1
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Yáñez-Castillo YM, Melgarejo-Segura MT, Morales-Martínez A, Ruiz-Ruiz SA, Arrabal-Polo MÁ. Paravesical aggressive angiomyxoma, a rare cause of pelvic tumor in men. Int Urol Nephrol 2024; 56:1649-1650. [PMID: 38133727 DOI: 10.1007/s11255-023-03921-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 12/10/2023] [Indexed: 12/23/2023]
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2
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Wu SJ, Shi QR. Pelvic aggressive angiomyxoma: A case report. Asian J Surg 2024; 47:2245-2246. [PMID: 38326110 DOI: 10.1016/j.asjsur.2024.01.135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 01/26/2024] [Indexed: 02/09/2024] Open
Affiliation(s)
- Si-Jia Wu
- Department of Gynaecology and Obstetrics, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, 362000, China
| | - Qi-Rong Shi
- Department of Gynaecology and Obstetrics, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, 362000, China.
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3
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Kondracki B, Olszewski K, Baczewski K. Giant and asymptomatic atrial myxoma: a rare case of heart tumor. Pol Arch Intern Med 2024; 134:16683. [PMID: 38380606 DOI: 10.20452/pamw.16683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Affiliation(s)
- Bartosz Kondracki
- Department of Cardiology, Medical University of Lublin, Lublin, Poland.
| | | | - Kamil Baczewski
- Department of Cardiac Surgery, Medical University of Lublin, Lublin, Poland
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4
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Silva RRP, Magalhães CJ, da Silva RSV, Rocha GAF, Cavalcanti PEF, Montenegro ST. Acute ST-Elevation Myocardial Infarction in a Young Adult: Rare Presentation of Giant Atrial Myxoma. Arq Bras Cardiol 2024; 121:e20230538. [PMID: 38655985 PMCID: PMC11081103 DOI: 10.36660/abc.20230538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 11/15/2023] [Accepted: 12/13/2023] [Indexed: 04/26/2024] Open
Abstract
Cardiac tumors are rare entities, among which atrial myxoma (AM) stands as the most frequent, accounting for approximately half of all reported cases. The incidence of AM is estimated to range from 0.001% to 0.3% within the general population, yet only about 0.06% of these cases present with coronary embolic events. We report on a 33-year-old male smoker who experienced acute, severe precordial pain radiating to the left upper limb, lasting for one hour. The electrocardiographic evaluation demonstrated ST-segment elevation in leads D2, D3, and aVF, alongside significantly elevated serum troponin levels, confirming a diagnosis of ST-segment elevation myocardial infarction (STEMI). Subsequent coronary angiography revealed proximal occlusion of the right coronary artery due to thrombus. An initial attempt of thrombus aspiration was unsuccessful, followed by primary angioplasty with balloon inflation without stent placement. Further diagnostic exploration through transthoracic echocardiography identified a homogenous, smooth-surfaced mass measuring 5.2 cm x 2.3 cm attached to the interatrial septum. This mass, characterized by lobulations, prolapsed into the mitral valve and left ventricle during diastole, consistent with AM. Surgical resection of the mass was successfully performed, with the patient being discharged asymptomatic. In the reported case, the patient's profile, notably his age, and gender, diverges from the typical epidemiological characteristics associated with AM. This case adds to the limited number of reports where the inferior wall is affected by the right coronary artery being occluded. This report emphasizes the significance of differential diagnoses in younger patients presenting with STEMI.
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Affiliation(s)
- Rodrigo Rufino Pereira Silva
- Pronto Socorro Cardiológico de Pernambuco Professor Luiz TavaresRecifePEBrasilPronto Socorro Cardiológico de Pernambuco Professor Luiz Tavares (PROCAPE), Recife, PE – Brasil
- Universidade de PernambucoRecifePEBrasilUniversidade de Pernambuco (UPE), Recife, PE – Brasil
| | - Carolina Jerônimo Magalhães
- Pronto Socorro Cardiológico de Pernambuco Professor Luiz TavaresRecifePEBrasilPronto Socorro Cardiológico de Pernambuco Professor Luiz Tavares (PROCAPE), Recife, PE – Brasil
- Universidade de PernambucoRecifePEBrasilUniversidade de Pernambuco (UPE), Recife, PE – Brasil
| | - Rafael Silvestre Vieira da Silva
- Pronto Socorro Cardiológico de Pernambuco Professor Luiz TavaresRecifePEBrasilPronto Socorro Cardiológico de Pernambuco Professor Luiz Tavares (PROCAPE), Recife, PE – Brasil
- Universidade de PernambucoRecifePEBrasilUniversidade de Pernambuco (UPE), Recife, PE – Brasil
| | | | - Paulo Ernando Ferraz Cavalcanti
- Pronto Socorro Cardiológico de Pernambuco Professor Luiz TavaresRecifePEBrasilPronto Socorro Cardiológico de Pernambuco Professor Luiz Tavares (PROCAPE), Recife, PE – Brasil
- Universidade de PernambucoRecifePEBrasilUniversidade de Pernambuco (UPE), Recife, PE – Brasil
| | - Sérgio Tavares Montenegro
- Pronto Socorro Cardiológico de Pernambuco Professor Luiz TavaresRecifePEBrasilPronto Socorro Cardiológico de Pernambuco Professor Luiz Tavares (PROCAPE), Recife, PE – Brasil
- Universidade de PernambucoRecifePEBrasilUniversidade de Pernambuco (UPE), Recife, PE – Brasil
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5
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Sakakibara S, Yamauchi T, Ohmori T. A surgical resection case of myxoma arising from the posterior wall of the left atrium complicated with complete atrioventricular block. J Cardiothorac Surg 2024; 19:229. [PMID: 38627746 PMCID: PMC11020980 DOI: 10.1186/s13019-024-02715-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 03/29/2024] [Indexed: 04/19/2024] Open
Abstract
An 80-year-old female was referred to our institution due to transient right upper limb weakness. Transthoracic and transesophageal echocardiography revealed a tumor in the left atrium. The tumor was attached to the posterior wall of the left atrium near the atrioventricular node. Intraoperative pathological examination revealed that the tumor was a myxoma, and complete resection was successfully performed. However, she experienced persistent complete atrioventricular block postoperatively and required pacemaker implantation.
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Affiliation(s)
- Satoshi Sakakibara
- Department of Cardiovascular Surgery, Higashiosaka City Medical Center, 3-4-5 Nishi iwata, Higashiosaka, 578-8588, Osaka, Japan
| | - Takashi Yamauchi
- Department of Cardiovascular Surgery, Higashiosaka City Medical Center, 3-4-5 Nishi iwata, Higashiosaka, 578-8588, Osaka, Japan.
| | - Takahiro Ohmori
- Department of Cardiovascular Surgery, Higashiosaka City Medical Center, 3-4-5 Nishi iwata, Higashiosaka, 578-8588, Osaka, Japan
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6
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Rana AD, Vallurupalli S, Mitchell M, Duncan D, Xu J. All that Doesn't Enhance Isn't a Thrombus: Pitfalls Using Cardiac MRI TI 600 Sequence to Distinguish Between Cardiac Thrombus Versus Myxoma. Methodist Debakey Cardiovasc J 2024; 20:23-25. [PMID: 38618609 PMCID: PMC11011946 DOI: 10.14797/mdcvj.1322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Accepted: 12/15/2023] [Indexed: 04/16/2024] Open
Abstract
A 51-year-old male with a complicated medical history presented with shortness of breath. Preoperative workup confirmed the presence of a large atrial mass. However, delayed gadolinium enhancement CMR with long inversion time (TI 600) showed lack of enhancement, which was suggestive of a thrombus. During cardiac magnetic resonance imaging, delayed gadolinium enhancement sequences with long inversion time (TI 600) are commonly used to distinguish between an avascular thrombus versus a vascular tumor.
