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1.
Rev Port Cir Cardiotorac Vasc ; 28(1): 53-55, 2021 Apr 08.
Artigo em Inglês | MEDLINE | ID: mdl-33834651

RESUMO

Myxomas are the most common cardiac tumors; however right ventricular myxomas are very rare. We present the case of an asymptomatic 74 year old female with a right ventricular myxoma originating from the interventricular septum diagnosed during a routine echocardiographic examination. Initially the patient refused surgery due to being asymptomatic, but agreed to be operated two months later. Surgical removal was uneventful, as was the postoperative course. Histopathological analysis confirmed the suspected diagnosis of cardiac myxoma.


Assuntos
Neoplasias Cardíacas , Mixoma , Idoso , Ecocardiografia , Feminino , Neoplasias Cardíacas/diagnóstico por imagem , Neoplasias Cardíacas/cirurgia , Ventrículos do Coração/diagnóstico por imagem , Humanos , Mixoma/diagnóstico por imagem , Mixoma/cirurgia , Período Pós-Operatório
2.
BMC Surg ; 21(1): 64, 2021 Jan 29.
Artigo em Inglês | MEDLINE | ID: mdl-33514381

RESUMO

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


Assuntos
Neoplasias Cardíacas/complicações , Neoplasias Cardíacas/cirurgia , Mixoma/complicações , Mixoma/cirurgia , Adulto , Feminino , Insuficiência Cardíaca/etiologia , Insuficiência Cardíaca/cirurgia , Neoplasias Cardíacas/diagnóstico por imagem , Ventrículos do Coração/diagnóstico por imagem , Ventrículos do Coração/cirurgia , Humanos , Mixoma/diagnóstico por imagem , Doenças Raras , Resultado do Tratamento
3.
BMJ Case Rep ; 14(1)2021 Jan 18.
Artigo em Inglês | MEDLINE | ID: mdl-33461997

RESUMO

Primary cardiac valve tumours are rare. This is a case report of a 32-year-old non-smoker man with a history of stroke 1 year prior and no other cardiovascular risk factors. The patient was admitted to our acute stroke ward for recurrent left hemiparesis, slurring of speech, facial asymmetry and central retinal artery occlusion. Initial laboratory investigations and ECG were normal. An urgent CT brain showed a large hypodense area at the right frontal, parietal, temporal, occipital region with effaced sulci and right lateral ventricle with midline shift and cerebral oedema in keeping with acute infarction. We proceeded with CT angiography of the cerebral and carotid on the following day, which revealed no evidence of thrombosis, aneurysm or arteriovenous malformation. There were no abnormal beaded vessels to suggest vasculitis. Transthoracic echocardiography revealed a large mobile mass in the left atrium. Meanwhile, MRI cardiac confirmed a large ill-defined mobile solid mass attached to the mitral valve's inferoseptal component suggestive of mitral valve myxoma. This case report highlights the significance of considering a cardiogenic source of emboli in patients with large cerebral infarcts and other cardiac embolic phenomena. Imaging modalities such as echocardiography and cardiac MRI will help detect treatable conditions, such as valvular myxoma and prevent further complications.


Assuntos
Ecocardiografia , Neoplasias Cardíacas/diagnóstico por imagem , Mixoma/diagnóstico por imagem , Oclusão da Artéria Retiniana/etiologia , Tomografia Computadorizada por Raios X , Adulto , Neoplasias Cardíacas/complicações , Humanos , Masculino , Valva Mitral/diagnóstico por imagem , Valva Mitral/patologia , Mixoma/complicações , Oclusão da Artéria Retiniana/diagnóstico
4.
Kyobu Geka ; 73(11): 905-909, 2020 Oct.
Artigo em Japonês | MEDLINE | ID: mdl-33130711

RESUMO

A 48-year-old woman developed paralysis of the left upper limb and dysarthria. Two days later, she was admitted to a local hospital due to no improvement of symptoms. Brain magnetic resonance imaging showed acute hemorrhagic cerebral infarction in the left nucleus basalis. Echocardiography demonstrated a large left atrial mass in the left atrium, shuttling between the left atrium and the left ventricle and moderate mitral regurgitation. Then, she was transferred to our hospital for surgery. Five days after the initial symptoms, resection of the left atrial mass was performed under total cardiopulmonary bypass. First, heparin sodium, and then nafamostat mesilate were used as intraoperative anticoagulation treatment. The left mitral mass was removed via an atrial septal incision and the defect was repaired using a bovine pericardium. The mitral valve was intact and there was no regurgitation. The mass was immunohistologically diagnosed as myxoma. Postoperative brain computed tomography scans demonstrated no exacerbation of the cerebral infarction. She was discharged 13 days after surgery without neurological symptoms.


