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Wu SJ, Shi QR. Pelvic aggressive angiomyxoma: A case report. Asian J Surg 2024; 47:2245-2246. [PMID: 38326110 DOI: 10.1016/j.asjsur.2024.01.135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 01/26/2024] [Indexed: 02/09/2024] Open
Affiliation(s)
- Si-Jia Wu
- Department of Gynaecology and Obstetrics, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, 362000, China
| | - Qi-Rong Shi
- Department of Gynaecology and Obstetrics, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, 362000, China.
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2
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Kondracki B, Olszewski K, Baczewski K. Giant and asymptomatic atrial myxoma: a rare case of heart tumor. Pol Arch Intern Med 2024; 134:16683. [PMID: 38380606 DOI: 10.20452/pamw.16683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Affiliation(s)
- Bartosz Kondracki
- Department of Cardiology, Medical University of Lublin, Lublin, Poland.
| | | | - Kamil Baczewski
- Department of Cardiac Surgery, Medical University of Lublin, Lublin, Poland
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3
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Sakakibara S, Yamauchi T, Ohmori T. A surgical resection case of myxoma arising from the posterior wall of the left atrium complicated with complete atrioventricular block. J Cardiothorac Surg 2024; 19:229. [PMID: 38627746 PMCID: PMC11020980 DOI: 10.1186/s13019-024-02715-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 03/29/2024] [Indexed: 04/19/2024] Open
Abstract
An 80-year-old female was referred to our institution due to transient right upper limb weakness. Transthoracic and transesophageal echocardiography revealed a tumor in the left atrium. The tumor was attached to the posterior wall of the left atrium near the atrioventricular node. Intraoperative pathological examination revealed that the tumor was a myxoma, and complete resection was successfully performed. However, she experienced persistent complete atrioventricular block postoperatively and required pacemaker implantation.
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Affiliation(s)
- Satoshi Sakakibara
- Department of Cardiovascular Surgery, Higashiosaka City Medical Center, 3-4-5 Nishi iwata, Higashiosaka, 578-8588, Osaka, Japan
| | - Takashi Yamauchi
- Department of Cardiovascular Surgery, Higashiosaka City Medical Center, 3-4-5 Nishi iwata, Higashiosaka, 578-8588, Osaka, Japan.
| | - Takahiro Ohmori
- Department of Cardiovascular Surgery, Higashiosaka City Medical Center, 3-4-5 Nishi iwata, Higashiosaka, 578-8588, Osaka, Japan
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4
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Liu Y, Wang H, Huang H, Han F, Zhuang J, Ou Y, Lin Y, Zhang W. Management of left atrial myxoma in pregnant women: a case series. J Cardiothorac Surg 2024; 19:197. [PMID: 38600499 PMCID: PMC11008003 DOI: 10.1186/s13019-024-02747-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Accepted: 03/29/2024] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND Left atrial myxoma during pregnancy is rare. We present three cases in order to aid in the management. CASE PRESENTATION Three cases of left atrial myxoma during pregnancy were presented in this article. Three patients all received multidisciplinary team work and acquired good outcomes. The case 1 had no symptoms and delivered before traditional cardiac surgery. The case 2 and case 3 undergone totally endoscopic minimally invasive cardiac surgery during pregnancy. The case 3 maintained pregnancy to term and gave birth to a healthy baby via vaginal delivery. No relapse of the tumor was observed. CONCLUSIONS The management of left atrial myxoma during pregnancy ought to be individualized and combined with the gestational age. If the diagnosis was made in the first two trimesters of pregnancy, totally endoscopic minimally invasive cardiac surgery during pregnancy would be an optimal choice. The patients can benefit from the multidisciplinary team work.
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Affiliation(s)
- Yanli Liu
- Department of Obstetrics, Guangdong Provincial People's Hospital(Guangdong Academy of Medical Sciences), Southern Medical University, No. 106 Zhongshan 2nd road, Guangzhou, 510080, Guangdong, China
| | - Haiping Wang
- Prenatal Diagnosis Center, Guangdong Provincial People's Hospital(Guangdong Academy of Medical Sciences), Southern Medical University, No. 106 Zhongshan 2nd road, Guangzhou, 510080, Guangdong, China.
| | - Huanlei Huang
- Department of Cardiac Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital(Guangdong Academy of Medical Sciences), Southern Medical University, No. 106 Zhongshan 2nd road, Guangzhou, 510080, Guangdong, China.
| | - Fengzhen Han
- Department of Obstetrics, Guangdong Provincial People's Hospital(Guangdong Academy of Medical Sciences), Southern Medical University, No. 106 Zhongshan 2nd road, Guangzhou, 510080, Guangdong, China
| | - Jian Zhuang
- Department of Cardiac Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital(Guangdong Academy of Medical Sciences), Southern Medical University, No. 106 Zhongshan 2nd road, Guangzhou, 510080, Guangdong, China
| | - Yanqiu Ou
- Department of Cardiac Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital(Guangdong Academy of Medical Sciences), Southern Medical University, No. 106 Zhongshan 2nd road, Guangzhou, 510080, Guangdong, China
| | - Yanyan Lin
- Department of Obstetrics, Guangdong Provincial People's Hospital(Guangdong Academy of Medical Sciences), Southern Medical University, No. 106 Zhongshan 2nd road, Guangzhou, 510080, Guangdong, China
| | - Weina Zhang
- Department of Obstetrics, Guangdong Provincial People's Hospital(Guangdong Academy of Medical Sciences), Southern Medical University, No. 106 Zhongshan 2nd road, Guangzhou, 510080, Guangdong, China
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Rana AD, Vallurupalli S, Mitchell M, Duncan D, Xu J. All that Doesn't Enhance Isn't a Thrombus: Pitfalls Using Cardiac MRI TI 600 Sequence to Distinguish Between Cardiac Thrombus Versus Myxoma. Methodist Debakey Cardiovasc J 2024; 20:23-25. [PMID: 38618609 PMCID: PMC11011946 DOI: 10.14797/mdcvj.1322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Accepted: 12/15/2023] [Indexed: 04/16/2024] Open
Abstract
A 51-year-old male with a complicated medical history presented with shortness of breath. Preoperative workup confirmed the presence of a large atrial mass. However, delayed gadolinium enhancement CMR with long inversion time (TI 600) showed lack of enhancement, which was suggestive of a thrombus. During cardiac magnetic resonance imaging, delayed gadolinium enhancement sequences with long inversion time (TI 600) are commonly used to distinguish between an avascular thrombus versus a vascular tumor.
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Affiliation(s)
- Aakash D. Rana
- Central Arkansas Veteran Affairs Health System, Little Rock, Arkansas, US
| | | | - Mark Mitchell
- Novant Health Forsyth Medical Center, Winston-Salem, North Carolina, US
| | - David Duncan
- Novant Health Forsyth Medical Center, Winston-Salem, North Carolina, US
| | - Jack Xu
- Novant Health Forsyth Medical Center, Winston-Salem, North Carolina, US
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Liang C, Feng L, Shunlin G. A rare case of massive myxoma. Asian J Surg 2024; 47:1785-1786. [PMID: 38160155 DOI: 10.1016/j.asjsur.2023.12.117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 12/04/2023] [Accepted: 12/15/2023] [Indexed: 01/03/2024] Open
Affiliation(s)
- Cao Liang
- Department of Radiology, The First Hospital of Lanzhou University, Lanzhou, 730000, China
| | - Liu Feng
- The First Clinical Medical College, Lanzhou University, Lanzhou, 730000, China
| | - Guo Shunlin
- Department of Radiology, The First Hospital of Lanzhou University, Lanzhou, 730000, China.