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Affiliation(s)
- Aakash D. Rana
- Central Arkansas Veteran Affairs Health System, Little Rock, Arkansas, US
| | | | - Mark Mitchell
- Novant Health Forsyth Medical Center, Winston-Salem, North Carolina, US
| | - David Duncan
- Novant Health Forsyth Medical Center, Winston-Salem, North Carolina, US
| | - Jack Xu
- Novant Health Forsyth Medical Center, Winston-Salem, North Carolina, US
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7
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Yano K, Yoneda A, Ohta Y, Kaneshiro Y. Carpal Tunnel Syndrome Caused by a Juxta-articular Myxoma: A Case Report. J Hand Surg Asian Pac Vol 2024; 29:152-155. [PMID: 38494160 DOI: 10.1142/s2424835524720056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
Juxta-articular myxoma (JAM) is a rare soft tissue tumour predominantly composed of mucinous tissue and usually found around large joints. We report a 73-year-old woman with a 5-year history of a soft tissue mass in the thenar eminence of the right wrist who presented to our department. An initial diagnosis of a ganglion cyst was made using magnetic resonance imaging (MRI) and the jellied content of the mass by aspiration. Two years after presentation, surgical treatment with tumour resection and carpal tunnel release via the radial approach was performed because the symptoms of carpal tunnel syndrome worsened, and the tumour invaded the carpal tunnel. Histopathological examination revealed a JAM. At the 1-year follow-up, the symptoms of carpal tunnel syndrome had resolved, and no recurrence was confirmed by MRI. Level of Evidence: Level V (Therapeutic).
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Affiliation(s)
- Koichi Yano
- Department of Orthopaedic Surgery, Seikeikai Hospital, Osaka, Japan
| | - Akira Yoneda
- Department of Orthopaedic Surgery, Seikeikai Hospital, Osaka, Japan
| | - Yoshio Ohta
- Department of Diagnostic Pathology, Izumi City General Hospital, Osaka, Japan
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8
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Liang C, Feng L, Shunlin G. A rare case of massive myxoma. Asian J Surg 2024; 47:1785-1786. [PMID: 38160155 DOI: 10.1016/j.asjsur.2023.12.117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 12/04/2023] [Accepted: 12/15/2023] [Indexed: 01/03/2024] Open
Affiliation(s)
- Cao Liang
- Department of Radiology, The First Hospital of Lanzhou University, Lanzhou, 730000, China
| | - Liu Feng
- The First Clinical Medical College, Lanzhou University, Lanzhou, 730000, China
| | - Guo Shunlin
- Department of Radiology, The First Hospital of Lanzhou University, Lanzhou, 730000, China.
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9
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Lee HJ, Kim H, Song K. Left atrial myxoma presenting as a mass with cystic component. Echocardiography 2024; 41:e15814. [PMID: 38581303 DOI: 10.1111/echo.15814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 03/29/2024] [Accepted: 03/30/2024] [Indexed: 04/08/2024] Open
Affiliation(s)
- Hee Jeong Lee
- Department of Cardiology, Keimyung University Dongsan Hospital, Keimyung University College of Medicine, Daegu, Republic of Korea
| | - Hyungseop Kim
- Department of Cardiology, Keimyung University Dongsan Hospital, Keimyung University College of Medicine, Daegu, Republic of Korea
| | - Kyungsub Song
- Department of Thoracic and Cardiovascular Surgery, Keimyung University Dongsan Hospital, Keimyung University College of Medicine, Daegu, Republic of Korea
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10
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Bennani G, Atlas I, Zahri S, Haboub M, Drighil A, Habbal R. [Association of a myxoma of the left atrium and a mitral stenosis : About a case]. Ann Cardiol Angeiol (Paris) 2024; 73:101719. [PMID: 38266406 DOI: 10.1016/j.ancard.2023.101719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 10/28/2023] [Accepted: 12/06/2023] [Indexed: 01/26/2024]
Abstract
Atrial myxoma is a rare and benign clinical entity. It remains common in women and mainly affects the left atrium. Its clinical picture is polymorphic. We report the case of a 53-year-old woman who consulted for dyspnea with cardiac failure's picture. The diagnosis of myxoma of the left atrium was made on echocardiography which also objectified the existence of mitral stenosis. The patient underwent surgical excision and mitral valve replacement with good postoperative outcomes.
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Affiliation(s)
- G Bennani
- Service de cardiologie du CHU IBN ROCHD, Casablanca, Maroc.
| | - I Atlas
- Service de cardiologie du CHU IBN ROCHD, Casablanca, Maroc
| | - S Zahri
- Service de cardiologie du CHU IBN ROCHD, Casablanca, Maroc
| | - M Haboub
- Service de cardiologie du CHU IBN ROCHD, Casablanca, Maroc
| | - A Drighil
- Service de cardiologie du CHU IBN ROCHD, Casablanca, Maroc
| | - R Habbal
- Service de cardiologie du CHU IBN ROCHD, Casablanca, Maroc
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11
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Lancaster I, Hrobowski-Blackman T, Patel D, Chatoor L, Simon J, Willinger A. Left atrial myxoma with cardiogenic shock following a myocardial infarction: a case report. J Med Case Rep 2024; 18:151. [PMID: 38462621 PMCID: PMC10926659 DOI: 10.1186/s13256-024-04420-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 01/30/2024] [Indexed: 03/12/2024] Open
Abstract
BACKGROUND Myxomas are the most common primary cardiac tumor and typically originate in the left atrium. Atrial myxomas may present following complications of obstruction and emboli. If an atrial myxoma goes untreated, complications such as congestive heart failure, embolic stroke, and sudden death can occur. CASE PRESENTATION A 58-year-old Caucasian male presented following a cardiac arrest. He was taken emergently to the cardiac catheterization lab and received two drug eluting stents. Following the procedure, he was found to have a left atrial mass that was intermittently obstructing the mitral valve on echocardiography. After leaving the cardiac catheterization lab, he was hypotensive and placed on multiple intravenous medications for hemodynamic support as well as an Impella device. Following medical optimization, he underwent one vessel coronary artery bypass graft as well as surgical excision of the left atrial mass, which pathology had shown to be an atrial myxoma. CONCLUSION This patient's case of cardiogenic shock following revascularization was complicated by the identification of an atrial myxoma, which, when large enough, can obstruct blood flow through the mitral valve leading to acute mitral dynamic stenosis. This condition results in circulatory collapse due to obstruction of the left ventricle in diastole as the myxoma occludes the mitral valve.
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Affiliation(s)
- Ian Lancaster
- HCA Healthcare/USF Morsani College of Medicine GME Programs, Largo Medical Center, 201 14Th St SW, Largo, FL, 33770, USA.
| | - Tara Hrobowski-Blackman
- HCA Healthcare/USF Morsani College of Medicine GME Programs, Largo Medical Center, 201 14Th St SW, Largo, FL, 33770, USA
| | - Deep Patel
- HCA Healthcare/USF Morsani College of Medicine GME Programs, Largo Medical Center, 201 14Th St SW, Largo, FL, 33770, USA
| | - Lubna Chatoor
- HCA Healthcare/USF Morsani College of Medicine GME Programs, Largo Medical Center, 201 14Th St SW, Largo, FL, 33770, USA
| | - Joshini Simon
- HCA Healthcare/USF Morsani College of Medicine GME Programs, Largo Medical Center, 201 14Th St SW, Largo, FL, 33770, USA
| | - Andrew Willinger
- HCA Healthcare/USF Morsani College of Medicine GME Programs, Largo Medical Center, 201 14Th St SW, Largo, FL, 33770, USA
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12
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Shahbuddin HMAW, Hussin SA, W Isa WYH, Mamat AZ, Marzuki A, Yusof Z. Dizzy spells in pregnancy: successful antenatal removal of a huge left atrial myxoma with mitral valve obstruction. BMJ Case Rep 2024; 17:e259675. [PMID: 38453227 PMCID: PMC10921428 DOI: 10.1136/bcr-2024-259675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2024] Open
Abstract
Diagnosing atrial myxoma in pregnancy is challenging because patients may present with non-specific symptoms that might be overlooked. The timing of non-obstetric operation usually depends on the nature of the disease, after careful consideration of feto-maternal safety, including the use of cardiopulmonary bypass and placental transfer of anaesthetic drug. A woman in her 30s at 18 weeks of pregnancy presented with recurring dizziness. She underwent successful myxoma excision at 20 weeks under general anaesthesia and cardiopulmonary bypass. The 6×5 cm myxoma was histologically confirmed as myxoma. Early detection of atrial myxoma in pregnancy is crucial, and a clinician has to consider the diagnosis of left atrial myxoma with mitral valve obstruction as a cause of severe dizziness. Optimal outcomes require multidisciplinary management. In this case, surgery during the second trimester of pregnancy enabled a full-term pregnancy with the patient's and foetal well-being and normal postprocedural echocardiography.