Assuntos
Fibrilação Atrial , Neoplasias Cardíacas , Insuficiência da Valva Mitral , Mixoma , Animais , Bovinos , Infarto Cerebral/diagnóstico por imagem , Infarto Cerebral/etiologia , Infarto Cerebral/cirurgia , Feminino , Átrios do Coração/diagnóstico por imagem , Átrios do Coração/cirurgia , Neoplasias Cardíacas/complicações , Neoplasias Cardíacas/diagnóstico por imagem , Neoplasias Cardíacas/cirurgia , Humanos , Pessoa de Meia-Idade , Insuficiência da Valva Mitral/diagnóstico por imagem , Insuficiência da Valva Mitral/etiologia , Insuficiência da Valva Mitral/cirurgia , Mixoma/complicações , Mixoma/diagnóstico por imagem , Mixoma/cirurgia
5.
Clin Nucl Med ; 45(10): 833-835, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32804771

RESUMO

A 52-year-old man had shortness of breath and chest discomfort for 2 months. Chest CT and MRI showed a mass in the left atrium attached to the mitral annulus without obvious enhancement. Initial diagnosis was suspected of myxoma. Preoperative FDG PET/CT demonstrated the corresponding lesion with abnormal FDG uptake, indicating a malignancy. Finally, histopathologic examination revealed primary undifferentiated sarcoma.


Assuntos
Fluordesoxiglucose F18 , Átrios do Coração/diagnóstico por imagem , Neoplasias Cardíacas/diagnóstico por imagem , Mixoma/diagnóstico por imagem , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Sarcoma/diagnóstico por imagem , Diagnóstico Diferencial , Humanos , Masculino , Pessoa de Meia-Idade , Sarcoma/patologia
6.
J Card Surg ; 35(10): 2863-2865, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32720392

RESUMO

BACKGROUND: Cardiac myxomas are common and account for 50% of primary intracardiac tumors. Atypical locations of cardiac myxoma increase the risk of intraoperative iatrogenic injuries. Herein, we report a case of using three-dimensional printing (3D) to facilitate the removal of an atypical cardiac myxoma in a 63-year-old woman. METHODS AND RESULTS: Mass in the high posterior atrial septum was confirmed through imaging. Due to the potential involvement of the mass to surrounding vital structures, 3D printing of the cardiac mass was performed. The tumor was completely resected via median sternotomy and the resulting defect was repaired with the bovine pericardium. The patient had an uncomplicated postoperative course except for the development of sick sinus syndrome. One-year follow-up showed no tumor recurrent. CONCLUSION: 3D printing technology in patients with atypical cardiac tumors enhances our understanding of the extent of the tumor invasion and facilitates planning the operation to avoid intraoperative complications.


Assuntos
Procedimentos Cirúrgicos Cardíacos/métodos , Neoplasias Cardíacas/diagnóstico por imagem , Neoplasias Cardíacas/cirurgia , Doença Iatrogênica/prevenção & controle , Complicações Intraoperatórias/prevenção & controle , Modelos Anatômicos , Mixoma/diagnóstico por imagem , Mixoma/cirurgia , Impressão Tridimensional , Animais , Bioprótese , Bovinos , Feminino , Átrios do Coração/diagnóstico por imagem , Átrios do Coração/patologia , Átrios do Coração/cirurgia , Neoplasias Cardíacas/patologia , Septos Cardíacos/diagnóstico por imagem , Septos Cardíacos/cirurgia , Humanos , Pessoa de Meia-Idade , Mixoma/patologia , Invasividade Neoplásica , Pericárdio/transplante , Esternotomia/métodos , Tomografia Computadorizada por Raios X , Resultado do Tratamento
7.
J Card Surg ; 35(8): 2097-2099, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32652738

RESUMO

Cardiac myxomas are benign primer cardiac tumors of the heart. They can be fatal with a thromboembolic presentation. Myocardial infarction is one of these unusual thromboembolic presentations. We report a patient who presented with cardiac arrest due to ventricular fibrillation related to myocardial infarction. After successful resuscitation, coronary angiography and transthoracic echocardiography were performed. A left atrial mass was observed and interpreted as a possible cause of coronary embolism leading to myocardial infarction. After surgical excision, the pathological examination confirmed myxoma, which was the essential cause of the tendency to arterial embolism.