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7
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Shahim A, Ivert T, Dalén M. Giant Right Atrial Myxoma - An Unusual Cause of Dyspnoea. Heart Lung Circ 2024; 33:e25-e26. [PMID: 38461107 DOI: 10.1016/j.hlc.2024.01.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 12/22/2023] [Accepted: 01/16/2024] [Indexed: 03/11/2024]
Affiliation(s)
- Angiza Shahim
- Department of Cardiothoracic Surgery, Karolinska University Hospital, Stockholm, Sweden; Division of Cardiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Torbjörn Ivert
- Department of Cardiothoracic Surgery, Karolinska University Hospital, Stockholm, Sweden; Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
| | - Magnus Dalén
- Department of Cardiothoracic Surgery, Karolinska University Hospital, Stockholm, Sweden; Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
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Lee HJ, Kim H, Song K. Left atrial myxoma presenting as a mass with cystic component. Echocardiography 2024; 41:e15814. [PMID: 38581303 DOI: 10.1111/echo.15814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 03/29/2024] [Accepted: 03/30/2024] [Indexed: 04/08/2024] Open
Affiliation(s)
- Hee Jeong Lee
- Department of Cardiology, Keimyung University Dongsan Hospital, Keimyung University College of Medicine, Daegu, Republic of Korea
| | - Hyungseop Kim
- Department of Cardiology, Keimyung University Dongsan Hospital, Keimyung University College of Medicine, Daegu, Republic of Korea
| | - Kyungsub Song
- Department of Thoracic and Cardiovascular Surgery, Keimyung University Dongsan Hospital, Keimyung University College of Medicine, Daegu, Republic of Korea
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9
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Cardenas Lara FJ, Bauzon JS, Perry WRG, Kelley SR. Aggressive Angiomyxoma of the Pelvis: 35-Year Experience. Dis Colon Rectum 2024; 67:514-522. [PMID: 38100620 DOI: 10.1097/dcr.0000000000003152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2023]
Abstract
BACKGROUND Aggressive angiomyxoma is a very rare mesenchymal tumor most commonly found in the pelvic and perineal regions. Although many are estrogen and progesterone hormone receptor positive, the pathogenesis is unknown. Due to its rarity, there is a paucity of literature relating to this pathology. This article presents a case series on the management of aggressive angiomyxoma of the pelvis. OBJECTIVE To present a 35-year experience managing aggressive angiomyxoma of the pelvis. DESIGN This was a retrospective single-system analysis. SETTINGS This study was conducted at a quaternary referral academic health care system. PATIENTS All patients treated for aggressive angiomyxoma of the pelvis. INTERVENTIONS All patients underwent surgical or medical management of their disease. MAIN OUTCOME MEASURES The primary outcomes were disease recurrence and mortality. Secondary outcomes included risk factors for recurrence. RESULTS A total of 32 patients (94% women) were identified with a median follow-up of 65 months. Thirty patients (94%) underwent operative resection and 2 patients were treated solely with medical management. Fifteen achieved an R0 resection (negative microscopic margins) at the index operation, of which 4 (27%) experienced tumor recurrence. There were no mortalities. No risk factors for disease recurrence were identified. LIMITATIONS Limitations to our study include its nonrandomized retrospective nature, single health care system experience, and small patient sample size. CONCLUSIONS Aggressive angiomyxoma is a rare, slow-growing tumor with locally invasive features and a high potential for recurrence even after resection with negative margins. Imaging modalities such as CT or MRI should be obtained to aid in diagnosis and surgical planning. Workup should be paired with preoperative biopsy and testing for hormone receptor status, which can increase diagnostic accuracy and guide medical treatment. Close posttreatment surveillance is imperative to detect recurrence. See Video Abstract . ANGIOMIXOMA AGRESIVO DE PELVIS EXPERIENCIA DE AOS ANTECEDENTES:El angiomixoma agresivo es un tumor mesenquimal muy raro que se encuentra más comúnmente en las regiones pélvica y perineal. Aunque muchos son positivos para los receptores hormonales como el estrógeno y la progesterona, la patogénesis es aún desconocida. Debido a su rareza, existe escasa literatura relacionada con esta patología. Este artículo presenta una serie de casos sobre el tratamiento del angiomixoma agresivo de pelvis.OBJETIVO:Presentar una experiencia de 35 años en el manejo del angiomixoma agresivo de pelvis.DISEÑO:Este fue un análisis retrospectivo de sistema único.AJUSTES:Este estudio se llevó a cabo en un sistema de salud académico de referencia de nivel cuaternario.PACIENTES:Todos los pacientes tratados por angiomixoma agresivo de pelvis.INTERVENCIONES:Todos los pacientes se sometieron a tratamiento quirúrgico y/o médico de su enfermedad.PRINCIPALES MEDIDAS DE RESULTADO:Los resultados primarios fueron la recurrencia de la enfermedad y la mortalidad. Los resultados secundarios incluyeron factores de riesgo de recurrencia.RESULTADOS:Se identificaron un total de 32 pacientes (94% mujeres) con una mediana de seguimiento de 65 meses. Treinta (94%) fueron sometidos a resección quirúrgica y dos fueron tratados únicamente con tratamiento médico. Quince lograron una resección R0 (márgenes microscópicos negativos) en la operación inicial, de los cuales cuatro (27%) experimentaron recurrencia tumoral. No hubo mortalidades. No se identificaron factores de riesgo para la recurrencia de la enfermedad.LIMITACIONES:Las limitaciones de nuestro estudio incluyen su naturaleza retrospectiva no aleatoria, la experiencia de un solo sistema de atención médica y el tamaño pequeño de la muestra de pacientes.CONCLUSIONES:El angiomixoma agresivo es un tumor raro, de crecimiento lento, con características localmente invasivas y un alto potencial de recurrencia incluso después de una resección con márgenes negativos. Se deben obtener modalidades de imágenes como CT y/o MRI para la ayuda diagnóstica y la planificación quirúrgica. El estudio debe combinarse con una biopsia preoperatoria y pruebas del estado de los receptores hormonales, que pueden aumentar la precisión del diagnóstico y guiar el tratamiento médico. Es imperativa una estrecha vigilancia posterior al tratamiento para detectar recurrencia. (Traducción-Dr Osvaldo Gauto ).
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Affiliation(s)
| | | | - William R G Perry
- Division of Colon and Rectal Surgery, Mayo Clinic, Rochester, Minnesota
| | - Scott R Kelley
- Division of Colon and Rectal Surgery, Mayo Clinic, Rochester, Minnesota
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Saad EA, Mukherjee T, Gandour G, Fatayerji N, Rammal A, Samuel P, Abdallah N, Ashok T. Cardiac myxomas: causes, presentations, diagnosis, and management. Ir J Med Sci 2024; 193:677-688. [PMID: 37737916 DOI: 10.1007/s11845-023-03531-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 09/14/2023] [Indexed: 09/23/2023]
Abstract
Cardiac myxomas (CM) are one of the most common benign tumors which are typical in adults with a yearly incidence of 0.5-1 case per million individuals. This review article includes discussions based on existing literature on the role of interleukin interactions in the pathophysiology of cardiac myxoma which can lead to embolic complications, aneurysms, and CNS involvement. The objective of this narrative review was to study the variable clinical presentations of cardiac myxoma, its detection and diagnosis involving multiple modalities like genetic and hematological testing, echocardiography, CT, and MRI, of which transoesophageal echocardiogram shows excellent precision with a 90% to 96% accuracy in diagnosing CM. Individuals with the Carney complex are prone to such neoplasia. Cardiac myxomas are challenging to diagnose due to the ambiguity of their differential with thrombi. Myxomas can also be diagnosed by tumor markers like interleukin-6 and endothelial growth factors. The management of CM includes surgical excision like median sternotomy and robotic minimally invasive surgery. The use of robotic surgery in CM increased from 1.8% in 2012 to 15.1% in 2018. Tumor recurrences are uncommon but can occur due to inadequate surgical resection.
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Affiliation(s)
- Elio Assaad Saad
- Faculty of Medicine and Medical Sciences, University of Balamand, Al Koura, Lebanon
| | - Tishya Mukherjee
- Faculty of Medicine, Nicolae Testemițanu State University of Medicine and Pharmacy, Chișinău, Moldova
| | - Georges Gandour
- Faculty of Medicine and Medical Sciences, University of Balamand, Al Koura, Lebanon
| | - Nora Fatayerji
- Faculty of Medicine and Medical Sciences, Poznan University of Medical Sciences, Poznan, Poland
| | - Aya Rammal
- Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Peter Samuel
- International Faculty of Medicine, Tbilisi State Medical University, Tbilisi, Georgia.
| | - Nicolas Abdallah
- Faculty of Medicine and Medical Sciences, University of Balamand, Al Koura, Lebanon
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Lancaster I, Hrobowski-Blackman T, Patel D, Chatoor L, Simon J, Willinger A. Left atrial myxoma with cardiogenic shock following a myocardial infarction: a case report. J Med Case Rep 2024; 18:151. [PMID: 38462621 PMCID: PMC10926659 DOI: 10.1186/s13256-024-04420-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 01/30/2024] [Indexed: 03/12/2024] Open
Abstract
BACKGROUND Myxomas are the most common primary cardiac tumor and typically originate in the left atrium. Atrial myxomas may present following complications of obstruction and emboli. If an atrial myxoma goes untreated, complications such as congestive heart failure, embolic stroke, and sudden death can occur. CASE PRESENTATION A 58-year-old Caucasian male presented following a cardiac arrest. He was taken emergently to the cardiac catheterization lab and received two drug eluting stents. Following the procedure, he was found to have a left atrial mass that was intermittently obstructing the mitral valve on echocardiography. After leaving the cardiac catheterization lab, he was hypotensive and placed on multiple intravenous medications for hemodynamic support as well as an Impella device. Following medical optimization, he underwent one vessel coronary artery bypass graft as well as surgical excision of the left atrial mass, which pathology had shown to be an atrial myxoma. CONCLUSION This patient's case of cardiogenic shock following revascularization was complicated by the identification of an atrial myxoma, which, when large enough, can obstruct blood flow through the mitral valve leading to acute mitral dynamic stenosis. This condition results in circulatory collapse due to obstruction of the left ventricle in diastole as the myxoma occludes the mitral valve.
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Affiliation(s)
- Ian Lancaster
- HCA Healthcare/USF Morsani College of Medicine GME Programs, Largo Medical Center, 201 14Th St SW, Largo, FL, 33770, USA.
| | - Tara Hrobowski-Blackman
- HCA Healthcare/USF Morsani College of Medicine GME Programs, Largo Medical Center, 201 14Th St SW, Largo, FL, 33770, USA
| | - Deep Patel
- HCA Healthcare/USF Morsani College of Medicine GME Programs, Largo Medical Center, 201 14Th St SW, Largo, FL, 33770, USA
| | - Lubna Chatoor
- HCA Healthcare/USF Morsani College of Medicine GME Programs, Largo Medical Center, 201 14Th St SW, Largo, FL, 33770, USA
| | - Joshini Simon
- HCA Healthcare/USF Morsani College of Medicine GME Programs, Largo Medical Center, 201 14Th St SW, Largo, FL, 33770, USA
| | - Andrew Willinger
- HCA Healthcare/USF Morsani College of Medicine GME Programs, Largo Medical Center, 201 14Th St SW, Largo, FL, 33770, USA
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Lee SE, Lee SB, Kim K, Sung JY. Conjunctival myxoma: A case report and review of a rare tumor. Medicine (Baltimore) 2024; 103:e37342. [PMID: 38457580 PMCID: PMC10919476 DOI: 10.1097/md.0000000000037342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 02/02/2024] [Indexed: 03/10/2024] Open
Abstract
RATIONALE Conjunctival myxoma is a rare benign tumor, which can mimic more common conjunctival lesions such as a cyst, lymphangioma, amelanotic nevus, neurofibroma, amelanotic melanoma, or lipoma. We describe a patient with the conjunctival myxoma, who was initially misdiagnosed as a conjunctival cyst. This case report includes intraoperative photographs and various immunohistochemical staining images. PATIENTS CONCERNS A 55-year-old woman presented with a painless mass in the superotemporal conjunctiva of the left eye, which she had noticed 1 month ago. The patient had no previous history of trauma or eye surgery. Slit-lamp examination revealed a well-circumscribed, freely movable, pinkish, semi-translucent mass on the temporal bulbar conjunctiva, suggestive of a conjunctival cyst. DIAGNOSES Histopathological analysis showed stellate- and spindle-shaped cells within the loose myxoid stroma, confirming a diagnosis of conjunctival myxoma. INTERVENTIONS The conjunctival lesion was completely excised under local anesthesia. OUTCOMES After 4 months of follow-up, the patient remained in good health without recurrence of the conjunctival lesion and no evidence of any systemic abnormality. LESSONS Myxoma is an extremely uncommon benign tumor derived from primitive mesenchyme. Considering the rarity of the tumor and its similarity to other conjunctival tumors, diagnosis can be challenging. Ophthalmologists should consider myxoma as a possible differential diagnosis when encountering conjunctival lesions. Surgical excision is essential to confirm the diagnosis and careful systemic evaluation is required to prevent potentially life-threatening underlying systemic conditions.