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Affiliation(s)
| | - Siti Aisyah Hussin
- Cardiology Unit, Hospital Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
- School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kota Bharu, Kelantan, Malaysia
| | - W Yus Haniff W Isa
- Cardiology Unit, Hospital Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
- School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kota Bharu, Kelantan, Malaysia
| | - Ahmad Zuhdi Mamat
- School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kota Bharu, Kelantan, Malaysia
- Cardiothoracic Surgery Unit, Hospital Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
| | - Ariffin Marzuki
- School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kota Bharu, Kelantan, Malaysia
- Department of Anaesthesia and Intensive Care, Hospital Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
| | - Zurkurnai Yusof
- Cardiology Unit, Hospital Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
- School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kota Bharu, Kelantan, Malaysia
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Bandlamuri S, Custozzo A, Silva J, Bandlamuri SK, Qian J, Paul AR. Systematic Review and Case of Thrombectomy for Pediatric Stroke Due to Myxoma Embolism. World Neurosurg 2024; 183:e761-e771. [PMID: 38211812 DOI: 10.1016/j.wneu.2024.01.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 01/04/2024] [Indexed: 01/13/2024]
Abstract
BACKGROUND Stroke presentation secondary to a cardiac myxoma thromboembolism is rare in the pediatric population. Because of such rarity, the reported cases in the literature are primarily case reports. Additionally, general pediatric stroke management lacks evidence-based guidelines because of its low incidence and lack of clinical trials. In pediatric strokes identified from a cardiac myxoma, the incidence favors boys with the classical presentation of unilateral weakness and aphasia. We present a pediatric patient who presented with strokelike symptoms secondary to an intracranial embolus from a previously undiagnosed cardiac myxoma. METHODS We performed a systematic review by searching PubMed, Google Scholar, Web of Science, and Embase databases for cases of pediatric myxoma causing stroke (n = 2431) and identified 19 reported uses of surgical management in treating pediatric patients who present with stroke symptoms secondary to a cardiac myxoma thromboembolism. RESULTS The most common imaging modality was magnetic resonance imaging in 42% of cases, computed tomography in 36.8%, followed by computed tomography angiography in 31.6% of cases. Of these 19 children treated with procedures, 36.8% of pediatric patients aged between 4 and 14 years underwent neurosurgery (n = 7). CONCLUSIONS We describe an urgent mechanical thrombectomy and share preoperative and postoperative images and pathology slides confirming a stroke from myxoma origin. We provide added insight in the safe use of mechanical thrombectomy as treatment for pediatric strokes secondary to a thromboembolism.
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Affiliation(s)
- Sruti Bandlamuri
- Department of Neurosurgery, Albany Medical Center, Albany, New York, USA
| | - Amanda Custozzo
- Department of Neurosurgery, Albany Medical Center, Albany, New York, USA
| | - Jonathan Silva
- Department of Neurosurgery, Albany Medical Center, Albany, New York, USA
| | | | - Jiang Qian
- Department of Pathology and Laboratory Medicine, Albany Medical Center, Albany, New York, USA
| | - Alexandra R Paul
- Department of Neurosurgery, Albany Medical Center, Albany, New York, USA.
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An KR, Marshall TC, Cusimano RJ. Vasculitic rash and cerebral emboli in an adolescent with left atrial myxoma. BMJ Case Rep 2024; 17:e258822. [PMID: 38417930 PMCID: PMC10900332 DOI: 10.1136/bcr-2023-258822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2024] Open
Abstract
A previously healthy woman in late adolescence presented to the emergency department with stroke-like symptoms following a two-month history of bilateral foot pain and oedema, accompanied by a macular rash and progressive lower extremity weakness. On further investigation, she was found to have multiple cerebral emboli and a left atrial myxoma fixed to the interatrial septum. The patient subsequently underwent urgent surgical excision of the myxoma. On follow-up, her cutaneous and neurological symptoms were significantly improved. This case suggests that, in the presence of a vasculitic rash without evident or obvious cause, cardiac myxoma should be included in the differential diagnosis.
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Affiliation(s)
- Kevin R An
- Division of Cardiac Surgery, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Terrel C Marshall
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Robert J Cusimano
- Division of Cardiac Surgery, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada
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15
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Qu Y, Li L, Deng M, Song D, Gao M, Su G. Considerations and anesthetic management of a patient with giant right atrial myxoma: A case report and literature review. Medicine (Baltimore) 2024; 103:e37141. [PMID: 38363890 PMCID: PMC10869086 DOI: 10.1097/md.0000000000037141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 01/11/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND Myxoma is a common type of primary cardiac tumor. However, there are few researches to illustrate challenge of safely inducing anesthesia in a patient with a giant right atrial myxoma at moderate altitude. PATIENT CONCERNS AND DIAGNOSES A 54-year-old female patient lived in a city with an average altitude of 1932 m with scheduled surgical treatment for giant right atrial myxoma, prompting discussions on appropriate anesthesia modalities given her prolonged residence at moderate altitude. METHODS AND RESULTS Considering the potential impact of moderate altitude on perioperative management, this study emphasizes the necessity of adequate volume preload therapy and the utility of transthoracic echocardiography or transesophageal echocardiography to prevent hemodynamic compromise. Furthermore, it highlights the unique consideration that, post-tumor removal, hypotension may not necessarily lead to decreased oxygen saturation in these patients. CONCLUSION This case underscores the importance of avoiding hypotension, as pre-tumor resection blood pressure maintenance primarily determines blood oxygen concentration. Additionally, it sheds light on the intriguing observation that post-tumor removal hypotension may not result in decreased oxygen saturation. These findings have significant implications for the perioperative care of patients with giant right atrial myxoma at moderate altitudes.
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Affiliation(s)
- Yan Qu
- Department of Anesthesiology, Affiliated Hospital of Yunnan University, Kunming, Yunnan, PR China
| | - Lei Li
- Department of Radiology, Affiliated Hospital of Yunnan University, Kunming, Yunnan, PR China
| | - Min Deng
- Department of Anesthesiology, Affiliated Hospital of Yunnan University, Kunming, Yunnan, PR China
| | - Duanyi Song
- Department of Anesthesiology, Affiliated Hospital of Yunnan University, Kunming, Yunnan, PR China
| | - Min Gao
- Department of Anesthesiology, Affiliated Hospital of Yunnan University, Kunming, Yunnan, PR China
| | - Guoning Su
- Department of Anesthesiology, Affiliated Hospital of Yunnan University, Kunming, Yunnan, PR China
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16
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Potey K, Jhajhria N, Mallik M, Bhushan R, Aiyer P, Grover V. Our 10-Year Experience with Atrial Myxomas: Is Concurrent Valve Intervention Really Warranted? Braz J Cardiovasc Surg 2024; 39:e20230040. [PMID: 38315074 PMCID: PMC10836847 DOI: 10.21470/1678-9741-2023-0040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 06/06/2023] [Indexed: 02/07/2024] Open
Abstract
INTRODUCTION Primary cardiac myxomas are rare tumors. Concurrent valvular lesion is a common finding on evaluation which is thought to be due to annular dilatation secondary to tumor movement across the valve, functional obstruction across the valve, and severe pulmonary hypertension secondary to chronic obstruction. A common belief among surgeons is that excision of myxoma leads to abatement of symptoms, and further valve intervention may not be warranted. METHODS A 10-year retrospective descriptive study was designed to analyze patients who underwent excision of cardiac myxoma at our center. Data was analyzed regarding presenting features, echocardiographic findings of myxoma and valve morphology, intraoperative assessment, and postoperative outcome with/without valve repair/replacement in all patients. RESULTS A total of 22 patients underwent surgery for myxoma. Six patients underwent successful mitral valve repair with ring annuloplasty, two had moderate mitral regurgitation, three had severe mitral regurgitation, and one patient had no mitral regurgitation on preoperative assessment, but moderate mitral regurgitation was found intraoperatively. Four of these patients had no residual mitral regurgitation in follow-up period while two had mild residual mitral regurgitation. One patient had severe mitral stenosis of concurrent rheumatic etiology and successfully underwent mitral valve replacement. CONCLUSION Cardiac myxomas are rare benign tumors commonly associated with mitral valve insufficiency. Mitral valve should be assessed intraoperatively after excision of mass as preoperative assessment might often be insufficient. Concomitant mitral valve intervention might be needed with a case-specific tailored approach, and mitral valve repair with ring annuloplasty offers best surgical outcome in such cases.
