Complete remission of immune thrombocytopenia in a 30-year old woman after excision of a right atrial myxoma

Cardiac Myxomas As Chameleons: A Scoping Review of Their Paraneoplastic Presentations

This scoping review aims to explore the relationship between cardiac myxomas (CMs) and paraneoplastic syndromes (PS). CMs are the most common tumors in the heart, with the majority located in the left atrium, and are often associated with a triad of obstructive, embolic, and constitutional symptoms. However, they can also present with unrelated symptoms that are part of a PS. This study performed a thorough literature search of 11 databases and included 12 papers in the final review. All of the patients were diagnosed with atrial myxoma, which initially presented as a PS. Surgery was the curative measure in all cases and resulted in remission in every case, with patients reporting resolution of symptoms at follow-up. The majority of patients in the study were female, with comorbid rheumatologic conditions often present. This study highlights the heterogeneity of presentations of CMs and their associated PS.

Primary Cardiac Lymphoma Presenting with Thrombocytopenia, Right Heart Failure, and Cardiogenic Shock

Primary cardiac lymphoma (PCL) is a rare, potentially fatal subtype of non-Hodgkin's lymphoma. Thrombocytopenia has also infrequently been reported in association with other primary cardiac tumours and can add substantial morbidity to an already life-threatening diagnosis if present. We report a rare case of a 70-year-old man who presented with thrombocytopenia (91 × 10⁹/L) and progressive right heart failure. Transthoracic echocardiogram revealed a large 8 × 4 cm right atrial mass with severe tricuspid obstruction, confirmed as PCL on subsequent endomyocardial biopsy and immunohistochemistry. He deteriorated into cardiogenic shock precipitated by atrial fibrillation, with worsening thrombocytopenia (18 × 10⁹/L) in the setting of ischaemic hepatitis. The patient stabilised with initiation of high dose steroids prior to tissue diagnosis and platelet counts normalised following chemotherapy. This case demonstrates the importance of considering PCL as a diagnosis and preemptive initiation of high dose steroids to improve outcomes in PCL associated with cardiogenic shock. This case also elucidates a potential pathophysiological association between PCL and thrombocytopenia.

Giant cardiac myxoma in a patient with thrombocytopenia: is there a physiopathologic link? (a case report)

Atrial myxoma is the most common primary cardiac tumor. We report the case of left atrium myxoma accompanied by severe thrombocytopenia in a 72-years-old woman. The thrombocytopenia has been discovered 5 years ago, it was explored, no obvious cause was found, the diagnosis of idiopathic thrombocytopenia was retained based on clinical and paraclinical arguments, corticosteroid treatment was ineffective and platelet count remains low. Complete surgical excision of the mass was performed. Platelet count was gradually increased to reach 95 103/µl after 6 months postoperatively. In this report, we highlight that thrombocytopenia might be one rare hematological manifestation of myxoma but need more cases for support. By illustrating this association, we hope to facilitate an earlier diagnosis of cardiac myxoma to treat and avoid complications of both thrombocytopenia and myxoma.