Mixoma auricular gigante como diagnóstico diferencial de disnea: a propósito de un caso y revisión de la literatura / Giant atrial myxoma as differential diagnosis of dyspnea: a case report and literature review

Cardiac myxomas are the most common benign primary tumors and are most often located in the left atrium at the level of the interatrial septum, with the characteristic of being pedunculated and highly mobile, which is why they sometimes interfere with the functioning of the mitral valve, generating variable degrees of stenosis and mitral insufficiency. Diagnosis is by echocardiography and treatment is surgical resection. We present the case of a patient with a large atrial myxoma and severe double mitral lesion.

Clinical Experiences of Cardiac Myxoma

Although cardiac myxoma is rare, it is the most common primary cardiac tumor. Seventy-four cases of cardiac myxoma that were surgically treated in our center between August 1980 and February 2005 were retrospectively reviewed. The mean patient age was 50.4+/-15.0 (range 7-80) years, and 53 patients (71.6%) were female. The most common preoperative symptom, occurring in 44 patients, was dyspnea. The interval from onset of symptoms to surgery was 9 months. Seventy cases were located in the left atrium, 3 in the right atrium and 1 in the right ventricle. The myxoma in the right ventricle could not be resected completely, due to severe infiltration. Cardiopulmonary bypass and aortic cross clamp times were 100.4+/-37.1 and 64.8+/-29.8 minutes, respectively. There were no hospital deaths, and 7 patients suffered from postoperative complications including atrial fibrillation in 2 cases. During the follow up period (mean 105.7+/-73.6 months), there was no tumor recurrence and 6 late deaths that were not related to the underlying tumor. There was no evidence of tumor growth in the cases with incomplete resection during the 14-month follow-up. In conclusion, in this study there was no recurrence of tumors after complete resection and surgical resection is considered to be the curative method of treatment for cardiac myxoma.

Clinical Experiences of Cardiac Myxoma

Although cardiac myxoma is rare, it is the most common primary cardiac tumor. Seventy-four cases of cardiac myxoma that were surgically treated in our center between August 1980 and February 2005 were retrospectively reviewed. The mean patient age was 50.4+/-15.0 (range 7-80) years, and 53 patients (71.6%) were female. The most common preoperative symptom, occurring in 44 patients, was dyspnea. The interval from onset of symptoms to surgery was 9 months. Seventy cases were located in the left atrium, 3 in the right atrium and 1 in the right ventricle. The myxoma in the right ventricle could not be resected completely, due to severe infiltration. Cardiopulmonary bypass and aortic cross clamp times were 100.4+/-37.1 and 64.8+/-29.8 minutes, respectively. There were no hospital deaths, and 7 patients suffered from postoperative complications including atrial fibrillation in 2 cases. During the follow up period (mean 105.7+/-73.6 months), there was no tumor recurrence and 6 late deaths that were not related to the underlying tumor. There was no evidence of tumor growth in the cases with incomplete resection during the 14-month follow-up. In conclusion, in this study there was no recurrence of tumors after complete resection and surgical resection is considered to be the curative method of treatment for cardiac myxoma.

Neoplasias primárias do coraçäo: apresentaçäo clínica e histológica de 50 casos / Primary neoplasms of the heart: clinical and histological presentation of 50 cases

OBJECTIVE: To analyze clinical and histologic findings of 50 patients with primary neoplams of the heart in a tertiary referral center. METHODS: From 1980 to 1998, we retrospectively analyzed 50 patients, 32 of whom were females, whose ages ranged from 9 to 73 years (mean age = 44.16 + or -18 years). RESULTS: Most tumors were located in the left side of the heart (72 percent), myxoma being the most common (84 percent) histologic type. The other histologic types found were as follows: fibroma (4 percent), lipoma (2 percent), rhabdomyosarcoma (2 percent), hemangioma (2 percent), sarcoma (2 percent), angiosarcoma (2 percent), and lymphoma (2 percent). Diagnosis was established by echocardiography in 94 percent of the cases. Clinical findings were as follows: dyspnea (36 percent), weight loss (20 percent), palpitations (18 percent), chest pain (16 percent), fever (8 percent), and arthralgia (6 percent). All patients with thromboembolic phenomena (10 percent) had left atrial myxoma. Approximately 20 percent of the patients were asymptomatic at the initial clinical assessment. CONCLUSION: Primary cardiac tumors are a rare entity with diverse clinical and histologic findings, requiring, therefore, a high level of clinical suspicion

Mixoma y sindrome de anticuerpos antifosfolípidos / Myxoma and antiphospholipid antibodies syndrome: report of one case

We report a 26 years old female with a Cerebral Palsy as a consequence of a perinatal vascular accident. She was admitted in August 1996 with a left hemiplegia due to a right M1 median artery thrombotic occlusion, as demonstrated by magnetic resonance imaging angiography. Transesophagical bi-dimensional echocardiography showed a right atrial myxoma and ruled out the persistence of an oval foramen. The study of coagulation disorders lead to the diagnosis of a primary antiphospholipid syndrome. We postulate that interleukin-6 produced by the myxoma could trigger an immunological reaction leading to the primary antiphospholipid syndrome