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Affiliation(s)
- Ketika Potey
- Department of Cardiothoracic and Vascular Surgery, Dr Ram Manohar
Lohia Hospital and Post Graduate Institute of Medical Education and Research, New
Delhi, New Delhi, India
| | - Narender Jhajhria
- Department of Cardiothoracic and Vascular Surgery, Dr Ram Manohar
Lohia Hospital and Post Graduate Institute of Medical Education and Research, New
Delhi, New Delhi, India
| | - Manish Mallik
- Department of Cardiothoracic and Vascular Surgery, Dr Ram Manohar
Lohia Hospital and Post Graduate Institute of Medical Education and Research, New
Delhi, New Delhi, India
| | - Rahul Bhushan
- Department of Cardiothoracic and Vascular Surgery, Dr Ram Manohar
Lohia Hospital and Post Graduate Institute of Medical Education and Research, New
Delhi, New Delhi, India
| | - Palash Aiyer
- Department of Cardiothoracic and Vascular Surgery, Dr Ram Manohar
Lohia Hospital and Post Graduate Institute of Medical Education and Research, New
Delhi, New Delhi, India
| | - Vijay Grover
- Department of Cardiothoracic and Vascular Surgery, Dr Ram Manohar
Lohia Hospital and Post Graduate Institute of Medical Education and Research, New
Delhi, New Delhi, India
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Yang L, Xiao B, Xiao F, Hu P, Zheng S, Jing H. Myxoma with rich blood supply in the left atrium. Echocardiography 2024; 41:e15763. [PMID: 38411366 DOI: 10.1111/echo.15763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 01/10/2024] [Accepted: 01/10/2024] [Indexed: 02/28/2024] Open
Abstract
Cardiac myxoma is the most common primary benign cardiac tumors, mostly found in the left atrium. It was previously reported that the main component of myxoma was myxoid stroma riched in acid-mucopolysaccharide, the blood vessels in which were sparsely distributed, being characterized as hypovascular tumor by contrast echocardiography (CE) and computed tomography angiography (CTA). There are few reports of myxoma with rich blood supply and we report one in the left atrium.
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Affiliation(s)
- Lei Yang
- Department of Ultrasound, Renmin Hospital, Hubei University of Medicine, Shiyan, China
| | - Bin Xiao
- Department of Ultrasound, Renmin Hospital, Hubei University of Medicine, Shiyan, China
| | - Fei Xiao
- Department of Ultrasound, Renmin Hospital, Hubei University of Medicine, Shiyan, China
| | - Pei Hu
- Department of Ultrasound, Renmin Hospital, Hubei University of Medicine, Shiyan, China
| | - Shuang Zheng
- Department of Ultrasound, Renmin Hospital, Hubei University of Medicine, Shiyan, China
| | - Hongxia Jing
- Department of Ultrasound, Renmin Hospital, Hubei University of Medicine, Shiyan, China
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18
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Slootweg PJ. RE: Odontogenic Myxoma in a 17-month Old Child: A Case Report. J Oral Maxillofac Surg 2024; 82:5. [PMID: 38161068 DOI: 10.1016/j.joms.2023.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 10/06/2023] [Indexed: 01/03/2024]
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19
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Affiliation(s)
- Lin Tan
- Department of Gastroenterology, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, Hubei, 441000, China
| | - Zelin Zhang
- Department of Oncology, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, 441000, China
| | - Pin Cao
- Department of Oncology, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, 441000, China.
| | - Dongdong Zhang
- Department of Oncology, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, 441000, China.
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20
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Smet C, Martins AC, Costa T. Deep (aggressive) angiomyxoma of the vulva in a pregnant woman. BMJ Case Rep 2023; 16:e254564. [PMID: 38129079 DOI: 10.1136/bcr-2023-254564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Abstract
Aggressive angiomyxoma is a rare mesenchymal tumour, which usually appears in the pelvic region of women in their reproductive age. Although benign, it is a locally infiltrative tumour with frequent recurrence. We report a case of a pregnant woman in her 30s with a vulvar aggressive angiomyxoma which was initially misdiagnosed. Features of this case are discussed, highlighting the difficulty in its diagnosis and the challenge of the follow-up and treatment of recurrences.
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Affiliation(s)
- Carolina Smet
- Obstetrics and Gynecology department, Centro Hospitalar de Lisboa Ocidental - Hospital de São Francisco Xavier, Lisboa, Portugal
| | - Ana Constâncio Martins
- Obstetrics and Gynecology department, Centro Hospitalar de Lisboa Ocidental - Hospital de São Francisco Xavier, Lisboa, Portugal
| | - Teresa Costa
- Pathological anatomy and cytology, Centro Hospitalar de Lisboa Ocidental - Hospital de Egas Moniz, Lisboa, Portugal
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21
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Billones AR, Imperial CR, Gutierrez-Cayetano M. Embolism from a left ventricular myxoma presenting with acute limb ischaemia. BMJ Case Rep 2023; 16:e254934. [PMID: 38050388 PMCID: PMC10693896 DOI: 10.1136/bcr-2023-254934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/06/2023] Open
Abstract
Acute limb ischaemia (ALI) secondary to cardiac myxoma is uncommon. Embolic myxoma should be considered a differential diagnosis in young patients with ALI who do not have apparent cardiovascular risk factors. A multidisciplinary approach and comprehensive care can improve outcomes and optimise the collaborative treatment of ALI. Early referral to a hospital that can provide specialised treatment for ALI helps prevent significant tissue loss and surgical complications, such as amputation.A man in his 20s presented with bilateral ALI of both lower extremities, and an arterial duplex scan revealed a thrombus occluding all arterial segments of the bilateral lower extremities. An intracardiac mass adherent to the apical and anterior interventricular septum on two-dimensional echocardiography suggested a complex myxoma. The patient was diagnosed with ALI Rutherford category III, and bilateral hip disarticulation was performed. The patient was discharged with an anticoagulant.
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22
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Lee DPH, Ho TW, Wong IMH, Wong ECY, Lee MKY. Novel contrast echocardiographic features of cardiac myxoma with cystic degeneration: a case report. Hong Kong Med J 2023; 29:545-547. [PMID: 38105740 DOI: 10.12809/hkmj2210246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2023] Open
Affiliation(s)
- D P H Lee
- Department of Medicine, Queen Elizabeth Hospital, Hong Kong SAR, China
| | - T W Ho
- Department of Pathology, Queen Elizabeth Hospital, Hong Kong SAR, China
| | - I M H Wong
- Department of Medicine, Queen Elizabeth Hospital, Hong Kong SAR, China
| | - E C Y Wong
- Department of Medicine, Queen Elizabeth Hospital, Hong Kong SAR, China
| | - M K Y Lee
- Department of Medicine, Queen Elizabeth Hospital, Hong Kong SAR, China
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23
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Ale P, Gurung A, Hargroves D, Omojowolo O. Atrial myxoma: A cause for concern in multiple cerebral infarctions in absence of cardiac symptoms. BMJ Case Rep 2023; 16:e257157. [PMID: 38011961 PMCID: PMC10685979 DOI: 10.1136/bcr-2023-257157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023] Open
Abstract
Ischaemic cerebral infarct is the most common neurological manifestation of myxomas. We present a mid-70s man who was brought to the stroke unit with sudden onset right hemiparesis and dysarthria. Although he had risk factors for developing stroke like hypertension, hypercholesterolaemia, history of prostate cancer and new paroxysmal atrial flutter on admission, clinical suspicion and detailed investigations in the absence of cardiac symptoms revealed a 9 cm myxoma causing severe mitral stenosis. He underwent successful surgical resection with good functional recovery. This also highlights the need for thorough clinical examination especially in the absence of cardiac symptoms.
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Affiliation(s)
- Pramol Ale
- Stroke Medicine, Kent and Canterbury Hospital, Canterbury, UK
| | - Abinas Gurung
- Stroke Medicine, Kent and Canterbury Hospital, Canterbury, UK
| | - David Hargroves
- Stroke Medicine, Kent and Canterbury Hospital, Canterbury, UK
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24
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Xu Y, Jiang J, Zhang M. Atrial myxoma embolization of the basilar artery presenting with a convulsive seizure: Case report. Medicine (Baltimore) 2023; 102:e36138. [PMID: 38013263 PMCID: PMC10681622 DOI: 10.1097/md.0000000000036138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 10/25/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Basilar artery occlusion (BAO) is a rare cause of convulsive seizure. Such patients who are treated for epilepsy will miss the optimal time for treatment. Atrial myxoma is a rare cause of stroke and should be surgically removed as soon as possible after diagnosis. CASE SUMMARY We report a patient who presented with convulsions as the initial symptom and was diagnosed with BAO by computed tomographic angiography. After transthoracic echocardiogram, the cause of the disease was diagnosed as atrial myxoma. The patient recovered well after endovascular treatment and resection of the atrial myxoma. CONCLUSION A small number of patients with BAO present with convulsive seizures. It is very important to make a timely diagnosis. Direct thrombaspiration may be the best choice for basilar artery cardioembolization, and thrombectomy for distal moderate vascular occlusion in posterior circulation is feasible. Atrial myxoma is a rare cause of cardioembolic stroke and should be resected as soon as possible to prevent further embolic complications.
