors have excellent prognosis following surgery. Therefore, a high index of suspicion and a wide differential diagnosis are very important in detecting rare conditions that can affect otherwise healthy individuals. We present an uncommon case of a right ventricular myxoma that was discovered when the patient was performing inverted yoga and experienced a near syncopal episode. Patient subsequently underwent an echocardiographic evaluation and was found to have a right ventricular myxoma that was excised. Although recurrence is rare, it is important for physicians to remain vigilant and continue careful and consistent follow-up for patients with a history of a cardiac myxoma.

Right Ventricular Myxoma in an Asymptomatic Patient: A Rare Case Report

Right Ventricular Myxoma in an Asymptomatic Patient: A Rare Case Report