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Affiliation(s)
- Seong Eun Lee
- Department of Ophthalmology, Chungbuk National University Hospital, Cheongju, Republic of Korea
| | - Sung Bok Lee
- Department of Ophthalmology, Chungnam National University College of Medicine, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Kyunghee Kim
- Department of Pathology, Chungnam National University College of Medicine, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Jae Yun Sung
- Department of Ophthalmology, Chungnam National University College of Medicine, Chungnam National University Sejong Hospital, Sejong, Republic of Korea
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Shahbuddin HMAW, Hussin SA, W Isa WYH, Mamat AZ, Marzuki A, Yusof Z. Dizzy spells in pregnancy: successful antenatal removal of a huge left atrial myxoma with mitral valve obstruction. BMJ Case Rep 2024; 17:e259675. [PMID: 38453227 PMCID: PMC10921428 DOI: 10.1136/bcr-2024-259675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2024] Open
Abstract
Diagnosing atrial myxoma in pregnancy is challenging because patients may present with non-specific symptoms that might be overlooked. The timing of non-obstetric operation usually depends on the nature of the disease, after careful consideration of feto-maternal safety, including the use of cardiopulmonary bypass and placental transfer of anaesthetic drug. A woman in her 30s at 18 weeks of pregnancy presented with recurring dizziness. She underwent successful myxoma excision at 20 weeks under general anaesthesia and cardiopulmonary bypass. The 6×5 cm myxoma was histologically confirmed as myxoma. Early detection of atrial myxoma in pregnancy is crucial, and a clinician has to consider the diagnosis of left atrial myxoma with mitral valve obstruction as a cause of severe dizziness. Optimal outcomes require multidisciplinary management. In this case, surgery during the second trimester of pregnancy enabled a full-term pregnancy with the patient's and foetal well-being and normal postprocedural echocardiography.
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Affiliation(s)
| | - Siti Aisyah Hussin
- Cardiology Unit, Hospital Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
- School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kota Bharu, Kelantan, Malaysia
| | - W Yus Haniff W Isa
- Cardiology Unit, Hospital Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
- School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kota Bharu, Kelantan, Malaysia
| | - Ahmad Zuhdi Mamat
- School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kota Bharu, Kelantan, Malaysia
- Cardiothoracic Surgery Unit, Hospital Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
| | - Ariffin Marzuki
- School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kota Bharu, Kelantan, Malaysia
- Department of Anaesthesia and Intensive Care, Hospital Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
| | - Zurkurnai Yusof
- Cardiology Unit, Hospital Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
- School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kota Bharu, Kelantan, Malaysia
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Bandlamuri S, Custozzo A, Silva J, Bandlamuri SK, Qian J, Paul AR. Systematic Review and Case of Thrombectomy for Pediatric Stroke Due to Myxoma Embolism. World Neurosurg 2024; 183:e761-e771. [PMID: 38211812 DOI: 10.1016/j.wneu.2024.01.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 01/04/2024] [Indexed: 01/13/2024]
Abstract
BACKGROUND Stroke presentation secondary to a cardiac myxoma thromboembolism is rare in the pediatric population. Because of such rarity, the reported cases in the literature are primarily case reports. Additionally, general pediatric stroke management lacks evidence-based guidelines because of its low incidence and lack of clinical trials. In pediatric strokes identified from a cardiac myxoma, the incidence favors boys with the classical presentation of unilateral weakness and aphasia. We present a pediatric patient who presented with strokelike symptoms secondary to an intracranial embolus from a previously undiagnosed cardiac myxoma. METHODS We performed a systematic review by searching PubMed, Google Scholar, Web of Science, and Embase databases for cases of pediatric myxoma causing stroke (n = 2431) and identified 19 reported uses of surgical management in treating pediatric patients who present with stroke symptoms secondary to a cardiac myxoma thromboembolism. RESULTS The most common imaging modality was magnetic resonance imaging in 42% of cases, computed tomography in 36.8%, followed by computed tomography angiography in 31.6% of cases. Of these 19 children treated with procedures, 36.8% of pediatric patients aged between 4 and 14 years underwent neurosurgery (n = 7). CONCLUSIONS We describe an urgent mechanical thrombectomy and share preoperative and postoperative images and pathology slides confirming a stroke from myxoma origin. We provide added insight in the safe use of mechanical thrombectomy as treatment for pediatric strokes secondary to a thromboembolism.
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Affiliation(s)
- Sruti Bandlamuri
- Department of Neurosurgery, Albany Medical Center, Albany, New York, USA
| | - Amanda Custozzo
- Department of Neurosurgery, Albany Medical Center, Albany, New York, USA
| | - Jonathan Silva
- Department of Neurosurgery, Albany Medical Center, Albany, New York, USA
| | | | - Jiang Qian
- Department of Pathology and Laboratory Medicine, Albany Medical Center, Albany, New York, USA
| | - Alexandra R Paul
- Department of Neurosurgery, Albany Medical Center, Albany, New York, USA.
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15
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Qu Y, Li L, Deng M, Song D, Gao M, Su G. Considerations and anesthetic management of a patient with giant right atrial myxoma: A case report and literature review. Medicine (Baltimore) 2024; 103:e37141. [PMID: 38363890 PMCID: PMC10869086 DOI: 10.1097/md.0000000000037141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 01/11/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND Myxoma is a common type of primary cardiac tumor. However, there are few researches to illustrate challenge of safely inducing anesthesia in a patient with a giant right atrial myxoma at moderate altitude. PATIENT CONCERNS AND DIAGNOSES A 54-year-old female patient lived in a city with an average altitude of 1932 m with scheduled surgical treatment for giant right atrial myxoma, prompting discussions on appropriate anesthesia modalities given her prolonged residence at moderate altitude. METHODS AND RESULTS Considering the potential impact of moderate altitude on perioperative management, this study emphasizes the necessity of adequate volume preload therapy and the utility of transthoracic echocardiography or transesophageal echocardiography to prevent hemodynamic compromise. Furthermore, it highlights the unique consideration that, post-tumor removal, hypotension may not necessarily lead to decreased oxygen saturation in these patients. CONCLUSION This case underscores the importance of avoiding hypotension, as pre-tumor resection blood pressure maintenance primarily determines blood oxygen concentration. Additionally, it sheds light on the intriguing observation that post-tumor removal hypotension may not result in decreased oxygen saturation. These findings have significant implications for the perioperative care of patients with giant right atrial myxoma at moderate altitudes.
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Affiliation(s)
- Yan Qu
- Department of Anesthesiology, Affiliated Hospital of Yunnan University, Kunming, Yunnan, PR China
| | - Lei Li
- Department of Radiology, Affiliated Hospital of Yunnan University, Kunming, Yunnan, PR China
| | - Min Deng
- Department of Anesthesiology, Affiliated Hospital of Yunnan University, Kunming, Yunnan, PR China
| | - Duanyi Song
- Department of Anesthesiology, Affiliated Hospital of Yunnan University, Kunming, Yunnan, PR China
| | - Min Gao
- Department of Anesthesiology, Affiliated Hospital of Yunnan University, Kunming, Yunnan, PR China
| | - Guoning Su
- Department of Anesthesiology, Affiliated Hospital of Yunnan University, Kunming, Yunnan, PR China
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16
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Potey K, Jhajhria N, Mallik M, Bhushan R, Aiyer P, Grover V. Our 10-Year Experience with Atrial Myxomas: Is Concurrent Valve Intervention Really Warranted? Braz J Cardiovasc Surg 2024; 39:e20230040. [PMID: 38315074 PMCID: PMC10836847 DOI: 10.21470/1678-9741-2023-0040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 06/06/2023] [Indexed: 02/07/2024] Open
Abstract
INTRODUCTION Primary cardiac myxomas are rare tumors. Concurrent valvular lesion is a common finding on evaluation which is thought to be due to annular dilatation secondary to tumor movement across the valve, functional obstruction across the valve, and severe pulmonary hypertension secondary to chronic obstruction. A common belief among surgeons is that excision of myxoma leads to abatement of symptoms, and further valve intervention may not be warranted. METHODS A 10-year retrospective descriptive study was designed to analyze patients who underwent excision of cardiac myxoma at our center. Data was analyzed regarding presenting features, echocardiographic findings of myxoma and valve morphology, intraoperative assessment, and postoperative outcome with/without valve repair/replacement in all patients. RESULTS A total of 22 patients underwent surgery for myxoma. Six patients underwent successful mitral valve repair with ring annuloplasty, two had moderate mitral regurgitation, three had severe mitral regurgitation, and one patient had no mitral regurgitation on preoperative assessment, but moderate mitral regurgitation was found intraoperatively. Four of these patients had no residual mitral regurgitation in follow-up period while two had mild residual mitral regurgitation. One patient had severe mitral stenosis of concurrent rheumatic etiology and successfully underwent mitral valve replacement. CONCLUSION Cardiac myxomas are rare benign tumors commonly associated with mitral valve insufficiency. Mitral valve should be assessed intraoperatively after excision of mass as preoperative assessment might often be insufficient. Concomitant mitral valve intervention might be needed with a case-specific tailored approach, and mitral valve repair with ring annuloplasty offers best surgical outcome in such cases.