Mixoma cardiaco: complicaciones neuro-oftalmológicas / Cardiac mixoma. Neuro-ophthalmological complications

Las manifestacines clínicas oftalmológicas del mixoma cardiaco son muy raras y cuando se sospeche de enfermedad embolígena debe de tomarse en cuenta en el diagnóstico diferencial. El presente caso ejemplifica cómo el mixom auricular puede ser manifestación simultánea de obstrucción de arteria central de la retina y de evento vascular cerebral. Se discuten las diversas causa de enfermedad embolígena y se lleva a cabo un ejercicio clínico para diferenciar al mixoma auricular de otras enfermedades sistémicas que nos pudieran dar la misma sintomatología neuro-oftalmológica

Mixoma odontogênicos: relato de caso com consideraçöes clínicas, radiográficas e histopatológicas / Odontogenic myxoma: case report with clinical, radiographic and histopathological considerations

Os autores relatam um caso de mixoma odontogênico sob os aspectos clínicos, radiográficos e histopatológicos em um paciente leucoderma, sexo masculino com 16 anos de idade

Mixoma Cardíaco

Se presentan los aspectos clínicos patológicos de dos casos de Mixoma cardíaco, todos localizados en la aurícula izquierda. Los dos casos se presentaron en adultos de 39 y 22 años de edad. Uno produjo insuficiencia cardíaca descompensada y el otro produjo complicación embólica cerebral

Tumores cardiacos / Cardiac neoplasms

En el pesente trabajo se analiza la bibliografía pertinenete, haciendo incapié en los aspectos clínicos, de laboratorio y gabinete de cada uno de los tumores cardiacos. Los tumores de corazón y pericardio se clasifican en primarios y secundarios, a su vez los primarios en benignos y malignos. Los tumores primarios son raros y representan entre 0.001 y 0.28 por ciento de los tumores globales del cuerpo. Los mixomas son los más comunes y constituyen alrededor de 50 por ciento de todos los tumores histológicamente benignos del corazón. Los tumores secundarios son hasta 40 veces más frecuentes que los primarios. Los que más metastatizan son los mielomas, melanomas, leucemias, carcinomas, lifomas y sarcomas. Cabe señalar que aunque los tumores cardiacos contituyen una patología poco común, ésta debe ser del conocimiento del médico en general y del internista y cardiólogo en particular, sobre todo porque son grandes simuladores de padecimientos cardiovasculares, pricipalmente los mixomas; lo que ha hecho que el cínico piense con mayor frecuencia en ellos y gracias a estudios no invasivos son diagnosticados con mayor facilidad y veracidad. El ecocardiograma modo M, doppler color y transesofágico, así como la resonancia magnética nuclear son los métodos de elección para el diagnóstico. Su tratamiento es puramente quirúrgico y debido a que algunos tienen una alta incidencia de complicaciones que varían desde fenómenos embólicos hasta muerte súbita, paciente diagnosticado, paciente que debe de ser valorado integralmente para ser intervenido quirúrgicamente. El pronóstico de estos tumores dependerá de su grado de malignidad, de las estructuras cardiacas afectadas, si es primario o secundario y de la presencia de metástasis

Cardiopatia neoplásica / Neoplasic cardiopathy

Mesmo diante do avanço propedêutico observado na Cardiologia moderna, devido à sua freqüência clínica realmente incomum, a chamada Cardiopatia Neoplásica exibe reduzido reconhecimento diagnóstico na prática médica. Os tumores cardíacos primários benignos sao menos raros do que os malignos, com predominância, neste aspecto, dos mixomas, ao passo que, em termos de câncer metastático, as neoplasias broncogênicas e de mama sao as que mais envolvem o coraçao durante seu curso evolutivo.

Mixoma do átrio esquerdo e manifestaçöes neurológicas: a propósito de um caso / Left atrial myxoma with neurologic manifestation: a case report

Este trabalho chama a atencao para uma etiologia de acidente vascular cerebral, principalmente em adolescentes e adultos jovens. E apresentado o relato de um caso: jovem de l6 anos de idade que apresentava infarto cerebral e aneurismas multiplos perifericos devido a mixoma do atrio esquerdo. Sao feitas consideracoes sobre a fisiopatologia do processo

Mixoma cardíaco en niños

El mixoma cardíaco aunque infrecuentemente en los grupos etarios jóvenes es la neoplasia más frencuente en el corazón de los pacientes de corta edad. Se presenta el caso de un niño de 13 años de edad con esta lesión a nivel de la aurícula izquierda con sus respectivos hallazgos de anatomía patológica. Posteriormente se revisan las principales características de este tumor que incluyen incidencia, hallazgos macrocópicos, microscópicos, clínica y tratamiento