Comparison of Clinical and Echocardiographic Characteristics between Cardiac Myxomas and Masses Mimicking Myxoma

Sun Hwa Lee,Joon Sung Park,Jae-Hyeong Park,Jung Yeon Chin,Won-Sik Yoon,Hyung Yoon Kim,Jae Yeong Cho,Kye Hun Kim,Won-Ho Kim 대한심장학회 2020 Korean Circulation Journal Vol.50 No.9

Background and Objectives: Cardiac myxoma is the most frequent benign cardiac tumor that can result in cardiac and systemic symptoms. We investigated clinical and echocardiographic characteristics of patients with cardiac masses suggesting myxoma. Methods: We investigated 265 consecutive patients with an echocardiographic diagnosis of cardiac myxomas in 4 teaching hospitals in Korea. Results: The mean age was 61±16 years and 169 patients (63.8%) were female. The most frequent referral reason for echocardiography was an evaluation of cardiac symptoms (43.4%). Tumors were incidentally detected in 82 patients (30.9%). Left atrium (LA) was the most frequently involved site (84.5%) and 19 patients (7.2%) had non-atrial tumors. The mean tumor size was 38.7×26.0 mm (range, 4–96 mm). Of 186 patients (70.2%) who had pathological diagnosis, 174 (93.5%) were confirmed with myxoma, 8 (4.3%) with other tumors and 4 (2.2%) with thrombi. Compared to myxoma, smaller size (20.4×12.6 mm vs. 41.4×27.6 mm, p<0.01) and non-LA location (87.5% vs. 10.5%, p<0.001) were associated with non-myxoma tumors, and more frequent atrial fibrillation (AF, 75.0% vs. 7.0%, p<0.001) and larger LA diameter (55.0±14.6 mm vs. 41.3±7.7 mm, p=0.001) were related to thrombi. Conclusions: Of 265 patients with an echocardiographic diagnosis with cardiac myxomas, 174 (65.7%) were surgically confirmed with myxomas. Compared with cardiac myxoma, other tumors were smaller and more frequently found in non-atrial sites. Thrombi were associated with AF and larger LA diameter.

심장 점액종에서 인터루킨-4, 인터루킨-6 및 종양괴사인자의 발현에 관한 면역조직화학적 연구

조민선,조수연,김미정,김성숙,한운섭,서정욱 대한병리학회 1995 Journal of Pathology and Translational Medicine Vol.29 No.5

Infected Left Atrial Myxoma Presenting Without Bacterial Growth on Blood Cultures: A Case Report

Kim Shi A,Pyo WonKyung,Jung Sung-Ho 대한흉부외과학회 2023 Journal of Chest Surgery (J Chest Surg) Vol.56 No.2

Although cardiac myxoma is one of the most common types of benign cardiac tumors, infected cardiac myxoma is very infrequent. The diagnosis of infected cardiac myxoma may be challenging because the presenting symptoms are non-specific and established management guidelines are lacking. This report describes a 39-year-old woman with a 5-month history of uncontrolled fever, chills, and myalgia who was diagnosed with myxoma and underwent mass excision. Although blood and urine cultures were negative for growing bacteria, a pathologic examination showed that the excised mass was a left atrial myxoma, with pan-bacterial polymerase chain reaction (PCR) of the surgical specimen revealing Haemophilus parainfluenzae at 99.87%, resulting in a diagnosis of infected cardiac myxoma. Laboratory tests, such as PCR, may supplement culture results in the diagnosis of infected cardiac myxoma.

심장 점액종에 의한 중심망막동맥폐쇄 1예

김준오(Jun o Kim),최인호(In Ho Choi),최경식(Kyung Seek Choi) 대한안과학회 2017 대한안과학회지 Vol.58 No.4