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Affiliation(s)
- Yaning Xu
- Department of Neurology, Army Medical Center of PLA, Army Military Medical University, Chongqing, China
| | - Jiaojin Jiang
- Department of Neurology, Army Medical Center of PLA, Army Military Medical University, Chongqing, China
| | - Meng Zhang
- Department of Neurology, Army Medical Center of PLA, Army Military Medical University, Chongqing, China
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25
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Mendes Franco R, Sousa J, Matos M, Albuquerque L, Azevedo E, Abreu P. Multiple intracranial aneurysms years after cardiac myxoma resection. Pract Neurol 2023; 23:519-520. [PMID: 37487705 DOI: 10.1136/pn-2023-003705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2023] [Indexed: 07/26/2023]
Affiliation(s)
- Roberto Mendes Franco
- Department of Neurology, Centro Hospitalar Universitário de São João, Porto, Portugal
- Department of Neurology, Hospital Dr. Nélio Mendonça, Funchal, Portugal
| | - José Sousa
- Neuroradiology, Centro Hospitalar Universitário de São João, Porto, Portugal
- Department of Clinical Neurosciences and Mental Health, Faculty of Medicine of University of Porto, Porto, Portugal
| | - Mariana Matos
- Department of Internal Medicine, Centro Hospitalar Universitário de São João, Porto, Portugal
- Department of Internal Medicine, Faculty of Medicine of University of Porto, Porto, Portugal
| | - Luís Albuquerque
- Neuroradiology, Centro Hospitalar Universitário de São João, Porto, Portugal
- Department of Clinical Neurosciences and Mental Health, Faculty of Medicine of University of Porto, Porto, Portugal
| | - Elsa Azevedo
- Department of Neurology, Centro Hospitalar Universitário de São João, Porto, Portugal
- Department of Clinical Neurosciences and Mental Health, Faculty of Medicine of University of Porto, Porto, Portugal
| | - Pedro Abreu
- Department of Neurology, Centro Hospitalar Universitário de São João, Porto, Portugal
- Department of Clinical Neurosciences and Mental Health, Faculty of Medicine of University of Porto, Porto, Portugal
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26
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Shinde RV, Anne SA, Firdos AP, Muralidhar V. Twisted aggressive angiomyxoma of the vulva presenting as an emergency with severe pain and impending gangrene. BMJ Case Rep 2023; 16:e257870. [PMID: 37996144 PMCID: PMC10668135 DOI: 10.1136/bcr-2023-257870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2023] Open
Affiliation(s)
- Ranoji V Shinde
- Obstetrics and Gynaecology, Chettinad Academy of Research and Education, Kanchipuram, Tamil Nadu, India
| | - Shreya A Anne
- Obstetrics and Gynaecology, Chettinad Academy of Research and Education, Kanchipuram, Tamil Nadu, India
| | - Alhaj P Firdos
- Obstetrics and Gynaecology, Chettinad Academy of Research and Education, Kanchipuram, Tamil Nadu, India
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27
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Boccia VD, Saitta L, Inglese M, Lapucci C. Cortical ischemic lesions from atrial myxoma as a mimic of disease activity in an RRMS antiCD20-treated patient. Mult Scler 2023; 29:1688-1692. [PMID: 37712415 DOI: 10.1177/13524585231195356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]
Abstract
Cortical lesions (CLs) detected with double inversion recovery (DIR) magnetic resonance imaging (MRI) are very helpful in differentiating multiple sclerosis (MS) from other neuroinflammatory diseases of the central nervous system (CNS), that is, neuromyelitis optica spectrum disorders (NMOSDs). Furthermore, CLs are closely related to motor and cognitive impairment. We report a case of a 48-year-old female MS patient who developed several CLs during anti-CD20 therapy. Some CLs disappeared during follow-up MRIs. In the suspicion of a treatment failure, the screening for the autologous hematopoietic stem cell transplant (AHSCT) was performed with the evidence of an atrial myxoma. In MS patients with new CLs, a comorbid ischemic pathology should be considered and carefully investigated.
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Affiliation(s)
- V D Boccia
- Department of Neurology, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
| | - L Saitta
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - M Inglese
- Department of Neurology, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - C Lapucci
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
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28
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Bethea J, Lodhi T, Peine B, Mendes J, Sutton T, Celio A, Allman R, Nifong LW. Robotic Resection of Left Atrial Myxoma With Cryoablation of Tumor Stalk. Innovations (Phila) 2023; 18:592-594. [PMID: 37794743 DOI: 10.1177/15569845231199736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Abstract
The purpose of this report is to demonstrate robotic cryoablation of an atrial myxoma stalk as a method to prevent recurrence and preserve atrial tissue. A 38-year-old female patient was taken to the operating room, and an atrial myxoma abutting the left inferior pulmonary vein was resected robotically. This was followed by cryoablation of the tumor stalk instead of a full-thickness resection to prevent an extensive reconstruction. The operation resulted in the successful resection of an atrial myxoma with minimal length of stay. Follow-up at 3 months has shown no evidence of residual or recurrent tumor. Follow-up at 1 year is planned. Cryoablation of an atrial myxoma stalk, when resection would require complex reconstruction, is a useful tool in the armamentarium of a minimally invasive cardiac surgeon.
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Affiliation(s)
- Joseph Bethea
- Division of Thoracic Surgery, Department of Cardiovascular Sciences, East Carolina University, Greenville, NC, USA
| | - Taha Lodhi
- Division of Thoracic Surgery, Department of Cardiovascular Sciences, East Carolina University, Greenville, NC, USA
| | - Brandon Peine
- Division of Thoracic Surgery, Department of Cardiovascular Sciences, East Carolina University, Greenville, NC, USA
| | - Jesse Mendes
- Division of Thoracic Surgery, Department of Cardiovascular Sciences, East Carolina University, Greenville, NC, USA
| | - Tia Sutton
- Division of Thoracic Surgery, Department of Cardiovascular Sciences, East Carolina University, Greenville, NC, USA
| | - Adam Celio
- Division of Thoracic Surgery, Department of Cardiovascular Sciences, East Carolina University, Greenville, NC, USA
| | - Robert Allman
- Division of Thoracic Surgery, Department of Cardiovascular Sciences, East Carolina University, Greenville, NC, USA
| | - L Wiley Nifong
- Division of Cardiac Surgery, Department of Cardiovascular Sciences, East Carolina Heart Institute, Greenville, NC, USA
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29
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Christa M, Müntze J, Lengenfelder B, Nordbeck P. Contrast-enhanced ultrasound for non-invasive differential diagnosis of unclear left atrial mass. Int J Cardiovasc Imaging 2023; 39:2173-2174. [PMID: 37665488 PMCID: PMC10673719 DOI: 10.1007/s10554-023-02926-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 07/31/2023] [Indexed: 09/05/2023]
Abstract
Transthoracic and transesophageal echocardiography detected a left atrial mass attached to the intra-atrialseptum. Intravenous contrast agent ruled out atrial thrombus, sugesting a left atrial myxoma. This highlights theimportance of contrast echocardiography for differential diagnosis of left atrial findings.
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Affiliation(s)
- Martin Christa
- Department of Internal Medicine I, University Hospital Würzburg, Oberdürrbacher Straße 6, Haus A3, D - 97080, Würzburg, Germany.
| | - Jonas Müntze
- Department of Internal Medicine I, University Hospital Würzburg, Oberdürrbacher Straße 6, Haus A3, D - 97080, Würzburg, Germany
| | - Björn Lengenfelder
- Department of Internal Medicine I, University Hospital Würzburg, Oberdürrbacher Straße 6, Haus A3, D - 97080, Würzburg, Germany
| | - Peter Nordbeck
- Department of Internal Medicine I, University Hospital Würzburg, Oberdürrbacher Straße 6, Haus A3, D - 97080, Würzburg, Germany
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30
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Ichinose M, Ogiwara M, Ozaki M, Nishino Y, Tanaka K. Cardiac surgery for a right atrial myxoma with traumatic intracranial hemorrhage: a case report. J Cardiothorac Surg 2023; 18:295. [PMID: 37848921 PMCID: PMC10580516 DOI: 10.1186/s13019-023-02402-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 09/30/2023] [Indexed: 10/19/2023] Open
Abstract
BACKGROUND The timing of cardiac surgery with cardiopulmonary bypass (CPB) for intracranial hemorrhage is controversial. CASE PRESENTATION We report the case of an 82-year-old woman who was transferred to our hospital because of a head injury. Brain computed tomography (CT) revealed traumatic intracranial hemorrhage, and transthoracic echocardiography revealed a giant right atrial myxoma. After confirming the disappearance of intracranial hemorrhage on brain CT, cardiac surgery with CPB was performed, which was uneventful. CONCLUSIONS For an uneventful surgery, the optimal timing of cardiac surgery with CPB in patients with giant right atrial myxoma and intracranial hemorrhage should be based on brain CT.