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Affiliation(s)
- Ketika Potey
- Department of Cardiothoracic and Vascular Surgery, Dr Ram Manohar
Lohia Hospital and Post Graduate Institute of Medical Education and Research, New
Delhi, New Delhi, India
| | - Narender Jhajhria
- Department of Cardiothoracic and Vascular Surgery, Dr Ram Manohar
Lohia Hospital and Post Graduate Institute of Medical Education and Research, New
Delhi, New Delhi, India
| | - Manish Mallik
- Department of Cardiothoracic and Vascular Surgery, Dr Ram Manohar
Lohia Hospital and Post Graduate Institute of Medical Education and Research, New
Delhi, New Delhi, India
| | - Rahul Bhushan
- Department of Cardiothoracic and Vascular Surgery, Dr Ram Manohar
Lohia Hospital and Post Graduate Institute of Medical Education and Research, New
Delhi, New Delhi, India
| | - Palash Aiyer
- Department of Cardiothoracic and Vascular Surgery, Dr Ram Manohar
Lohia Hospital and Post Graduate Institute of Medical Education and Research, New
Delhi, New Delhi, India
| | - Vijay Grover
- Department of Cardiothoracic and Vascular Surgery, Dr Ram Manohar
Lohia Hospital and Post Graduate Institute of Medical Education and Research, New
Delhi, New Delhi, India
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Fu J, Li H, Pan Z, Wu C, Li Y, Wang G, Dai J, Zhao L. Surgical treatment of primary cardiac tumors in children. Gen Thorac Cardiovasc Surg 2024; 72:112-120. [PMID: 37515628 PMCID: PMC10805930 DOI: 10.1007/s11748-023-01958-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 07/02/2023] [Indexed: 07/31/2023]
Abstract
OBJECTIVE Summarizing the treatment experience of primary cardiac tumors in children. METHODS The date of 24 children with primary cardiac tumors who underwent surgery in our department from July 2003 to September 2022 was collected and analyzed treatment efficacy. RESULTS All patients completed the surgery successfully, including 21 cases of complete tumor resection, 2 cases of partial tumor resection, and 1 case of tumor biopsy. The location: 5 cases in the right atrium, 5 cases in the right ventricle, 6 cases in the left atrium, 6 cases in the left ventricle, 1 case in the left, right ventricle and ventricular septum, and 1 case in the ventricular septum. 23 cases were benign: 11 cases of myxoma, 7 cases of fibroma, 3 cases of rhabdomyoma, 1 case of infantile capillary hemangioma, and 1 case of lipoma. There was 1 case of borderline or malignant tumor. 23 patients were discharged successfully, 1 patient died of cardiac failure on the first day after operation. Follow-up was done from 5 months to 19 years and 2 months, 2 cases were lost to follow-up, and 1 case died of cardiac failure in the second year after operation due to severe mitral regurgitation. There was 1 case of tumor biopsy with space-occupying lesion gradually shrinking during follow-up. The prognosis of another 19 children with complete or partial tumor resection was good. There was no recurrence, enlargement, or reoperation of the tumor during the follow-up period. CONCLUSIONS Primary cardiac tumors in children are mostly benign. Surgery is effective, but the timing of surgery depends on the patient's condition.
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Affiliation(s)
- Jian Fu
- Department of Cardiothoracic Surgery, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, No.136, Zhongshan 2nd Road, Yuzhong District, Chongqing, 400014, China.
| | - HongBo Li
- Department of Cardiothoracic Surgery, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, No.136, Zhongshan 2nd Road, Yuzhong District, Chongqing, 400014, China
| | - ZhengXia Pan
- Department of Cardiothoracic Surgery, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, No.136, Zhongshan 2nd Road, Yuzhong District, Chongqing, 400014, China
| | - Chun Wu
- Department of Cardiothoracic Surgery, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, No.136, Zhongshan 2nd Road, Yuzhong District, Chongqing, 400014, China
| | - YongGang Li
- Department of Cardiothoracic Surgery, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, No.136, Zhongshan 2nd Road, Yuzhong District, Chongqing, 400014, China
| | - Gang Wang
- Department of Cardiothoracic Surgery, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, No.136, Zhongshan 2nd Road, Yuzhong District, Chongqing, 400014, China
| | - JiangTao Dai
- Department of Cardiothoracic Surgery, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, No.136, Zhongshan 2nd Road, Yuzhong District, Chongqing, 400014, China
| | - Lu Zhao
- Department of Cardiothoracic Surgery, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, No.136, Zhongshan 2nd Road, Yuzhong District, Chongqing, 400014, China
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Oktaviono YH, Saputra PBT, Arnindita JN, Afgriyuspita LS, Kurniawan RB, Pasahari D, Milla C, Wungu CDK, Susilo H, Multazam CECZ, Alkaff FF. Clinical characteristics and surgical outcomes of cardiac myxoma: A meta-analysis of worldwide experience. Eur J Surg Oncol 2024; 50:107940. [PMID: 38219702 DOI: 10.1016/j.ejso.2023.107940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Accepted: 12/26/2023] [Indexed: 01/16/2024]
Abstract
Cardiac myxoma is the most common primary cardiac tumor. However, existing literature mainly consists of single-center experiences with limited subjects. This systematic review aimed to provide data on clinical characteristics and surgical outcomes of cardiac myxoma. We performed a thorough literature search on May 23, 2023 on PubMed, ProQuest, ScienceDirect, Scopus, and Web of Science. The inclusion criteria were English full-text, observational studies, and included >20 subjects. From the search, 112 studies with a total of 8150 patients were included in the analysis. The mean age was 51 years (95 % confidence interval [95%CI] = 49.1-52.3), and the majority were females (64.3 % [95 % CI = 62.8-65.8 %]). The most common clinical manifestation was cardiovascular symptoms. Echocardiography can diagnose almost all cases (98.1 % [95 % CI = 95.8-99.6 %]). Cardiac myxoma was mostly prevalent in left atrium (85.3 % [95%CI = 83.3-87 %]) and predominantly with pedunculated morphology (75.6 % [95%CI = 64.1-84.3 %]). Post-tumor excision outcomes were excellent, with an early mortality of 1.27 % (95 % CI = 0.8-1.8 %), late mortality rate of 4.7 (95 % CI = 2.5-7.4) per 1000 person-years, and recurrence rate at 0.5 (95 % CI = 0.0-1.1) per 1000 person-years. Tumor excision is warranted in a timely manner once the cardiac myxoma diagnosis is established.
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Affiliation(s)
- Yudi Her Oktaviono
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga - General Academic Hospital Dr. Soetomo, Surabaya, Indonesia; Cardiovascular Research and Innovation Center, Universitas Airlangga, Surabaya, Indonesia.
| | - Pandit Bagus Tri Saputra
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga - General Academic Hospital Dr. Soetomo, Surabaya, Indonesia; Cardiovascular Research and Innovation Center, Universitas Airlangga, Surabaya, Indonesia.
| | - Jannatin Nisa Arnindita
- Cardiovascular Research and Innovation Center, Universitas Airlangga, Surabaya, Indonesia; Faculty of Medicine, Universitas Airlangga, Indonesia
| | | | | | - Diar Pasahari
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga - General Academic Hospital Dr. Soetomo, Surabaya, Indonesia
| | - Clonia Milla
- Faculty of Medicine, Universitas Airlangga, Indonesia
| | - Citrawati Dyah Kencono Wungu
- Department of Physiology and Medical Biochemistry, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia; Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia
| | - Hendri Susilo
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga - Universitas Airlangga Hospital, Surabaya, East Java, Indonesia
| | | | - Firas Farisi Alkaff
- Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, Groningen, Netherlands; Division of Pharmacology and Therapy, Department of Anatomy, Histology, and Pharmacology, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.
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Mihara K, Kanemoto I, Ando T, Kawase K, Iguchi K, Yokoyama S, Asai A, Hoshi K. Simultaneous surgical repair of a cardiac myxoma causing left ventricular outflow tract obstruction and a ventricular septal defect in a small dog. Open Vet J 2024; 14:743-749. [PMID: 38549570 PMCID: PMC10970120 DOI: 10.5455/ovj.2024.v14.i2.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 01/21/2024] [Indexed: 04/02/2024] Open
Abstract
Background Cardiac myxomas are benign tumours that can occur in any heart chamber or valve. They are extremely rare in dogs. We present a novel case involving a cardiac myxoma in the left ventricular outflow tract (LVOT) and a ventricular septal defect (VSD) in a small dog. Case Description A female miniature dachshund (age, 7 months; weight, 2.88 kg) presented with growth insufficiency, lethargy, and a cardiac murmur. Echocardiography revealed a small polypoid mass in the LVOT and a membranous VSD. Simultaneous surgeries were performed to resect the mass (aortotomy) and close the VSD (right atriotomy) using low-flow cardiopulmonary bypass with surface-cooling hypothermia and retrograde cardioplegia. The tumour was histopathologically identified as a myxoma. The dog survived with no cardiac complications for 11 years after surgery. Conclusion To our knowledge, this is the first report of ante-mortem diagnosis and simultaneous surgical repair of a cardiac myxoma obstructing the LVOT and a VSD in a small-breed dog. In addition to describing this complicated case, this report presents what we believe is the first reported use of retrograde cardioplegia during open-heart surgery in a small-breed dog.
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Affiliation(s)
- Kippei Mihara
- Cardiac Surgery Team, Chayagasaka Animal Hospital, Nagoya, Aichi, Japan
| | - Isamu Kanemoto
- Cardiac Surgery Team, Chayagasaka Animal Hospital, Nagoya, Aichi, Japan
| | - Takanori Ando
- Cardiac Surgery Team, Chayagasaka Animal Hospital, Nagoya, Aichi, Japan
- Heart-Will Animal Hospital, Kita-Kyushu, Hukuoka, Japan
| | - Koudai Kawase
- Cardiac Surgery Team, Chayagasaka Animal Hospital, Nagoya, Aichi, Japan
- Sapporo Night Animal Hospital Emergency and Critical Care, Sapporo, Hokkaido, Japan
| | - Kazuhito Iguchi
- Cardiac Surgery Team, Chayagasaka Animal Hospital, Nagoya, Aichi, Japan
- Momijiyama Douri Hospital Pet Clinic, Tokyo, Japan
| | - Satoko Yokoyama
- Cardiac Surgery Team, Chayagasaka Animal Hospital, Nagoya, Aichi, Japan
- Miyashita Animal Hospital, Kure, Hiroshima, Japan
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Kato T, Umeda E, Suzui N, Fujii R, Ogura H, Sakai O, Shimabukuro K, Doi K. Rapid expansion of a left atrial myxoma caused by acute multiple internal hemorrhages: a case report and literature review. J Cardiothorac Surg 2024; 19:13. [PMID: 38245766 PMCID: PMC10799350 DOI: 10.1186/s13019-024-02495-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 01/14/2024] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND Left atrial myxoma is the most common benign tumor, with the growth rate remaining unknown because specific symptoms do not present until the tumor grows to a certain size. Early surgical management is performed in most cases once it is detected by physicians. Despite cardiac myxomas commonly being perceived as slow-growing tumors, rapid enlargement of myxomas has been reported. CASE PRESENTATION A 64-year-old woman was referred to our hospital with a diagnosis of a left atrial tumor. The pointed tumor changed morphologically in a few hours, and her respiratory condition, which had been normal at admission, suddenly deteriorated. Emergent surgery was performed, and the diagnosis was myxoma with multiple intratumor massive hematomas. The patient recovered uneventfully and was discharged on postoperative day 12 without any complications. CONCLUSIONS We report an extremely rare case of left atrial myxoma rapidly expanded due to acute multiple hemorrhages within itself. Massive internal hemorrhage alters the size, shape, and fragility of the tumor. We should recognize the potential risk of internal hemorrhage that may lead to acute deterioration of the so-called "slow-growing benign" tumors, such as myxomas.