목적: 중심망막동맥폐쇄 진단 후에 심장점액종이 발견되어 흉부외과에서 수술적 제거 후 경과관찰 중인 1예를 보고하고자 한다. 증례요약: 47세 여자 환자가 갑작스럽게 발생한 좌안의 시력저하를 주소로 안과에 내원하였다. 내원 당시 좌안 시력 안전수동, 안압 15.4 mmHg 측정되었으며, 좌안에 상대적 구심동공운동 장애가 관찰되었다. 안저검사에서 앵두반점 및 창백안저가 관찰되었으며, 빛간섭단층촬영검사상 황반부의 부종이 관찰되었다. 형광안저혈관조영에서 초기 및 후기에 맥락막 및 망막 혈관의 혈류 충만 장애 소견이 관찰되었고, 이를 바탕으로 좌안의 중심망막동맥폐쇄로 진단하였다. 신경외과에서 시행한 뇌혈관조영술에서 안동맥은 정상적으로 조영되었고, 혈관폐쇄는 관찰되지 않았다. 동맥폐쇄의 원인을 찾기 위해 심장내과와 신경과에 의뢰하였고, 심장초음파검사에서 좌심방에 4.46 × 2.09 cm의 심장점액종이 발견되었으며, 뇌 자기공명영상검사 후 급성 뇌경색을 진단하였다. 보존적 치료를 시행하며, 급성기 뇌경색 치료로 전신적 혈전 용해제를 사용하였고 흉부외과에서 좌심방점액종 절제술을 시행하였다. 심장점액종 절제술 시행 후 1개월째 시행한 형광안저혈관조영술상 망막의 혈액순환이 호전되었으나 시력은 개선되지 않았고, 3개월째 시행한 빛간섭단층촬영에서 황반부 부종은 감소했으나 망막층의 위축과 망막전막이 관찰되었다. 결론: 중심망막동맥폐쇄는 눈뿐만 아니라 전신적 질환을 함께 고려해야 하는 질병이다. 고혈압이나 심장질환, 당뇨 및 경동맥협착 등의 다양한 기저질환이 중심망막동맥폐쇄의 원인으로 알려져 있으며, 저자들은 심장점액종에 의해 망막중심동맥이 폐쇄된 증례를 경험하였기에 이를 보고하고자 한다. Purpose: We report the case of a patient diagnosed with central retinal artery occlusion caused by cardiac myxoma who underwent surgery to remove the myxoma. Case summary: A 47-year-old woman came to our clinic presenting with a sudden decrease of visual acuity in the left eye. At the first visit, left eye visual acuity was hand motion, and intraocular pressure was 15.4 mmHg. A relative afferent pupillary defect was observed in the left eye. On fundus examination, a pale retina and cherry-red spot were observed at the posterior pole. On optical coherence tomography, macular edema was found. On fluorescein angiography and indocyanine green angiography, delayed blood circulation of the retina and choroid was found at early and late stages. Cerebral angiography was performed in the neurosurgery department and showed no occlusion of the ophthalmic artery. Cardiac ultrasonography and brain magnetic resonance imaging were performed. On cardiac ultrasonography, 4.46 × 2.09 cm cardiac myxoma was found. Resection of the cardiac myxoma was conducted in the thoracic and cardiovascular surgery department. Multiple cerebral infarcts were detected by brain imaging, and antithrombotic treatment was administered. After one month, blood circulation in the retina and choroid was observed in fluorescence angiography, but there was no improvement of visual acuity. At the 3-month follow-up visit, macular edema was decreased, but retinal atrophy and epiretinal membrane were observed on optical coherence tomography. Conclusions: Central retinal artery occlusion is a disease related to one’s general condition. We experienced this case of central retinal artery occlusion caused by cardiac myxoma.

Case Reports : Cardiac Myxoma Diagnosed by Signs of Purpuric Macules on Both Palms and Soles

( Hyo Jin Lee ),( Jeung Young Park ),( Young Sik Kim ),( Dong Hoon Shin ),( Jong Soo Choi ),( Ki Hong Kim ),( Young Kyung Bae ) 대한피부과학회 2012 Annals of Dermatology Vol.24 No.3

Cardiac myxoma, the most prevalent primary cardiac tumor, is rare. The clinical features of this tumor are principally intracardiac obstruction, extracardiac embolism, and general symptoms including fever, myalgia, arthralgia. Although cutaneous manifestations in patients with cardiac myxoma are frequent, in rare cases, cutaneous signs have been clues to the correct diagnosis. We report a 42-year-old male who presented with recurrent multiple purpuric patches on both palms and soles for 4 months. Histopathological finding showed a myxomatous embolus in the arteriole in the lower dermis. Echocardiogram demonstrated the presence of a left atrial myxoma with a provisional diagnosis of left atrial myxoma. In our patient, skin examinations and histopatho-logical finding led us to the diagnosis of cardiac myxoma.

