Left Atrial Myxoma Presenting with Migratory Erythematous Maculopapules

ABSTRACT

Cardiac myxoma is the most common primary tumor of the heart. Although skin symptoms in patients with cardiac myxoma are common, cutaneous manifestations of cardiac myxoma are usually nonspecific. So only very rarely have the cutaneous signs been clue to the correct diagnosis. We present a 44-year-old-man with a history of episodes of migratory acral erythematous maculopapular lesions on his right hand and foot including the palm and sole, who also had episodes of myalgia in his right side upper and lower extremities. Histological examination revealed an embolus within the vessels in the dermis. Alcian blue staining was positive, consistent with a diagnosis of myxomatous embolus. Two-dimensional echocardiogram revealed a 4 (3cm-sized mobile mass in the left atrium. A diagnosis of left atrial myxoma was strongly suspected and the tumor was excised by open-heart surgery. No more cutaneous lesions or other symptoms of systemic embolism have appeared to date.