Assuntos
Trombose Coronária/diagnóstico por imagem , Trombose Coronária/etiologia , Neoplasias Cardíacas/complicações , Mixoma/complicações , Angiografia Coronária , Ecocardiografia , Feminino , Parada Cardíaca/etiologia , Neoplasias Cardíacas/diagnóstico por imagem , Neoplasias Cardíacas/cirurgia , Humanos , Pessoa de Meia-Idade , Infarto do Miocárdio/etiologia , Mixoma/diagnóstico por imagem , Mixoma/cirurgia , Fibrilação Ventricular/etiologia
8.
Clin Imaging ; 68: 161-165, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32623196

RESUMO

Intramuscular myxoma (IM) is a rare benign soft tumor of mesenchymal origin. Most IMs are located in the large skeletal muscles, and they are typically painless slow-growing masses that are detected incidentally. Surgical excision of IM usually has a good prognosis. Because of its rarity, diagnosing IM via imaging modalities such as ultrasonography (US), computed tomography, positron emission tomography/computed tomography, and magnetic resonance imaging (MRI) can be challenging. Relevant literature and cases were selected as per the inclusion and exclusion criteria. Characteristic imaging findings include a well-defined, ovoid mass with regular morphology and an orientation whereby the long axis is aligned with the course of muscle fibers. In US, IMs exhibit solid cystic mixed echo without obvious blood flow signal. However, MRI reveals hypointensity on T1-weighted images and hyperintensity on T2-weighted images with mild and patchy enhancement. In cases of suspected or potential IM, US and MRI can provide excellent resolution at a reasonable cost. This report aims to improve the recognition rate of IM. Herein, we review imaging characteristics that can contribute to the differential diagnosis of IM.


Assuntos
Mixoma , Humanos , Imagem por Ressonância Magnética , Mixoma/diagnóstico por imagem , Mixoma/cirurgia , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Tomografia Computadorizada por Raios X , Ultrassonografia
13.
BMC Cardiovasc Disord ; 20(1): 119, 2020 03 05.
Artigo em Inglês | MEDLINE | ID: mdl-32138674

RESUMO

BACKGROUND: A cardiac myxoma in a young person may pose a diagnostic challenge as symptoms may be variable and the differential diagnosis is wide. The differential diagnosis can include rheumatic mitral valve disease, pulmonary hypertension, endocarditis, myocarditis and vasculitis. CASE PRESENTATION: This case report involves a 49 years old female with a 2.8 cm × 3.4 cm myxoma in the left atrium causing mitral valve obstruction. She presented with fatigue, fever of unknown origin, transient ischemic attack and shortness of breath. Prompt surgery is often recommended due to the risk of embolic complications or complete obstruction. Due to her symptoms, patient underwent successful cardiothoracic surgery to excise the myxoma within 2 weeks of confirmation by cardiac echocardiography. CONCLUSION: This case also emphasizes the diagnostic challenge as symptoms may be variable, ranging from fatigue, fever and shortness of breath to transient ischemic attack and at worst, sudden cardiac death. In conclusion, if a cardiac mass is suspected, echocardiography should be performed early. Surgical resection is curative and recurrence rate is very rare in sporadic isolated myxomas, however, recurrence can be higher in genetic diseases associated with increased frequency of myxomas such as Carney complex. This subpopulation of patients may present further research opportunity to learn more about the perioperative management of patients with myxomas such as determining the optimal time to surgical intervention and decision to anticoagulate.