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Affiliation(s)
- Maki Ichinose
- Department of Anesthesiology, Showa General Hospital, Tokyo, Japan.
| | - Masanori Ogiwara
- Division of Cardiovascular Surgery, Showa General Hospital, Tokyo, Japan
| | - Masahiko Ozaki
- Division of Cardiovascular Surgery, Showa General Hospital, Tokyo, Japan
| | - Yoshifumi Nishino
- Division of Cardiovascular Surgery, Showa General Hospital, Tokyo, Japan
| | - Kensuke Tanaka
- Department of Anesthesiology, Showa General Hospital, Tokyo, Japan
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31
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Ajjikuttira A, Coulthard A. Multiple cerebral aneurysms as a late complication of atrial myxoma: imaging findings. BMJ Case Rep 2023; 16:e257765. [PMID: 37798045 PMCID: PMC10565320 DOI: 10.1136/bcr-2023-257765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2023] Open
Affiliation(s)
- Aiyapa Ajjikuttira
- Department of Medical Imaging, Royal Brisbane and Women's Hospital, Queensland Health, Herston, Queensland, Australia
| | - Alan Coulthard
- Department of Medical Imaging, Royal Brisbane and Women's Hospital, Queensland Health, Herston, Queensland, Australia
- Faculty of Medicine, The University of Queensland, Herston, Queensland, Australia
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32
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Cullom C, Frank S, McCabe MD. Bilateral Atrial Myxoma With Mechanical Disruption of the Mitral Valvular Apparatus. J Cardiothorac Vasc Anesth 2023; 37:2032-2039. [PMID: 37357034 DOI: 10.1053/j.jvca.2023.05.047] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 05/25/2023] [Accepted: 05/30/2023] [Indexed: 06/27/2023]
Affiliation(s)
- Christopher Cullom
- Department of Anesthesiology, Loma Linda University Medical Center, Loma Linda, CA.
| | - Stephanie Frank
- Department of Anesthesiology, Loma Linda University Medical Center, Loma Linda, CA
| | - Melissa D McCabe
- Department of Anesthesiology, Loma Linda University Medical Center, Loma Linda, CA
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33
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Galzerano D, Eltayeb A, Alamri S, Alamri S, Arbili L, Mohammed S. A Ping Pong Ball in the Left Ventricle. J Cardiothorac Vasc Anesth 2023; 37:2153-2156. [PMID: 37394386 DOI: 10.1053/j.jvca.2023.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 06/01/2023] [Indexed: 07/04/2023]
Abstract
Diagnosing cardiac masses, especially those related to cardiac tumors, is often challenging in clinical practice. Though myxomas are the most common and well-known benign cardiac tumors, other rare and often-neglected tumors can be difficult to diagnose. In this case report, the authors describe a left ventricular cardiac mass with unique and striking imaging features.
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Affiliation(s)
- Domenico Galzerano
- The Heart Centre, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia; College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.
| | - Abdalla Eltayeb
- The Heart Centre, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia
| | - Soaad Alamri
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Sultan Alamri
- King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Lana Arbili
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Shamayel Mohammed
- Department of Pathology and Laboratory Medicine, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
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Hamdan M, Alam B, Kossaify A. A polo ball in the right atrium, importance of echocardiographic characteristics of intracardiac myxomas: a case report. J Med Case Rep 2023; 17:403. [PMID: 37730679 PMCID: PMC10512563 DOI: 10.1186/s13256-023-04130-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 08/14/2023] [Indexed: 09/22/2023] Open
Abstract
BACKGROUND Myxomas are the most prevalent type of heart tumors, mainly occurring in the left atrium, with approximately 20% of cases found in the right atrium. Timely diagnosis and appropriate management of myxomas are crucial for favorable outcomes and to minimize complications. CASE PRESENTATION A 77-year-old Asian male with no significant medical history presented with intermittent trepopnea and palpitations. Physical examination revealed regular heart sounds and no other relevant findings. A transthoracic echocardiogram showed a large, round-shaped, smooth-edged mass with diameter of 86 mm, occupying most of the right atrium. Mild tricuspid flow obstruction and mild left ventricular systolic dysfunction were also observed. Cardiac tomography confirmed the size, smooth edges, and showed microcalcifications of the mass, with no invasion of surrounding tissues. Surgical intervention successfully removed the spheroid mass, leading to the alleviation of symptoms. Histopathology confirmed the myxoma nature of the mass. A comprehensive discussion based on relevant medical literature is provided, with emphasis on echocardiographic characteristics of the mass with relation to potential embolic disease. CONCLUSION This case shows an atypical presentation of an exceptionally large myxoma in the right atrium, resembling the size of a polo ball, in a patient presenting with supraventricular arrhythmia and trepopnea. Early diagnosis and appropriate management played a vital role in achieving a successful outcome for the patient.
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Affiliation(s)
- Mira Hamdan
- Cardiology Division, Saint Esprit Kaslik University USEK, Hospital Notre Dame des Secours, Saint Charbel Street- PO Box # 3, Byblos, 12345, Lebanon
| | - Boutros Alam
- Cardiology Division, Saint Esprit Kaslik University USEK, Hospital Notre Dame des Secours, Saint Charbel Street- PO Box # 3, Byblos, 12345, Lebanon
| | - Antoine Kossaify
- Cardiology Division, Saint Esprit Kaslik University USEK, Hospital Notre Dame des Secours, Saint Charbel Street- PO Box # 3, Byblos, 12345, Lebanon.
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35
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Kakimoto S, Harada Y, Shimizu T. Periportal halo in a patient with right atrial myxoma. QJM 2023; 116:710-711. [PMID: 37094183 DOI: 10.1093/qjmed/hcad073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Indexed: 04/26/2023] Open
Affiliation(s)
- Shintaro Kakimoto
- Department of Diagnostic and Generalist Medicine, Dokkyo Medical University Hospital, Mibu, Tochigi 321-0293, Japan
| | - Yukinori Harada
- Department of Diagnostic and Generalist Medicine, Dokkyo Medical University Hospital, Mibu, Tochigi 321-0293, Japan
| | - Taro Shimizu
- Department of Diagnostic and Generalist Medicine, Dokkyo Medical University Hospital, Mibu, Tochigi 321-0293, Japan
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Xu Y, Duan Y, Zhou H, Chen H, Yan W. Ultrasonic features of superficial angiomyxoma in the scrotum: A case image. J Clin Ultrasound 2023; 51:1273-1275. [PMID: 37219372 DOI: 10.1002/jcu.23487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 04/25/2023] [Accepted: 05/09/2023] [Indexed: 05/24/2023]
Abstract
Superficial angiomyxoma in the scrotum is a well-circumscribed, ovoid-shaped, heterogeneously echogenic mass in the ultrasonography. On Doppler ultrasonography, vascular flow signals are visible in and around the mass(M).
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Affiliation(s)
- Yadi Xu
- Department of Ultrasound, Hubei Traditional Chinese Medicine Hospital, People's Republic of China
- Affiliated Hospital of Hubei University of Traditional Chinese Medicine, People's Republic of China
- Hubei University of Traditional Chinese Medicine, People's Republic of China
| | - Yun Duan
- Department of Ultrasound, Hubei Traditional Chinese Medicine Hospital, People's Republic of China
- Affiliated Hospital of Hubei University of Traditional Chinese Medicine, People's Republic of China
- Hubei University of Traditional Chinese Medicine, People's Republic of China
| | - Heng Zhou
- Department of Ultrasound, Hubei Traditional Chinese Medicine Hospital, People's Republic of China
- Affiliated Hospital of Hubei University of Traditional Chinese Medicine, People's Republic of China
- Hubei University of Traditional Chinese Medicine, People's Republic of China
| | - Haoyi Chen
- Department of Ultrasound, Hubei Traditional Chinese Medicine Hospital, People's Republic of China
- Affiliated Hospital of Hubei University of Traditional Chinese Medicine, People's Republic of China
- Hubei University of Traditional Chinese Medicine, People's Republic of China
| | - Wei Yan
- Department of Ultrasound, Hubei Traditional Chinese Medicine Hospital, People's Republic of China
- Affiliated Hospital of Hubei University of Traditional Chinese Medicine, People's Republic of China
- Hubei University of Traditional Chinese Medicine, People's Republic of China
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Martin SJ, Maxey-Jones C, Zhou Z, Nazem A, Cherney A, Lutz CJ. Robot-Assisted Excision of a Left Ventricular Myxoma and Hemangioma. Innovations (Phila) 2023; 18:506-508. [PMID: 37786985 DOI: 10.1177/15569845231199741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
Left ventricular masses are rare entities that often require surgical excision when diagnosed due to the risk of embolization. We report 2 separate patients presenting with evidence of cerebral embolization both of whom were diagnosed with isolated left ventricular masses and underwent surgical excision through a robot-assisted approach. Microscopic pathology revealed a myxoma and hemangioma, respectively. Both cases demonstrate that left ventricular masses can be feasibly excised through a robot-assisted minithoracotomy approach.
