DOI QR코드

DOI QR Code

Clinical and Histopathological Analysis of 66 Cases with Cardiac Myxoma

  • Zheng, Jian-Jie (Cardiac Surgery, the First Affiliated Hospital of Xi'an Jiaotong University School of Medicine) ;
  • Geng, Xi-Gang (Cardiac Surgery, the First Affiliated Hospital of Xi'an Jiaotong University School of Medicine) ;
  • Wang, Hai-Chen (Cardiac Surgery, the First Affiliated Hospital of Xi'an Jiaotong University School of Medicine) ;
  • Yan, Yang (Cardiac Surgery, the First Affiliated Hospital of Xi'an Jiaotong University School of Medicine) ;
  • Wang, Hong-Yan (Department of Pathology, the First Affiliated Hospital of Xi'an Jiaotong University School of Medicine)
  • Published : 2013.03.30

Abstract

Background and Purpose: Cardiac myxoma is a major primary heart tumor which often causes unexpected symptoms or sudden death. This present study was designed to investigate its clinical pathological features and biological behavior. Methods: A retrospective analysis of the clinical pathologic and immunohistochemical features of 66 cases with cardiac myxoma was conducted. Results: In 66 patients with cardiac myxoma, 61 cases had involvement of the left atrium, one case in both the right ventricular and left atria. The female: male ratio was 2.7:1. Patients had symptoms of blood flow obstruction and systemic alterations with performance of arterial embolization. Tumors were spherical, lobulated or irregular in shape, and soft and brittle. Immunohistochemical markers of vimentin and CD34 in tumor cells were positive. Conclusion: Cardiac myxoma always exists in the left atrium and is more common in women, with diverse clinical manifestations and pathomorphism. Although proliferative activity and the recurrence rate are low, in addition to thorough surgical resection, strengthened review is important for young patients.

References

  1. Val-Bernal JF, Acebo E, Gomez-Roman JJ, et al (2003). Anticipated diagnosis of left atrial myxoma following histological investigation of limb embolectomy specimens: a report of two cases. Pathol Int, 53, 489-94. https://doi.org/10.1046/j.1440-1827.2003.01504.x
  2. Elbardissi AW, Dearani JA, Daly RC, et al (2008). Survival after resection of primary cardiac tumors: a 48-year experience. Circulation, 30, S7-15.
  3. Kotylo PK, Kennedy JE, Waller BF, et al (1991). DNA analysis of atrial myxomas. Chest, 99, 1203-07. https://doi.org/10.1378/chest.99.5.1203
  4. Kuroczynski W, Peivandi AA, Ewald P, et al (2009). Cardiac myxomas: short- and long-term follow-up. Cardiol J, 16, 447-54.
  5. Lamba G, Frishman WH (2012). Cardiac and pericardial tumors. Cardiol Rev, 20, 237-52. https://doi.org/10.1097/CRD.0b013e31825603e7
  6. Leonhardt ET, Kullenberg KP (1977). Bilateral atrial myxomas with multiple arterial aneurysms--a syndrome mimicking polyarteritis nodosa. Am J Med, 62, 792-4. https://doi.org/10.1016/0002-9343(77)90885-3
  7. Molina JE, Edwards JE, Ward HB (1990). Primary cardiac tumors: experience at the university of minnesota. Thorac Aardiovasc Surg, 38, 183-91. https://doi.org/10.1055/s-2007-1014064
  8. Pinede L, Duhaut P, Loire R (2001).Clinical presentation of left atrial cardiac myxoma. A series of 112 consecutive cases. Medicine (Baltimore), 80, 159-72. https://doi.org/10.1097/00005792-200105000-00002
  9. Pucci A, Gagliardotto P, Zanini C, et al (2000). Histopathologic and clinical characterization of cardiac myxoma: review of 53 cases from a single institution. Am Heart J, 140, 134-8. https://doi.org/10.1067/mhj.2000.107176
  10. Sakamoto H, Sakamaki T, Sumino H, et al (2004). Production of endothelin-1 and big endothelin-1 by human cardiac myxoma cells-implications of the origin of myxomas. Circ J, 68, 1230-32. https://doi.org/10.1253/circj.68.1230
  11. Salcedo EE, Cohen GI, White RD, et al (1992). Cardiac tumors: diagnosis and management. Curr Probl Cardiol, 17, 73-137.
  12. Singh SK, Kumar A, Tewarson V, et al (2012). Calcified left atrial myxoma with osseous metaplasia. Indian J Chest Dis Allied Sci, 54, 201-3.
  13. Tasoglu I, Tutun U, Lafci G, et al (2009). Primary cardiac myxomas: clinical experience and surgical results in 67 patients. J Card Surg, 24, 256-9. https://doi.org/10.1111/j.1540-8191.2008.00797.x
  14. Vaideeswar P, Gupta R, Mishra P, et al (2012). Atypical cardiac myxomas: a clinicopathologic analysis and their comparison to 64 typical myxomas. Cardiovasc Pathol, 21, 180-7. https://doi.org/10.1016/j.carpath.2011.07.001
  15. Acebo E, Val-Bernal JF, Gomez-Roman JJ, et al (2003). Clinicopathologic study and DNA analysis of 37 cardiac myxomas: a 28-year experience. Chest, 123, 1379-85. https://doi.org/10.1378/chest.123.5.1379
  16. Amano J, Kono T, Wada Y, et al (2003). Cardiac myxoma: its origin and tumor characteristics. Ann Thorac Cardiovasc Surg, 9, 215-21.
  17. Barh D, Kumar A, Chatterjee S, et al (2009). Molecular features, markers, drug targets, and prospective targeted therapeutics in cardiac myxoma. Current Cancer Drug Targets, 9, 705-16. https://doi.org/10.2174/156800909789271549
  18. Berrutti L, Silverman JS (1996). Cardiac myxoma is rich in Fator XIIIa positive dendrophages: immunohistochemical study of four cases. Histopathology, 28, 529-35. https://doi.org/10.1046/j.1365-2559.1996.d01-470.x
  19. Chu PH, Jung SM, Yeh TS, et al (2005). MUC1, MUC2 AND MUC5AC expressions in cardiac myxoma. Virchows Arch, 446, 52-5. https://doi.org/10.1007/s00428-004-1147-5
  20. D'Alfonso A, Catania S, Pierri MD, et al (2008). Atrial myxoma: a 25-year single-institutional follow-up study. J Cardiovasc Med (Hagerstown), 9, 178-81. https://doi.org/10.2459/JCM.0b013e3281ac22cb