Assuntos
Proteína C-Reativa/análise , Fadiga/etiologia , Febre de Causa Desconhecida/etiologia , Neoplasias Cardíacas/complicações , Mixoma/complicações , Biomarcadores/sangue , Diagnóstico Diferencial , Fadiga/diagnóstico , Feminino , Átrios do Coração , Neoplasias Cardíacas/diagnóstico por imagem , Neoplasias Cardíacas/cirurgia , Humanos , Pessoa de Meia-Idade , Mixoma/diagnóstico por imagem , Mixoma/cirurgia , Valor Preditivo dos Testes , Resultado do Tratamento
14.
J Med Case Rep ; 14(1): 29, 2020 Feb 13.
Artigo em Inglês | MEDLINE | ID: mdl-32051024

RESUMO

BACKGROUND: Atrial myxoma remains a rare clinical entity with an incidence of surgically resected cases of 0.5-0.7 per million population and prevalence of < 5 per 10,000. It typically manifests in woman after third decade of life; symptoms vary greatly and may present with arrhythmia, intracardiac flow obstruction, embolic phenomenon, and associated constitutional symptoms. Neurological complications associated with atrial myxoma most frequently include cerebral infarct due to embolus. Cerebellar involvement is very rare and only a few cases have been reported in the literature. CASE PRESENTATION: A 55-year-old Brahmin man with no history of diabetes mellitus and hypertension, presented with complaints of dizziness, headache, vomiting, double vision, and unsteadiness of gait for 2 weeks. His headache was sudden in onset, of a pulsating type and localized on left temporal side. Vomiting was projectile and bilious. Double vision was present in all directions of gaze and he had uncoordinated movement of his body and tilting to the left side. On examination, his cerebellar functions were impaired. He was thoroughly investigated for the cause of stroke after abnormal magnetic resonance imaging results with normal computed tomography angiography of his brain. Echocardiography and computed tomography of his chest showed a mass attached to intra-atrial septum and prolapsing through mitral valve, which was suggestive of left atrial myxoma. Five days following admission, he developed abdominal pain due to thromboembolism causing splenic and renal infarct. CONCLUSION: Although rare, atrial myxoma has to be considered a cause of stroke and other embolic phenomenon causing multiorgan infarctions. Early and timely diagnosis of the condition can prevent further recurrence and inappropriate anticoagulant therapy. It would be pertinent to have echocardiography done in patients who present with a stroke, arrhythmias, and other constitutional symptoms. The tumor once detected must be removed surgically as early as possible, which not only reduces serious thromboembolic complications but can be potentially curative.


Assuntos
Neoplasias Cardíacas/cirurgia , Mixoma/cirurgia , Átrios do Coração/diagnóstico por imagem , Átrios do Coração/patologia , Neoplasias Cardíacas/complicações , Neoplasias Cardíacas/diagnóstico por imagem , Neoplasias Cardíacas/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Mixoma/complicações , Mixoma/diagnóstico por imagem , Mixoma/patologia , Infarto do Baço/diagnóstico por imagem , Infarto do Baço/etiologia , Infarto do Baço/patologia , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/etiologia
16.
Monaldi Arch Chest Dis ; 90(1)2020 Jan 21.
Artigo em Inglês | MEDLINE | ID: mdl-31970966

RESUMO

We report a case of a recurrence of 5 cardiac myxomas in both atria with atypical anatomical features difficult to image. Although a multimodality imaging was performed, three-dimensional echocardiography (3DE) was the only technique able to correctly identify all the recurrences and the anatomical characteristics of the myxomas. MRI detected the blood supply of the mass but even after careful review was able to identify only 4 of the 5 lesions. Even though it was already reported the usefulness of 3DE to better delineate the site of attachment of cardiac tumors, it was never reported its sensibility in the setting of multiple myxomas; this case highlights the ability of the 3DE in this challenging scenario and its potential for being considered the key adjunctive modality for the anatomy when advanced surgical plan is required.


Assuntos
Ecocardiografia Tridimensional/métodos , Átrios do Coração/patologia , Mixoma/diagnóstico por imagem , Adulto , Feminino , Neoplasias Cardíacas/patologia , Humanos , Imagem por Ressonância Magnética/métodos , Mixoma/cirurgia , Recidiva Local de Neoplasia/cirurgia , Reoperação/métodos , Resultado do Tratamento
17.
J Card Surg ; 35(2): 422-424, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31794111

RESUMO

Cardiac myxomas (CM) is by far the most common type of primary cardiac neoplasm that commonly arise within the left atria and is composed of primitive connective tissue cells and stroma. Despite the benign nature, the CMs are often surgically removed because they can lead to severe complications. Large, thin, and hypermobile forms are unusual. The frequency of recurrence is about 22% for complex forms and 12% for other familial forms and 1% to 3% for sporadic myxomas, which seldom recur after surgery. Although transesophageal echocardiography shows usually accurate imaging capabilities to detect the myxoma, further imaging methods including computed tomography, cardiovascular magnetic resonance imaging, and 18 F-fluorodeoxyglucose positron-emission tomography/computed tomography may be useful to diagnosis for it. Surgery is the mainstay of treatment.