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Affiliation(s)
- Takayoshi Kato
- Department of Cardiovascular Surgery, Gifu University Hospital, 1-1 Yanagido, Gifu City, Gifu, 501-1193, Japan.
| | - Etsuji Umeda
- Department of Cardiovascular Surgery, Gifu University Hospital, 1-1 Yanagido, Gifu City, Gifu, 501-1193, Japan
| | - Natsuko Suzui
- Department of Pathology, Gifu University Hospital, Gifu, Japan
| | - Ryo Fujii
- Department of Cardiovascular Surgery, Gifu University Hospital, 1-1 Yanagido, Gifu City, Gifu, 501-1193, Japan
| | - Hiroki Ogura
- Department of Cardiovascular Surgery, Gifu University Hospital, 1-1 Yanagido, Gifu City, Gifu, 501-1193, Japan
| | - Osamu Sakai
- Department of Cardiovascular Surgery, Gifu University Hospital, 1-1 Yanagido, Gifu City, Gifu, 501-1193, Japan
| | - Katsuya Shimabukuro
- Department of Cardiovascular Surgery, Gifu University Hospital, 1-1 Yanagido, Gifu City, Gifu, 501-1193, Japan
| | - Kiyoshi Doi
- Department of Cardiovascular Surgery, Gifu University Hospital, 1-1 Yanagido, Gifu City, Gifu, 501-1193, Japan
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Hao Y, Fan C, Gao Y, Liu Y, Cao H, Lu L, Shen Y. Cerebral Embolism and MINOCA Secondary to Left Atrial Myxoma after Occlusion of Atrial Septal Defect by Amplatzer Occluder: A Case Report. Heart Surg Forum 2024; 27:E006-E013. [PMID: 38286647 DOI: 10.59958/hsf.5803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 09/14/2023] [Indexed: 01/31/2024]
Abstract
Primary heart tumors are rare, with atrial myxomas being the most common type. Atrial myxomas can lead to embolisms, heart obstruction, and systemic symptoms. Herein, we report a case of 72-year-old woman who presented with a left atrial myxoma at the atrial septal defect occluder, a new acute cerebral infarction, and MINOCA (myocardial infarction with no obstructive coronary atherosclerosis). Left atrial myxoma is a common primary cardiac tumor; however, left atrial myxomas arising after percutaneous atrial septal defect occlusion are rare. Additionally, the patient presented with a new case of multiple systemic emboli. The patient underwent surgical resection of a left atrial myxoma, occluder, and left atrium, and atrial septal repair, and was discharged with good recovery for outpatient follow-up. The possibility of a cardiac tumor, especially an atrial myxoma, which can lead to a series of complications, should be considered at the closure site after percutaneous atrial septal closure. Therefore, active surgical treatment and long-term follow-up are warranted in such cases.
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Affiliation(s)
- Ying Hao
- Department of Cardiovascular Medicine, Shanghai East Hospital, Tongji University School of Medicine, 200092 Shanghai, China; Department of Cardiovascular Medicine, Shanghai East Hospital Ji'an Hospital, 343000 Ji'an, Jiangxi, China.
| | - Chenghui Fan
- Department of Cardiovascular Medicine, Shanghai East Hospital, Tongji University School of Medicine, 200092 Shanghai, China; Department of Cardiovascular Medicine, Shanghai East Hospital Ji'an Hospital, 343000 Ji'an, Jiangxi, China.
| | - Yang Gao
- Department of Cardiovascular Medicine, Shanghai East Hospital, Tongji University School of Medicine, 200092 Shanghai, China.
| | - Yong Liu
- Department of Cardiovascular Medicine, Shanghai East Hospital, Tongji University School of Medicine, 200092 Shanghai, China.
| | - Hao Cao
- Department of Cardiovascular Medicine, Shanghai East Hospital, Tongji University School of Medicine, 200092 Shanghai, China.
| | - Linxiang Lu
- Department of Cardiovascular Medicine, Shanghai East Hospital, Tongji University School of Medicine, 200092 Shanghai, China; Department of Cardiovascular Medicine, Shanghai East Hospital Ji'an Hospital, 343000 Ji'an, Jiangxi, China.
| | - Yunli Shen
- Department of Cardiovascular Medicine, Shanghai East Hospital, Tongji University School of Medicine, 200092 Shanghai, China; Department of Cardiovascular Medicine, Shanghai East Hospital Ji'an Hospital, 343000 Ji'an, Jiangxi, China.
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22
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Slootweg PJ. RE: Odontogenic Myxoma in a 17-month Old Child: A Case Report. J Oral Maxillofac Surg 2024; 82:5. [PMID: 38161068 DOI: 10.1016/j.joms.2023.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 10/06/2023] [Indexed: 01/03/2024]
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Affiliation(s)
- Lin Tan
- Department of Gastroenterology, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, Hubei, 441000, China
| | - Zelin Zhang
- Department of Oncology, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, 441000, China
| | - Pin Cao
- Department of Oncology, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, 441000, China.
| | - Dongdong Zhang
- Department of Oncology, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, 441000, China.
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Smet C, Martins AC, Costa T. Deep (aggressive) angiomyxoma of the vulva in a pregnant woman. BMJ Case Rep 2023; 16:e254564. [PMID: 38129079 DOI: 10.1136/bcr-2023-254564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Abstract
Aggressive angiomyxoma is a rare mesenchymal tumour, which usually appears in the pelvic region of women in their reproductive age. Although benign, it is a locally infiltrative tumour with frequent recurrence. We report a case of a pregnant woman in her 30s with a vulvar aggressive angiomyxoma which was initially misdiagnosed. Features of this case are discussed, highlighting the difficulty in its diagnosis and the challenge of the follow-up and treatment of recurrences.
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Affiliation(s)
- Carolina Smet
- Obstetrics and Gynecology department, Centro Hospitalar de Lisboa Ocidental - Hospital de São Francisco Xavier, Lisboa, Portugal
| | - Ana Constâncio Martins
- Obstetrics and Gynecology department, Centro Hospitalar de Lisboa Ocidental - Hospital de São Francisco Xavier, Lisboa, Portugal
| | - Teresa Costa
- Pathological anatomy and cytology, Centro Hospitalar de Lisboa Ocidental - Hospital de Egas Moniz, Lisboa, Portugal
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Mondal S, Kumar SS, Iliyas M. Atrial myxoma presenting as bilateral cerebellar infarct and mitral obstruction. Acta Cardiol 2023; 78:1153-1155. [PMID: 37882625 DOI: 10.1080/00015385.2023.2268420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 10/02/2023] [Indexed: 10/27/2023]
Affiliation(s)
- Sudipta Mondal
- Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
| | - Swasthi S Kumar
- Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
| | - Mohamed Iliyas
- Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
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Xu Y, Jiang J, Zhang M. Atrial myxoma embolization of the basilar artery presenting with a convulsive seizure: Case report. Medicine (Baltimore) 2023; 102:e36138. [PMID: 38013263 PMCID: PMC10681622 DOI: 10.1097/md.0000000000036138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 10/25/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Basilar artery occlusion (BAO) is a rare cause of convulsive seizure. Such patients who are treated for epilepsy will miss the optimal time for treatment. Atrial myxoma is a rare cause of stroke and should be surgically removed as soon as possible after diagnosis. CASE SUMMARY We report a patient who presented with convulsions as the initial symptom and was diagnosed with BAO by computed tomographic angiography. After transthoracic echocardiogram, the cause of the disease was diagnosed as atrial myxoma. The patient recovered well after endovascular treatment and resection of the atrial myxoma. CONCLUSION A small number of patients with BAO present with convulsive seizures. It is very important to make a timely diagnosis. Direct thrombaspiration may be the best choice for basilar artery cardioembolization, and thrombectomy for distal moderate vascular occlusion in posterior circulation is feasible. Atrial myxoma is a rare cause of cardioembolic stroke and should be resected as soon as possible to prevent further embolic complications.
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Affiliation(s)
- Yaning Xu
- Department of Neurology, Army Medical Center of PLA, Army Military Medical University, Chongqing, China
| | - Jiaojin Jiang
- Department of Neurology, Army Medical Center of PLA, Army Military Medical University, Chongqing, China
| | - Meng Zhang
- Department of Neurology, Army Medical Center of PLA, Army Military Medical University, Chongqing, China
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Mendes Franco R, Sousa J, Matos M, Albuquerque L, Azevedo E, Abreu P. Multiple intracranial aneurysms years after cardiac myxoma resection. Pract Neurol 2023; 23:519-520. [PMID: 37487705 DOI: 10.1136/pn-2023-003705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2023] [Indexed: 07/26/2023]
Affiliation(s)
- Roberto Mendes Franco
- Department of Neurology, Centro Hospitalar Universitário de São João, Porto, Portugal
- Department of Neurology, Hospital Dr. Nélio Mendonça, Funchal, Portugal
| | - José Sousa
- Neuroradiology, Centro Hospitalar Universitário de São João, Porto, Portugal
- Department of Clinical Neurosciences and Mental Health, Faculty of Medicine of University of Porto, Porto, Portugal
| | - Mariana Matos
- Department of Internal Medicine, Centro Hospitalar Universitário de São João, Porto, Portugal
- Department of Internal Medicine, Faculty of Medicine of University of Porto, Porto, Portugal
| | - Luís Albuquerque
- Neuroradiology, Centro Hospitalar Universitário de São João, Porto, Portugal
- Department of Clinical Neurosciences and Mental Health, Faculty of Medicine of University of Porto, Porto, Portugal
| | - Elsa Azevedo
- Department of Neurology, Centro Hospitalar Universitário de São João, Porto, Portugal
- Department of Clinical Neurosciences and Mental Health, Faculty of Medicine of University of Porto, Porto, Portugal
| | - Pedro Abreu
- Department of Neurology, Centro Hospitalar Universitário de São João, Porto, Portugal
- Department of Clinical Neurosciences and Mental Health, Faculty of Medicine of University of Porto, Porto, Portugal
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Meng ZQ, Yan SP, Xu Y, Chen KS. [Ovarian myxoma and sclerosing stromal tumor: report of a case]. Zhonghua Bing Li Xue Za Zhi 2023; 52:1177-1179. [PMID: 37899331 DOI: 10.3760/cma.j.cn112151-20230304-00171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Affiliation(s)
- Z Q Meng
- Department of Pathology, the First Affiliated Hospital of Zhengzhou University, Department of Pathology, College of Basic Medical Sciences, Zhengzhou University, Zhengzhou 450052, China
| | - S P Yan
- Department of Pathology, the First Affiliated Hospital of Zhengzhou University, Department of Pathology, College of Basic Medical Sciences, Zhengzhou University, Zhengzhou 450052, China
| | - Y Xu
- Department of Pathology, the First Affiliated Hospital of Zhengzhou University, Department of Pathology, College of Basic Medical Sciences, Zhengzhou University, Zhengzhou 450052, China
| | - K S Chen
- Department of Pathology, the First Affiliated Hospital of Zhengzhou University, Department of Pathology, College of Basic Medical Sciences, Zhengzhou University, Zhengzhou 450052, China
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Abstract
Cardiac myxoma is a relatively rare tumour, usually solitary, that occurs primarily in the left atrium of adults, but comprises only 30% of cardiac tumours in children. We recently treated a 12-year-old girl with multiple recurrent myxomas in three cardiac chambers(following surgical resection 3 years earlier). Genomic analysis showed the PKAR1A mutation typical for Carney complex.