Multi Modality Imaging Features of Cardiac Myxoma

Brylie J. McAllister 한국심초음파학회 2020 Journal of Cardiovascular Imaging (J Cardiovasc Im Vol.28 No.4

Primary cardiac neoplasms are rare entities of which approximately 75% are benign and the remaining 25% malignant. Myxomas are the most common benign primary cardiac tumor (30%) and most commonly arise in the left atrium from the interatrial septum at the fossa ovalis. However, they also can originate in any cardiac chamber. Clinical presentation and patient symptomatology are determined by size, location, and mobility of the myxoma. This review will discuss the clinical presentation, natural history, pathology, and multimodality imaging features of cardiac myxomas.

Delayed Cerebral Metastases from Completely Resected Cardiac Myxoma: Case Report and Review of Literature

김아현,이재욱,이미경,윤평호,김민정 대한자기공명의과학회 2011 Investigative Magnetic Resonance Imaging Vol.15 No.2

Cardiac myxoma is the most common benign tumor of the heart. However, low incidence of recurrence and metastasis has been reported. A 49-year-old female patient was admitted in the hospital due to sudden onset of left side weakness. Magnetic resonance imaging (MRI) of brain showed multifocal areas of diffusion restriction on diffusion weighted images. Echocardiography was performed to evaluate the cause of embolic brain infarction and cardiac myxoma was found in the left atrium. The patient underwent complete excision of the mass. One year later, the patient was readmitted with symptoms of dysarthria. Brain MRI showed newly developed multiple hemorrhagic metastatic lesions. The patient underwent radiotherapy of the metastatic lesions. Although rare, cardiac myxoma can cause delayed metastasis. We report a rare case of delayed multiple cerebral metastases from the completely resected cardiac myxoma.

심장점액종으로 발생한 색전뇌경색의 특징적인 자기공명영상 소견

정지연,강현구,추인성,김후원,김진호,안성환 대한신경과학회 2016 대한신경과학회지 Vol.34 No.1

While cardiac myxoma is a rare cause of stroke, it needs to be considered so that it can be detect promptly. We report the magnetic resonance imaging (MRI) characteristics of three patients who were histologically confirmed as cardiac myxoma. MRI revealed multiple infarctions in bilateral hemispheres and hemorrhagic transformation including microbleeds and macrobleeds. If either petechial hemorrhage or microbleeds along the cortical border zone are identified in MRI of acute stroke patients, the possibility of cardiac myxoma should be considered.

급성 뇌경색과 말초색전증이 함께 발생한 심장점액종 환자

김재겸,반광현,조경희 대한신경과학회 2016 대한신경과학회지 Vol.34 No.1

There are rare reports of vascular complications in patients with cardiac myxoma, including both central and peripheral arterial thrombosis. We report on a patient with cerebral infarctions affecting multiple territories, which may have been related to cardiac myxoma. The patient also exhibited cyanosis of the hand. A diagnosis was made of peripheral artery occlusion with myxomatous emboli. A careful physical examination with suspicion of concomitant peripheral embolism is needed in patients with acute embolic stroke induced by cardiac myxoma.

Left Atrial Intramural Hematoma after Removal of Atrial Myxoma: Cardiac Magnetic Resonance in the Differential Diagnosis of Intra-Cardiac Mass

이희선,김형관,박은아,김경환,김용진,손대원 한국심초음파학회 2014 Journal of Cardiovascular Imaging (J Cardiovasc Im Vol.22 No.4

Left atrial (LA) dissection is a rare entity, which is, in most cases, observed after valvular intervention. Transesophagealechocardiography (TEE) is considered to be a modality of choice in the diagnosis of LA dissection. However, LA dissection mightbe missed clinically in the absence of significant hemodynamic changes, and moreover physicians are occasionally reluctant toperform TEE due to its semi-invasiveness. Recently, cardiac magnetic resonance (CMR) has been introduced as a modality toperform different roles to existing imaging modalities, such as echocardiography. Given that CMR can provide information ontissue characteristics, it may give incremental information to TEE. We here present a rare case of LA dissection following LAmyxoma removal, where CMR can make a correct diagnosis and guide management strategy.