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38
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Li X, Luo H, Hou J. Atrial septal hematogenous cyst with calcification mimicking myxoma: A rare case. Echocardiography 2023; 40:1021-1023. [PMID: 37589953 DOI: 10.1111/echo.15672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 06/12/2023] [Accepted: 08/06/2023] [Indexed: 08/18/2023] Open
Abstract
A 61-year-old female presented with right atrial mass during physical examination. Contrast-enhanced left heart echocardiography revealed a mass with the size of 32*23 mm in the right atrium, attached to the atrial septum; there was a certain degree of activity and deformation. MRI showed a mass of about 35*22 mm in the right atrium adjacent to the atrial septum, which was diagnosed with right atrial myxoma. Intraoperative TEE showed that the mass was located in the atrial septum close to the inferior vena cava and spontaneous echo contrast with hyperechoic images within the mass. The lesion was resected under cardiopulmonary bypass. Pathological examination revealed that the filling defect was an atrial septal hematogenous cyst with calcification.
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Affiliation(s)
- Xuejie Li
- Department of Anesthesiology, West China Hospital, Sichuan University and The Research Units of West China (2018RU012), Chinese Academy of Medical Sciences, Chengdu, China
| | - Hongying Luo
- Operating Room of Anesthesia Surgery Center, West China Hospital/West China School of Nursing, Sichuan University, Chengdu, China
| | - Jianglong Hou
- Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu, China
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Yalçınkaya Öner D, Nadir Karakulak U. Reply to Letter to the Editor: 'Recurrent Cardiac Myxoma: A Puzzle to be Solved'. Anatol J Cardiol 2023; 27:499-500. [PMID: 37439231 PMCID: PMC10406139 DOI: 10.14744/anatoljcardiol.2023.3241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/14/2023] Open
Affiliation(s)
| | - Uğur Nadir Karakulak
- Department of Cardiology, Faculty of Medicine, Hacettepe University, Ankara, Türkiye
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40
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Yalta K, Yetkin E, Yalta T. Recurrent Cardiac Myxoma: A Puzzle to be Solved. Anatol J Cardiol 2023; 27:497-498. [PMID: 37466027 PMCID: PMC10406146 DOI: 10.14744/anatoljcardiol.2023.3240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023] Open
Affiliation(s)
- Kenan Yalta
- Department of Cardiology, Faculty of Medicine, Trakya University, Edirne, Türkiye
| | - Ertan Yetkin
- Department of Cardiology, Türkiye Hospital, İstanbul, Türkiye
| | - Tülin Yalta
- Department of Pathology, Faculty of Medicine, Trakya University, Edirne, Türkiye
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Kaibel Val R, Vázquez Echarri J, Kaibel Axpe I. Intramuscular myxoma in psoas muscle and in thigh. Cir Esp 2023; 101:577-579. [PMID: 37086839 DOI: 10.1016/j.cireng.2023.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/24/2023]
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Aminimoghaddam S, Sarchami N, Mahboub SS. Second recurrence of aggressive vulvar angiomyxoma: a case report. J Int Med Res 2023; 51:3000605231189366. [PMID: 37551697 PMCID: PMC10411273 DOI: 10.1177/03000605231189366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 07/05/2023] [Indexed: 08/09/2023] Open
Abstract
Aggressive angiomyxoma is a rare benign tumor with diverse clinical and radiologic presentations, making its differential diagnosis challenging. Here we report the second recurrence of an aggressive angiomyxoma of the vulva in a 33-year-old woman who presented with pain and swelling. Clinical examination revealed a well-circumscribed large palpable mass extending from the inferior part of the right labia major into the right side of the gluteus. A second recurrence of aggressive angiomyxoma was suspected based on the patient's history, clinical examination, and magnetic resonance imaging report, and the patient underwent surgical resection with a negative margin. Histological evaluation of the extracted lesion confirmed the diagnosis of aggressive angiomyxoma. At the 1-year follow-up, the patient was recurrence-free. The present report urges more awareness regarding the aggressiveness of angiomyxoma of the vulva. Closer attention should be given to margin-free removal of such tumors, and patients should be routinely followed up for at least 2 years postoperatively for early diagnosis of recurrence, thereby reducing the risk of morbidity.
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Affiliation(s)
- Soheila Aminimoghaddam
- Department of Obstetrics and Gynecology, Firoozgar Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Niloufar Sarchami
- Department of Obstetrics and Gynecology, Firoozgar Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Sarah Sadat Mahboub
- Department of Obstetrics and Gynecology, Firoozgar Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
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Zhang H, Ren Q, Zhang Z, Shao X. Obstructive shock due to a rare cause: a case of left atrial myxoma incarcerated at the mitral orifice. Minerva Med 2023; 114:542-544. [PMID: 36988492 DOI: 10.23736/s0026-4806.23.08494-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
Affiliation(s)
- Huijuan Zhang
- Hemodialysis Center, Zhejiang Hospital, Hangzhou, China
| | - Qi Ren
- Department of Critical Care Medicine, Zhejiang Hospital, Hangzhou, China
| | - Zhufeng Zhang
- Department of Emergency, Zhejiang Hospital, Hangzhou, China
| | - Xiaolu Shao
- Department of Medical Care, Zhejiang Hospital, Hangzhou, China -
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44
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Li X, Hou J. A rare case of left ventricular myxoma with LVIT and LVOT obstruction. Eur Heart J Cardiovasc Imaging 2023; 24:e199. [PMID: 37140073 DOI: 10.1093/ehjci/jead085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/05/2023] Open
Affiliation(s)
- Xuejie Li
- Department of Anesthesiology, West China Hospital, Sichuan University and The Research Units of West China (2018RU012), Chinese Academy of Medical Sciences, No.37 Guo Xue Xiang, Chengdu, Sichuan 610041, P.R. China
| | - Jianglong Hou
- Department of Cardiovascular Surgery, West China Hospital, Sichuan University, No.37 Guo Xue Xiang, Chengdu, Sichuan 610041, P.R. China
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45
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Zhang Q, Yan HL, Lu Q, Luo Y. Value of contrast-enhanced ultrasound in deep angiomyxoma using a biplane transrectal probe: A case report. World J Gastroenterol 2023; 29:4214-4221. [PMID: 37475848 PMCID: PMC10354570 DOI: 10.3748/wjg.v29.i26.4214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 05/23/2023] [Accepted: 06/13/2023] [Indexed: 07/10/2023] Open
Abstract
BACKGROUND Deep angiomyxoma (DAM) is a very rare tumor type. Magnetic resonance imaging (MRI) is considered the best imaging modality for diagnosing DAM. Computed tomography (CT) is used mainly to assess the invasion range of DAM. The value of ultrasonography in the diagnosis of DAM is still controversial. Through a literature review, we summarized the current state of ultrasonic examination for DAM and reported for the first time the contrast-enhanced ultrasound (CEUS) features of DAM seen using a biplane transrectal probe.
CASE SUMMARY A 37-year-old woman presented with a sacrococcygeal mass that had gradually increased in size over the previous 6 mo. MRI and CT examinations failed to allow a definite diagnosis to be made. Transperineal core needle biopsy (CNB) guided by transrectal ultrasound and CEUS was suggested after a multidisciplinary discussion. Grayscale ultrasound of the lesion showed a layered appearance with alternating hyperechoic and hypoechoic patterns. Transrectal CEUS showed a laminated distribution of the contrast agent that was consistent with the layered appearance of the tumor on grayscale ultrasound. We performed transperineal CNB of the enhanced area inside the tumor under transrectal CEUS guidance and finally made a definitive diagnosis of DAM through histopathology. The patient underwent laparoscopic-assisted transabdominal surgery combined with transperineal surgery for large pelvic tumor resection and pelvic floor peritoneal reconstruction. No recurrence or metastasis was found at the nine-month follow-up.