Cited by

  1. The Value of Multi-slice CT Imaging in Cardiac Myxomas in Comparison with Follow-Up Screening in Thoracoscopic Surgery vol.73, pp.2, 2015, https://doi.org/10.1007/s12013-015-0689-2
  2. Left Ventricular Myxoma—A Case Report vol.05, pp.03, 2016, https://doi.org/10.4236/crcm.2016.53016
  3. Right Ventricular Myxoma—A Case Report vol.05, pp.04, 2016, https://doi.org/10.4236/crcm.2016.54030
  4. Growth hormone and risk for cardiac tumors in Carney complex vol.23, pp.9, 2016, https://doi.org/10.1530/ERC-16-0246
  5. Left Atrial Myxomectomy with Intraoperative Severe Mitral Regurgitation and Complicated Postoperative Course – Case Report vol.9, pp.1179-5476, 2016, https://doi.org/10.4137/CCRep.S26625
  6. Cardiac myxoma: clinical characteristics, surgical intervention, intra-operative challenges and outcome vol.32, pp.8, 2017, https://doi.org/10.1177/0267659117722596
  7. A Case Report of Central Retinal Artery Occlusion Caused by Cardiac Myxoma vol.58, pp.4, 2017, https://doi.org/10.3341/jkos.2017.58.4.478
  8. Treating cardiac myxomas vol.17, pp.1, 2016, https://doi.org/10.2459/JCM.0000000000000114
  9. Left Atrial Myxoma in a Woman with Postpartum Heart Failure: The Culprit or an Incidental Bystander vol.07, pp.01, 2018, https://doi.org/10.4236/crcm.2018.71006
  10. Retinal artery occlusion as the manifestation of left atrial myxoma: a case report vol.14, pp.1, 2014, https://doi.org/10.1186/1471-2415-14-164
  11. Atrialised right ventricular myxoma in a patient with Ebstein’s anomaly vol.5, pp.1, 2018, https://doi.org/10.1530/ERP-17-0065