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Affiliation(s)
- Oscar Ballivián Burgos
- Unidad DE Cardiología Pediátrica, Hospital del Niño "Dr. Ovidio Aliaga Uría", La Paz, Bolivia
| | - Ericka Perez Albrecht
- Unidad DE Cirugía Cardiaca Pediátrica, Hospital del Niño "Dr. Ovidio Aliaga Uría", La Paz, Bolivia
| | - Jesus Pozo Robles
- Unidad DE Cardiología Pediátrica, Hospital del Niño "Dr. Ovidio Aliaga Uría", La Paz, Bolivia
| | | | - Rodrigo Soto
- Gift of Life International, Fresh Meadows, New York, USA
| | - Tom R Karl
- Queensland Paediatric Cardiac Service, Queensland Paediatric Cardiac Research, University of Queensland, Brisbane, Australia
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30
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Sánchez Sotelo VM, Velázquez Sotelo CE, Guzmán Delgado NE, Castro Rodríguez A, Martínez Salazar AE, Vega Hernández R. Surgical experience in cardiac myxomas at a tertiary hospital. Cir Esp 2023; 101:772-777. [PMID: 37423309 DOI: 10.1016/j.cireng.2023.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 03/27/2023] [Indexed: 07/11/2023]
Abstract
INTRODUCTION Cardiac myxomas account for 50% of all benign cardiac tumors. Their clinical presentation varies from embolisms to fever. Our objective was to describe the surgical experience in the resection of cardiac myxomas during an 8-year period. METHODS This is a retrospective, descriptive study of a series of cases with cardiac myxomas diagnosed from 2014 to 2022 at a tertiary care center. Descriptive statistics were used to define the populational and surgical characteristics. We used Pearson's correlation to study the relationship between postoperative complications and age, tumor size and affected cardiac chamber. RESULTS 31 patients were included, with a predominance of females (1:2 ratio). The prevalence was 0.44%, which was calculated based on the number of cardiac surgeries performed in our unit over the 8-year period. The main clinical manifestation was dyspnea (85%, n = 23), followed by cerebrovascular event (CVE) (18%, n = 5). Atriotomy and resection of the pedicle were performed with preservation of the interatrial septum. Mortality was 3.2%. The postoperative evolution was uneventful in 77%. Tumor recurrence occurred in 2 patients (7%), both debuting with embolic phenomena. No association was observed between postoperative complications or recurrence and tumor size, nor aortic clamping and extracorporeal circulation times with regard to age. CONCLUSIONS Four atrial myxoma resections are performed in our unit per year, with an estimated prevalence of 0.44%. The tumor characteristics described coincide with the previous literature. A relationship between embolisms and recurrences cannot be ruled out. Wide surgical resection of the pedicle and base of tumor implantation may influence tumor recurrence, although further studies are needed.
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Affiliation(s)
- Víctor M Sánchez Sotelo
- Department of Cardiothoracic Surgery, UMAE, Hospital of Cardiology No. 34 ''Dr. Alfonso J. Treviño Treviño'' of the National Medical Center of the Northeast, Mexican Institute of Social Security, Mexico.
| | - Claudia E Velázquez Sotelo
- Department of Cardiology, UMAE, Hospital of Cardiology No. 34 ''Dr. Alfonso J. Treviño Treviño'' of the National Medical Center of the Northeast, Mexican Institute of Social Security, Mexico
| | - Nancy E Guzmán Delgado
- Health Research Division, Teaching Department, UMAE, Hospital of Cardiology No. 34 ''Dr. Alfonso J. Treviño Treviño'' of the National Medical Center of the Northeast, Mexican Institute of Social Security, Mexico
| | - Amalia Castro Rodríguez
- Pathological Anatomy Department, UMAE, Hospital of Cardiology No. 34 ''Dr. Alfonso J. Treviño Treviño'' of the National Medical Center of the Northeast, Mexican Institute of Social Security, Mexico
| | - Adriana E Martínez Salazar
- Department of Cardiothoracic Surgery, UMAE, Hospital of Cardiology No. 34 ''Dr. Alfonso J. Treviño Treviño'' of the National Medical Center of the Northeast, Mexican Institute of Social Security, Mexico
| | - Raquel Vega Hernández
- Department of Cardiothoracic Surgery, UMAE, Hospital of Cardiology No. 34 ''Dr. Alfonso J. Treviño Treviño'' of the National Medical Center of the Northeast, Mexican Institute of Social Security, Mexico
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Bethea J, Lodhi T, Peine B, Mendes J, Sutton T, Celio A, Allman R, Nifong LW. Robotic Resection of Left Atrial Myxoma With Cryoablation of Tumor Stalk. Innovations (Phila) 2023; 18:592-594. [PMID: 37794743 DOI: 10.1177/15569845231199736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Abstract
The purpose of this report is to demonstrate robotic cryoablation of an atrial myxoma stalk as a method to prevent recurrence and preserve atrial tissue. A 38-year-old female patient was taken to the operating room, and an atrial myxoma abutting the left inferior pulmonary vein was resected robotically. This was followed by cryoablation of the tumor stalk instead of a full-thickness resection to prevent an extensive reconstruction. The operation resulted in the successful resection of an atrial myxoma with minimal length of stay. Follow-up at 3 months has shown no evidence of residual or recurrent tumor. Follow-up at 1 year is planned. Cryoablation of an atrial myxoma stalk, when resection would require complex reconstruction, is a useful tool in the armamentarium of a minimally invasive cardiac surgeon.
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Affiliation(s)
- Joseph Bethea
- Division of Thoracic Surgery, Department of Cardiovascular Sciences, East Carolina University, Greenville, NC, USA
| | - Taha Lodhi
- Division of Thoracic Surgery, Department of Cardiovascular Sciences, East Carolina University, Greenville, NC, USA
| | - Brandon Peine
- Division of Thoracic Surgery, Department of Cardiovascular Sciences, East Carolina University, Greenville, NC, USA
| | - Jesse Mendes
- Division of Thoracic Surgery, Department of Cardiovascular Sciences, East Carolina University, Greenville, NC, USA
| | - Tia Sutton
- Division of Thoracic Surgery, Department of Cardiovascular Sciences, East Carolina University, Greenville, NC, USA
| | - Adam Celio
- Division of Thoracic Surgery, Department of Cardiovascular Sciences, East Carolina University, Greenville, NC, USA
| | - Robert Allman
- Division of Thoracic Surgery, Department of Cardiovascular Sciences, East Carolina University, Greenville, NC, USA
| | - L Wiley Nifong
- Division of Cardiac Surgery, Department of Cardiovascular Sciences, East Carolina Heart Institute, Greenville, NC, USA
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32
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Christa M, Müntze J, Lengenfelder B, Nordbeck P. Contrast-enhanced ultrasound for non-invasive differential diagnosis of unclear left atrial mass. Int J Cardiovasc Imaging 2023; 39:2173-2174. [PMID: 37665488 PMCID: PMC10673719 DOI: 10.1007/s10554-023-02926-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 07/31/2023] [Indexed: 09/05/2023]
Abstract
Transthoracic and transesophageal echocardiography detected a left atrial mass attached to the intra-atrialseptum. Intravenous contrast agent ruled out atrial thrombus, sugesting a left atrial myxoma. This highlights theimportance of contrast echocardiography for differential diagnosis of left atrial findings.
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Affiliation(s)
- Martin Christa
- Department of Internal Medicine I, University Hospital Würzburg, Oberdürrbacher Straße 6, Haus A3, D - 97080, Würzburg, Germany.
| | - Jonas Müntze
- Department of Internal Medicine I, University Hospital Würzburg, Oberdürrbacher Straße 6, Haus A3, D - 97080, Würzburg, Germany
| | - Björn Lengenfelder
- Department of Internal Medicine I, University Hospital Würzburg, Oberdürrbacher Straße 6, Haus A3, D - 97080, Würzburg, Germany
| | - Peter Nordbeck
- Department of Internal Medicine I, University Hospital Würzburg, Oberdürrbacher Straße 6, Haus A3, D - 97080, Würzburg, Germany
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33
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Ajjikuttira A, Coulthard A. Multiple cerebral aneurysms as a late complication of atrial myxoma: imaging findings. BMJ Case Rep 2023; 16:e257765. [PMID: 37798045 PMCID: PMC10565320 DOI: 10.1136/bcr-2023-257765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2023] Open
Affiliation(s)
- Aiyapa Ajjikuttira
- Department of Medical Imaging, Royal Brisbane and Women's Hospital, Queensland Health, Herston, Queensland, Australia
| | - Alan Coulthard
- Department of Medical Imaging, Royal Brisbane and Women's Hospital, Queensland Health, Herston, Queensland, Australia
- Faculty of Medicine, The University of Queensland, Herston, Queensland, Australia
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34
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Cullom C, Frank S, McCabe MD. Bilateral Atrial Myxoma With Mechanical Disruption of the Mitral Valvular Apparatus. J Cardiothorac Vasc Anesth 2023; 37:2032-2039. [PMID: 37357034 DOI: 10.1053/j.jvca.2023.05.047] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 05/25/2023] [Accepted: 05/30/2023] [Indexed: 06/27/2023]
Affiliation(s)
- Christopher Cullom
- Department of Anesthesiology, Loma Linda University Medical Center, Loma Linda, CA.
| | - Stephanie Frank
- Department of Anesthesiology, Loma Linda University Medical Center, Loma Linda, CA
| | - Melissa D McCabe
- Department of Anesthesiology, Loma Linda University Medical Center, Loma Linda, CA
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35
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Sidhu MS, Jain K, Sood S, Kaur H. Localized aggressive angiomyxoma of axilla: A rare case report. J Cancer Res Ther 2023; 19:2101-2103. [PMID: 38376331 DOI: 10.4103/jcrt.jcrt_2286_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 12/29/2021] [Indexed: 02/21/2024]
Abstract
ABSTRACT Aggressive angiomyxoma (AAM) is a rare mesenchymal locally aggressive tumor arising in the pelvis and perineal region in females. On the other hand, extragenital AAMs are extremely rare, specifically in males. We are reporting male AAM which involves only axillary region along with its pathological features. To confirm it, immunohistochemistry (IHC) was done. In sum, pathological examination and IHC aid in distinguishing this lesion and help in differentiating it from other tumors of similar histology. Furthermore, it also aids in planning treatment.