CONCLUSION Transrectal CEUS can show the layered perfusion characteristics of the contrast agent, guiding subsequent transperineal CNB of the enhanced area within the DAM.
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Affiliation(s)
- Qiong Zhang
- Department of Medical Ultrasound, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Hua-Lin Yan
- Department of Medical Ultrasound, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Qiang Lu
- Department of Medical Ultrasound, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Yan Luo
- Department of Medical Ultrasound, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
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46
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Matsuo T, Tanaka T. Resection of Orbital Myxoma With Magnetic Resonance Imaging Evidence of Ethmoid Sinus Origin: Case Report and Review of 20 Patients in the Literature. J Investig Med High Impact Case Rep 2023; 11:23247096231201013. [PMID: 37737575 PMCID: PMC10517617 DOI: 10.1177/23247096231201013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 08/13/2023] [Accepted: 08/27/2023] [Indexed: 09/23/2023] Open
Abstract
A 41-year-old woman showed a palpable mass at the superonasal orbital edge on the right side. Magnetic resonance imaging demonstrated a lobulated fluid-containing tubular mass which extended anteriorly to posteriorly along the medial orbital wall, nasal to the eyeball. She was followed once a year for 8 years until the age of 49 years when she decided to undergo surgical resection because of the enlarged mass. The lobulated large mass was resected and the pathology showed sparsely distributed spindle cells, positive for CD34, in alcian blue-positive mucous substances, indicative of myxoma. Postoperative magnetic resonance imaging showed residual lobulated tubular mass along the optic nerve on the medial side and superior to the eyeball. The residual orbital mass showed stable structure with more evident connection with the ethmoid sinus lesion, suggestive of the ethmoid origin, in 12 years until the age of 61 years. In the review of 20 patients with orbital myxomas in the literature, in addition to this case, roughly classified locations in the orbit were retrobulbar in 8 patients, on the lateral side of the orbit in 4, on the superior side in 6, on the medial side in 1 (this patient), and in the orbit with no specific description in 2. In pathological examinations, immunohistochemistry was not done in 8 patients, done but all negative in 2, and positive in 11 patients: nerve sheath myxoma was diagnosed in 3 patients based on positive S100 staining. Orbital myxoma is rare but considered in differential diagnosis of orbital masses.
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Choi JH, Park W, Park JC, Ahn JS. Cerebral Myxomatous Aneurysms: Case Series and Systematic Review of Literature with Adequate Follow-Up Periods and Aneurysmal Wall Biopsy Results. World Neurosurg 2022; 172:e107-e119. [PMID: 36566979 DOI: 10.1016/j.wneu.2022.12.085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Cerebral myxomatous aneurysms (CMA) are intracranial aneurysms caused by cardiac myxoma. The exact mechanism underlying their development has not yet been elucidated. And an optimal treatment method has not yet been established because of rarity of the disease. In addition, most existing reports have had a short follow-up period or lack of follow-up imaging test results. The aim of this study was to provide better insights into the course and treatment options of CMAs. METHODS We describe 4 CMA patients treated in our hospital and literature search was performed using PubMed and Embase databases. Keywords used were as follows: "cerebral myxomatous aneurysm", "myxomatous aneurysm", "cardiac myxoma", and "intracranial aneurysm". Only publications in English and related to this disorder with adequate follow-up periods and aneurysmal wall biopsy results were included. Clinical, radiological, pathological, and treatment characteristics were analyzed. RESULTS A total of 134 CMA cases were managed conservatively that included 5 enlargements, 6 regressions, and 120 stable aneurysms, which were identified for a total of 453.33 aneurysm years (1.76% per aneurysm year, 1.32% per aneurysm year, and 26.47% per aneurysm year, respectively). Poor outcome rate was high in cases with hemorrhage (either parenchymal or subarachnoidal hemorrhage) due to rupture of the CMA (46.67%, 7 out of 15). Thirteen cases had aneurysm biopsy results of which 11 showed tumor invasion on the aneurysm wall. CONCLUSIONS Even though the natural course of unruptured, benign-looking CMAs appears to be favorable, the presence or absence of viable tumor cells in the aneurysm may promote an unfavorable disease course. In the case of large, symptomatic, and enlarging CMAs, surgical, endovascular, or combined treatment should be considered as the mortality and morbidity due to rupture might be high.
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Affiliation(s)
- June Ho Choi
- Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Wonhyoung Park
- Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jung Cheol Park
- Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jae Sung Ahn
- Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
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48
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Junze Z, Yuxi L, Jiande T, Xuezhe W, Yequan S. A cardiac malignant primary tumor: Left atrium myxosarcoma-A case report. J Clin Ultrasound 2022; 50:1262-1267. [PMID: 35899966 DOI: 10.1002/jcu.23275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 06/18/2022] [Accepted: 06/27/2022] [Indexed: 06/15/2023]
Abstract
Myxosarcoma only accounts for a very small proportion of primary malignant tumors of the heart. The disease has no specificity in clinical manifestations or features on medical images. In this case study, we report about a middle-aged female patient afflicted with cardiac myxosarcoma. The initial transthoracic echocardiography of the patient revealed a cardiac myxoma. However, the postoperative histopathology confirmed the presence of a malignant cardiac myxosarcoma. Post-surgery follow-up imaging examinations revealed local recurrence in the left atrium as well as soft-tissue and bone metastases. The recurrent tumor and metastases were subsequently treated with chemotherapy and radiotherapy. However, the tumor did not respond to treatment and the disease progressed.
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Affiliation(s)
- Zheng Junze
- School of Medical Imaging, Weifang Medical University, Weifang, China
- Department of Medical Image Center, Affiliated Hospital of Weifang Medical University, Weifang, China
| | - Liu Yuxi
- Department of Ultrasonic, Affiliated Hospital of Weifang Medical University, Weifang, China
| | - Tang Jiande
- Department of Ultrasonic, Affiliated Hospital of Weifang Medical University, Weifang, China
| | - Wei Xuezhe
- School of Medical Imaging, Weifang Medical University, Weifang, China
- Department of Medical Image Center, Affiliated Hospital of Weifang Medical University, Weifang, China
| | - Sun Yequan
- School of Medical Imaging, Weifang Medical University, Weifang, China
- Department of Medical Image Center, Affiliated Hospital of Weifang Medical University, Weifang, China
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49
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Cortese F, Costantino MF, Stabile E, D'Addeo G, Bochicchio A, Luzi G. [An atrial myxoma with a significant coronary vascularization]. G Ital Cardiol (Rome) 2022; 23:876-877. [PMID: 36300391 DOI: 10.1714/3900.38827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Affiliation(s)
- Francesca Cortese
- Unità di Cardiologia, Presidio Ospedaliero "Giovanni Paolo II", Policoro (MT)
| | | | - Eugenio Stabile
- Dipartimento Cardiovascolare, Istituto di Cardiologia, Ospedale San Carlo, Potenza
| | - Giampaolo D'Addeo
- Dipartimento Cardiovascolare, Istituto di Cardiologia, Ospedale San Carlo, Potenza
| | - Angela Bochicchio
- Dipartimento Cardiovascolare, Istituto di Cardiologia, Ospedale San Carlo, Potenza
| | - Giampaolo Luzi
- Dipartimento di Cardiochirurgia, Ospedale San Carlo, Potenza
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50
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Peng J, Sun PT, Cen H, Liu YX, Zhu W, Ran PC. Incremental value of combinatorial contrast echocardiography and 18F-fluorodeoxyglucose positron emission tomography/computed tomography in giant right atrial myxomas. J Clin Ultrasound 2022; 50:1268-1270. [PMID: 36215199 DOI: 10.1002/jcu.23360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 09/26/2022] [Accepted: 09/27/2022] [Indexed: 06/16/2023]
Abstract
Although several studies have shown that myocardial contrast echocardiography and 18-FDG PET/CT can differentiate between benign and malignant intracardiac masses, it is rarely used in practice to evaluate myxoma. This case describes the contrast echocardiography and 18-FDG PET/CT findings of a giant myxoma with an atypical location and subclinical symptoms.
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Affiliation(s)
- Jie Peng
- Department of Ultrasound, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Peng-Tao Sun
- Department of Ultrasound, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Huan Cen
- Department of Ultrasound, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Yue-Xia Liu
- Department of Ultrasound, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Wei Zhu
- Department of Cardiac surgery, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Peng-Cheng Ran
- Department of Nuclear medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
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