Assuntos
Neoplasias Cardíacas/cirurgia , Anuloplastia da Valva Mitral , Mixoma/cirurgia , Trombose/diagnóstico por imagem , Diagnóstico Diferencial , Ecocardiografia Transesofagiana , Feminino , Átrios do Coração , Neoplasias Cardíacas/diagnóstico por imagem , Neoplasias Cardíacas/patologia , Humanos , Pessoa de Meia-Idade , Mixoma/diagnóstico por imagem , Mixoma/patologia , Recidiva Local de Neoplasia , Trombose/patologia
18.
J Card Surg ; 35(2): 511-513, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31856315

RESUMO

Myxomas are the most common cardiac tumors, benign, and usually located in the left atrium. Typically echocardiography reveals a solid tumor, whereas cystic myxomas are rare with only a few cases documented in the literature. We describe the case of a 63-year-old, female patient with an unusual presentation of a left atrial myxoma as a cystic tumor.


Assuntos
Cistos/etiologia , Neoplasias Cardíacas/complicações , Neoplasias Cardíacas/patologia , Mixoma/complicações , Mixoma/patologia , Cistos/diagnóstico por imagem , Cistos/patologia , Ecocardiografia Transesofagiana , Feminino , Átrios do Coração , Neoplasias Cardíacas/diagnóstico por imagem , Humanos , Pessoa de Meia-Idade , Mixoma/diagnóstico por imagem , Tomografia Computadorizada por Raios X
19.
Cardiovasc Pathol ; 45: 107183, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31865270

RESUMO

Cardiac myxoma is the most frequently encountered primary neoplasm of the heart; however, other tumefactive lesions can share similar radiologic features. We present briefly the case of a 69-year-old man incidentally found to have a mobile right atrial mass that based on initial radiologic findings was considered to represent a myxoma. After pathologic examination, the lesion was determined instead to be a cardiac varix: an endocardial, blood filled cystic space lined by endothelium and considered to represent a dilated vein.


Assuntos
Vasos Coronários/patologia , Cardiopatias/patologia , Neoplasias Cardíacas/patologia , Mixoma/patologia , Varizes/patologia , Idoso , Biópsia , Vasos Coronários/diagnóstico por imagem , Vasos Coronários/cirurgia , Erros de Diagnóstico , Dilatação Patológica , Ecocardiografia Transesofagiana , Cardiopatias/diagnóstico por imagem , Cardiopatias/cirurgia , Neoplasias Cardíacas/diagnóstico por imagem , Humanos , Masculino , Mixoma/diagnóstico por imagem , Valor Preditivo dos Testes , Tomografia Computadorizada por Raios X , Varizes/diagnóstico por imagem , Varizes/cirurgia
20.
J Vasc Surg ; 71(5): 1759-1761, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-31708301

RESUMO

Cardiac myxomas are the most common benign cardiac tumors in adults that can present with peripheral embolization. Complete detachments of myxomas are rare and tend to cause aortoiliac embolism. We report a case of a middle-aged woman with bilateral popliteal artery and segmental renal artery embolisms secondary to a completely detached cardiac myxoma. This case highlights cardiac myxomas as an important cause of acute limb ischemia and that it is not excluded by a normal echocardiogram result.


Assuntos
Embolia/etiologia , Neoplasias Cardíacas/complicações , Isquemia/etiologia , Mixoma/complicações , Anticoagulantes/uso terapêutico , Angiografia por Tomografia Computadorizada , Diagnóstico Diferencial , Ecocardiografia , Embolia/diagnóstico por imagem , Embolia/terapia , Embolização Terapêutica , Feminino , Neoplasias Cardíacas/diagnóstico por imagem , Neoplasias Cardíacas/terapia , Humanos , Isquemia/diagnóstico por imagem , Isquemia/terapia , Extremidade Inferior/diagnóstico por imagem , Imagem por Ressonância Magnética , Pessoa de Meia-Idade , Mixoma/diagnóstico por imagem , Mixoma/terapia , Artéria Poplítea , Artéria Renal
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