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Affiliation(s)
| | - Kunal Jain
- Department of Medical Oncology, DMCH Cancer Center, Ludhiana, Punjab, India
| | - Sandhya Sood
- Department of Radiation Oncology, Ludhiana, Punjab, India
| | - Harpreet Kaur
- Department of Pathology, DMCH, Ludhiana, Punjab, India
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36
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Galzerano D, Eltayeb A, Alamri S, Alamri S, Arbili L, Mohammed S. A Ping Pong Ball in the Left Ventricle. J Cardiothorac Vasc Anesth 2023; 37:2153-2156. [PMID: 37394386 DOI: 10.1053/j.jvca.2023.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 06/01/2023] [Indexed: 07/04/2023]
Abstract
Diagnosing cardiac masses, especially those related to cardiac tumors, is often challenging in clinical practice. Though myxomas are the most common and well-known benign cardiac tumors, other rare and often-neglected tumors can be difficult to diagnose. In this case report, the authors describe a left ventricular cardiac mass with unique and striking imaging features.
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Affiliation(s)
- Domenico Galzerano
- The Heart Centre, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia; College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.
| | - Abdalla Eltayeb
- The Heart Centre, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia
| | - Soaad Alamri
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Sultan Alamri
- King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Lana Arbili
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Shamayel Mohammed
- Department of Pathology and Laboratory Medicine, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
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37
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Uchime KE, Olanipekun OA, Ogidan ON, Oguntola SO, Ezekpo OO, Olatunde OAO, Akinmade A. Left atrial myxoma presenting with acute pulmonary edema and syncope in a middle-aged black African woman: a case report. Pan Afr Med J 2023; 46:31. [PMID: 38145194 PMCID: PMC10746877 DOI: 10.11604/pamj.2023.46.31.41414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 09/04/2023] [Indexed: 12/26/2023] Open
Abstract
Cardiac myxoma is a very rare benign cardiac neoplasm. Its annual incidence globally is between 0.5 to 1 case per one million individuals. It has a 0.03% prevalence rate in the general population. It commonly occurs in the left atrium, but can also be located in the other heart chambers. Its clinical presentations are variable, non-specific, and can mimic various cardiovascular and systemic diseases, posing a diagnostic dilemma. Thus, a high index of suspicion with appropriate use of radiologic and laboratory diagnostic tools is essential for its accurate diagnosis and management. The diagnosis and management of a rare case of left atrial myxoma in a middle-aged African woman who presented with heart failure-like symptoms, features of acute pulmonary edema, and syncope is presented in this literature. The diagnosis was suspected following echocardiography. The tumor was surgically excised, and the diagnosis was confirmed histopathologically. The patient´s post-operative condition has been excellent.
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Affiliation(s)
- Kasiemobi Eberechukwu Uchime
- Department of Anatomic Pathology and Forensic Medicine, Afe Babalola University Ado-Ekiti Teaching Hospital (ABUADTH), Ekiti State, Nigeria
| | - Oladipo Ayoola Olanipekun
- Department of Internal Medicine, Afe Babalola University Ado-Ekiti Teaching Hospital (ABUADTH), Ekiti State, Nigeria
| | - Olamide Nelson Ogidan
- Department of Radiology, Afe Babalola University Ado-Ekiti Teaching Hospital (ABUADTH), Ekiti State, Nigeria
| | - Stephen Olawale Oguntola
- Department of Internal Medicine, Afe Babalola University Ado-Ekiti Teaching Hospital (ABUADTH), Ekiti State, Nigeria
| | - Okechukwu Obumneme Ezekpo
- Department of Internal Medicine, Afe Babalola University Ado-Ekiti Teaching Hospital (ABUADTH), Ekiti State, Nigeria
| | - Olaniyi Abiodun Oluwafemi Olatunde
- Department of Anatomic Pathology and Forensic Medicine, Afe Babalola University Ado-Ekiti Teaching Hospital (ABUADTH), Ekiti State, Nigeria
| | - Akinola Akinmade
- Department of Surgery, Afe Babalola University Ado-Ekiti Teaching Hospital (ABUADTH), Ekiti State, Nigeria
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38
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Hamdan M, Alam B, Kossaify A. A polo ball in the right atrium, importance of echocardiographic characteristics of intracardiac myxomas: a case report. J Med Case Rep 2023; 17:403. [PMID: 37730679 PMCID: PMC10512563 DOI: 10.1186/s13256-023-04130-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 08/14/2023] [Indexed: 09/22/2023] Open
Abstract
BACKGROUND Myxomas are the most prevalent type of heart tumors, mainly occurring in the left atrium, with approximately 20% of cases found in the right atrium. Timely diagnosis and appropriate management of myxomas are crucial for favorable outcomes and to minimize complications. CASE PRESENTATION A 77-year-old Asian male with no significant medical history presented with intermittent trepopnea and palpitations. Physical examination revealed regular heart sounds and no other relevant findings. A transthoracic echocardiogram showed a large, round-shaped, smooth-edged mass with diameter of 86 mm, occupying most of the right atrium. Mild tricuspid flow obstruction and mild left ventricular systolic dysfunction were also observed. Cardiac tomography confirmed the size, smooth edges, and showed microcalcifications of the mass, with no invasion of surrounding tissues. Surgical intervention successfully removed the spheroid mass, leading to the alleviation of symptoms. Histopathology confirmed the myxoma nature of the mass. A comprehensive discussion based on relevant medical literature is provided, with emphasis on echocardiographic characteristics of the mass with relation to potential embolic disease. CONCLUSION This case shows an atypical presentation of an exceptionally large myxoma in the right atrium, resembling the size of a polo ball, in a patient presenting with supraventricular arrhythmia and trepopnea. Early diagnosis and appropriate management played a vital role in achieving a successful outcome for the patient.
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Affiliation(s)
- Mira Hamdan
- Cardiology Division, Saint Esprit Kaslik University USEK, Hospital Notre Dame des Secours, Saint Charbel Street- PO Box # 3, Byblos, 12345, Lebanon
| | - Boutros Alam
- Cardiology Division, Saint Esprit Kaslik University USEK, Hospital Notre Dame des Secours, Saint Charbel Street- PO Box # 3, Byblos, 12345, Lebanon
| | - Antoine Kossaify
- Cardiology Division, Saint Esprit Kaslik University USEK, Hospital Notre Dame des Secours, Saint Charbel Street- PO Box # 3, Byblos, 12345, Lebanon.
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39
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Kakimoto S, Harada Y, Shimizu T. Periportal halo in a patient with right atrial myxoma. QJM 2023; 116:710-711. [PMID: 37094183 DOI: 10.1093/qjmed/hcad073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Indexed: 04/26/2023] Open
Affiliation(s)
- Shintaro Kakimoto
- Department of Diagnostic and Generalist Medicine, Dokkyo Medical University Hospital, Mibu, Tochigi 321-0293, Japan
| | - Yukinori Harada
- Department of Diagnostic and Generalist Medicine, Dokkyo Medical University Hospital, Mibu, Tochigi 321-0293, Japan
| | - Taro Shimizu
- Department of Diagnostic and Generalist Medicine, Dokkyo Medical University Hospital, Mibu, Tochigi 321-0293, Japan
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40
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Xu Y, Duan Y, Zhou H, Chen H, Yan W. Ultrasonic features of superficial angiomyxoma in the scrotum: A case image. J Clin Ultrasound 2023; 51:1273-1275. [PMID: 37219372 DOI: 10.1002/jcu.23487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 04/25/2023] [Accepted: 05/09/2023] [Indexed: 05/24/2023]
Abstract
Superficial angiomyxoma in the scrotum is a well-circumscribed, ovoid-shaped, heterogeneously echogenic mass in the ultrasonography. On Doppler ultrasonography, vascular flow signals are visible in and around the mass(M).
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Affiliation(s)
- Yadi Xu
- Department of Ultrasound, Hubei Traditional Chinese Medicine Hospital, People's Republic of China
- Affiliated Hospital of Hubei University of Traditional Chinese Medicine, People's Republic of China
- Hubei University of Traditional Chinese Medicine, People's Republic of China
| | - Yun Duan
- Department of Ultrasound, Hubei Traditional Chinese Medicine Hospital, People's Republic of China
- Affiliated Hospital of Hubei University of Traditional Chinese Medicine, People's Republic of China
- Hubei University of Traditional Chinese Medicine, People's Republic of China
| | - Heng Zhou
- Department of Ultrasound, Hubei Traditional Chinese Medicine Hospital, People's Republic of China
- Affiliated Hospital of Hubei University of Traditional Chinese Medicine, People's Republic of China
- Hubei University of Traditional Chinese Medicine, People's Republic of China
| | - Haoyi Chen
- Department of Ultrasound, Hubei Traditional Chinese Medicine Hospital, People's Republic of China
- Affiliated Hospital of Hubei University of Traditional Chinese Medicine, People's Republic of China
- Hubei University of Traditional Chinese Medicine, People's Republic of China
| | - Wei Yan
- Department of Ultrasound, Hubei Traditional Chinese Medicine Hospital, People's Republic of China
- Affiliated Hospital of Hubei University of Traditional Chinese Medicine, People's Republic of China
- Hubei University of Traditional Chinese Medicine, People's Republic of China
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41
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Martin SJ, Maxey-Jones C, Zhou Z, Nazem A, Cherney A, Lutz CJ. Robot-Assisted Excision of a Left Ventricular Myxoma and Hemangioma. Innovations (Phila) 2023; 18:506-508. [PMID: 37786985 DOI: 10.1177/15569845231199741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
Left ventricular masses are rare entities that often require surgical excision when diagnosed due to the risk of embolization. We report 2 separate patients presenting with evidence of cerebral embolization both of whom were diagnosed with isolated left ventricular masses and underwent surgical excision through a robot-assisted approach. Microscopic pathology revealed a myxoma and hemangioma, respectively. Both cases demonstrate that left ventricular masses can be feasibly excised through a robot-assisted minithoracotomy approach.
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Lin TPH, Wan KH, Cheuk W, Leung E, Yuen HKL, Lam DSC. Bilateral synchronous conjunctival myxoma and review of the literature. Eur J Ophthalmol 2023; 33:NP130-NP136. [PMID: 36083167 DOI: 10.1177/11206721221124665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE The purpose of this study was to report the clinicopathological features and management of the first case of bilateral synchronous conjunctival myxoma. METHODS This study was a case report and literature review. RESULTS A 66-year-old Chinese male with past ocular history of uncomplicated bilateral phacoemulsification and intraocular lens (IOLs) 3 years ago prior to presentation presented with bilateral red and swollen conjunctiva for over a year. On examination his corrected distance visual acuity (CDVA) was 25/20 in the right eye 20/20 in the left eye. Slit lamp examination revealed swollen temporal conjunctiva bilaterally which appeared as painless, well-circumscribed, salmon-pink, fleshy patches. The lesion in the right eye was subsequently excised, followed by excision of the lesion in the left eye at 3-week interval. Microscopically, histopathological examination of both excised specimens revealed hypocellular conjunctival mucosa covered by non-dysplastic epithelium, with presence of myxoid degeneration in the subepithelial stroma and immunostaining findings consistent with conjunctival myxoma. At his latest follow-up at 24 months, there were no recurrences of the conjunctival masses and the CDVA was the same as preoperatively.
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Affiliation(s)
- Timothy P H Lin
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
- Hong Kong Eye Hospital, Hong Kong, China
| | - Kelvin H Wan
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
- Hong Kong Eye Hospital, Hong Kong, China
| | - Wah Cheuk
- Department of Pathology, Queen Elizabeth Hospital, Hong Kong, China
| | - Enne Leung
- C-MER International Eye Research Center of The Chinese University of Hong Kong (Shenzhen), Shenzhen, China
| | - Hunter K L Yuen
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
- Hong Kong Eye Hospital, Hong Kong, China
| | - Dennis S C Lam
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
- C-MER International Eye Research Center of The Chinese University of Hong Kong (Shenzhen), Shenzhen, China
- C-MER (Shenzhen) Dennis Lam Eye Hospital, Shenzhen, China
- C-MER (Beijing) Dennis Lam Eye Hospital, Beijing, China
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Yalçınkaya Öner D, Nadir Karakulak U. Reply to Letter to the Editor: 'Recurrent Cardiac Myxoma: A Puzzle to be Solved'. Anatol J Cardiol 2023; 27:499-500. [PMID: 37439231 PMCID: PMC10406139 DOI: 10.14744/anatoljcardiol.2023.3241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/14/2023] Open
Affiliation(s)
| | - Uğur Nadir Karakulak
- Department of Cardiology, Faculty of Medicine, Hacettepe University, Ankara, Türkiye
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Yalta K, Yetkin E, Yalta T. Recurrent Cardiac Myxoma: A Puzzle to be Solved. Anatol J Cardiol 2023; 27:497-498. [PMID: 37466027 PMCID: PMC10406146 DOI: 10.14744/anatoljcardiol.2023.3240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023] Open
Affiliation(s)
- Kenan Yalta
- Department of Cardiology, Faculty of Medicine, Trakya University, Edirne, Türkiye
| | - Ertan Yetkin
- Department of Cardiology, Türkiye Hospital, İstanbul, Türkiye
| | - Tülin Yalta
- Department of Pathology, Faculty of Medicine, Trakya University, Edirne, Türkiye
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Kaibel Val R, Vázquez Echarri J, Kaibel Axpe I. Intramuscular myxoma in psoas muscle and in thigh. Cir Esp 2023; 101:577-579. [PMID: 37086839 DOI: 10.1016/j.cireng.2023.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/24/2023]
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Aminimoghaddam S, Sarchami N, Mahboub SS. Second recurrence of aggressive vulvar angiomyxoma: a case report. J Int Med Res 2023; 51:3000605231189366. [PMID: 37551697 PMCID: PMC10411273 DOI: 10.1177/03000605231189366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 07/05/2023] [Indexed: 08/09/2023] Open
Abstract
Aggressive angiomyxoma is a rare benign tumor with diverse clinical and radiologic presentations, making its differential diagnosis challenging. Here we report the second recurrence of an aggressive angiomyxoma of the vulva in a 33-year-old woman who presented with pain and swelling. Clinical examination revealed a well-circumscribed large palpable mass extending from the inferior part of the right labia major into the right side of the gluteus. A second recurrence of aggressive angiomyxoma was suspected based on the patient's history, clinical examination, and magnetic resonance imaging report, and the patient underwent surgical resection with a negative margin. Histological evaluation of the extracted lesion confirmed the diagnosis of aggressive angiomyxoma. At the 1-year follow-up, the patient was recurrence-free. The present report urges more awareness regarding the aggressiveness of angiomyxoma of the vulva. Closer attention should be given to margin-free removal of such tumors, and patients should be routinely followed up for at least 2 years postoperatively for early diagnosis of recurrence, thereby reducing the risk of morbidity.
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Affiliation(s)
- Soheila Aminimoghaddam
- Department of Obstetrics and Gynecology, Firoozgar Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Niloufar Sarchami
- Department of Obstetrics and Gynecology, Firoozgar Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Sarah Sadat Mahboub
- Department of Obstetrics and Gynecology, Firoozgar Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
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Zhang H, Ren Q, Zhang Z, Shao X. Obstructive shock due to a rare cause: a case of left atrial myxoma incarcerated at the mitral orifice. Minerva Med 2023; 114:542-544. [PMID: 36988492 DOI: 10.23736/s0026-4806.23.08494-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
Affiliation(s)
- Huijuan Zhang
- Hemodialysis Center, Zhejiang Hospital, Hangzhou, China
| | - Qi Ren
- Department of Critical Care Medicine, Zhejiang Hospital, Hangzhou, China
| | - Zhufeng Zhang
- Department of Emergency, Zhejiang Hospital, Hangzhou, China
| | - Xiaolu Shao
- Department of Medical Care, Zhejiang Hospital, Hangzhou, China -
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Wang A, Li F, Wu H, Bian C, Zhang P, Zhou H. Laparoscopic approach for giant pelvic aggressive angiomyxoma - A video vignette. Colorectal Dis 2023; 25:1740-1741. [PMID: 37403532 DOI: 10.1111/codi.16651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 05/09/2023] [Accepted: 05/29/2023] [Indexed: 07/06/2023]
Affiliation(s)
- Anqi Wang
- Division of Colorectal Surgery, Changzheng Hospital, Navy Medical University, Shanghai, China
| | - Fengfeng Li
- Division of Colorectal Surgery, Changzheng Hospital, Navy Medical University, Shanghai, China
| | - Honghong Wu
- Division of General Practice Medicine, Changzheng Hospital, Navy Medical University, Shanghai, China
| | - Ce Bian
- Division of Colorectal Surgery, Changzheng Hospital, Navy Medical University, Shanghai, China
| | - Peng Zhang
- Division of Colorectal Surgery, Changzheng Hospital, Navy Medical University, Shanghai, China
| | - Haiyang Zhou
- Division of Colorectal Surgery, Changzheng Hospital, Navy Medical University, Shanghai, China
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Li X, Hou J. A rare case of left ventricular myxoma with LVIT and LVOT obstruction. Eur Heart J Cardiovasc Imaging 2023; 24:e199. [PMID: 37140073 DOI: 10.1093/ehjci/jead085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/05/2023] Open
Affiliation(s)
- Xuejie Li
- Department of Anesthesiology, West China Hospital, Sichuan University and The Research Units of West China (2018RU012), Chinese Academy of Medical Sciences, No.37 Guo Xue Xiang, Chengdu, Sichuan 610041, P.R. China
| | - Jianglong Hou
- Department of Cardiovascular Surgery, West China Hospital, Sichuan University, No.37 Guo Xue Xiang, Chengdu, Sichuan 610041, P.R. China
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Zhang Q, Yan HL, Lu Q, Luo Y. Value of contrast-enhanced ultrasound in deep angiomyxoma using a biplane transrectal probe: A case report. World J Gastroenterol 2023; 29:4214-4221. [PMID: 37475848 PMCID: PMC10354570 DOI: 10.3748/wjg.v29.i26.4214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 05/23/2023] [Accepted: 06/13/2023] [Indexed: 07/10/2023] Open
Abstract
BACKGROUND Deep angiomyxoma (DAM) is a very rare tumor type. Magnetic resonance imaging (MRI) is considered the best imaging modality for diagnosing DAM. Computed tomography (CT) is used mainly to assess the invasion range of DAM. The value of ultrasonography in the diagnosis of DAM is still controversial. Through a literature review, we summarized the current state of ultrasonic examination for DAM and reported for the first time the contrast-enhanced ultrasound (CEUS) features of DAM seen using a biplane transrectal probe.
CASE SUMMARY A 37-year-old woman presented with a sacrococcygeal mass that had gradually increased in size over the previous 6 mo. MRI and CT examinations failed to allow a definite diagnosis to be made. Transperineal core needle biopsy (CNB) guided by transrectal ultrasound and CEUS was suggested after a multidisciplinary discussion. Grayscale ultrasound of the lesion showed a layered appearance with alternating hyperechoic and hypoechoic patterns. Transrectal CEUS showed a laminated distribution of the contrast agent that was consistent with the layered appearance of the tumor on grayscale ultrasound. We performed transperineal CNB of the enhanced area inside the tumor under transrectal CEUS guidance and finally made a definitive diagnosis of DAM through histopathology. The patient underwent laparoscopic-assisted transabdominal surgery combined with transperineal surgery for large pelvic tumor resection and pelvic floor peritoneal reconstruction. No recurrence or metastasis was found at the nine-month follow-up.
CONCLUSION Transrectal CEUS can show the layered perfusion characteristics of the contrast agent, guiding subsequent transperineal CNB of the enhanced area within the DAM.
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Affiliation(s)
- Qiong Zhang
- Department of Medical Ultrasound, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Hua-Lin Yan
- Department of Medical Ultrasound, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Qiang Lu
- Department of Medical Ultrasound, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Yan Luo
- Department of Medical Ultrasound, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
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