RECURRENT MYXOMA ARISING FROM MULTIPLE CARDIAC CHAMBERS WITH SYSTEMIC EMBOLIZATION:A CASE REPORT
Myxomas occupying multiple chambers of the heart are extremely rare, being more common in familial cases. Recurrence of these tumors after surgical excision is also a rare condition, observed in about 3% of patients in sporadic cases. Systemic embolization especially to the brain is one of the common presentations of cardiac myxomas apart from intracardiac obstruction and systemic symptoms.
We report an adolescent girl presenting with recurrent myxoma arising from multiple cardiac chambers with systemic embolization. As a diagnostic and preventive measure of recurrence and chronic systemic embolization, we recommend a regular follow up of such patients with echocardiographic evaluation following surgical resection.
Bruce CJ.Cardiac tumors:diagnosis and management. Heart 2011;97:151-160
Moran AM,Marx GR.Cardiac tumors: Allen HD,Driscol DJ,Shaddy RE,Feltes TE(Editors) :In Moss and Adams’Heart Disease in infants,children and adolescents including the fetus and young adult, 8th Edition,2013,Lippincot,Williams & Wilkins,pp. :1549-64.
Diaz A,Disalvo C,Lawrence D,et al.Left atrial and right ventricular myxoma: an uncommon presentation of a rare tumor. Interactive Cardiovascular &Thoracic Surgery 2011;12:622-625
Carvalho MS,Andrade MJ,Abecasis J,et al.Understanding cardiac myxoma recurrence;case report. Rev Port Cardiol 2013;32(3):239-242
Diarizumb SS,Char G.Large calcified right atrial myxoma in a newborn: rare cause of neonatal death. Br Heart J 1982;499-502
Silverman J,Olwin JS,Graettinger JS.Cardiac myxomas with systemic embolization.Review of the literature and report of a case. Circulation xxI,1962;99-103
Vatan MB,Gunduz H,Atakay S,et al(2011).Recurrent embolization of a left atrial myxoma resulting in cerebral ischemia. J Clinic Experment Cardiol,2.159 doi :10.4172/2155-9880.1000159
Lijoi A,Scoti P,Faveto C ,et al.Surgical management of intracardiac myxomas; A 16 year experience. Texas Heart Intitute J 1993;20:231-4
Elbardissi AW,De aram JA,Daly Rc et al:Survival after resection of primary cardiac tumors: A 48 year experience. Circulation 2008;118(suppl.14): s7-15
Bhan A,Mehrotra R,Choudhary SK,et al.Surgical experience with intracardiac myxomas: long term follow up. Ann Thorac Surg 1998;66:810-813
Liesting C,Ramjankhan FZ,Van Herwerden LA,et al.Systemic embolization as presentation and recurrence of cardiac myxoma two years after surgery. Neth Heart J 2010; 18:499-502.
Vidaillet Jr HT,Seward JB,FYKE FE,et al.”Syndromic myxoma” : a subset of patients of cardiac myxoma associated with pigmented skin lesions and peripheral and endocrine neoplasms. Br Heart J 1987;57:247-55
Mugge A,Daniel WG,Haverich A,et al.Diagnosis of noninfective cardiac mass lesions by two-diamensional echocardiography:comparison of the transthoracic and transoesophageal approaches. Circulation 1991;83:70-78
Engberdig R,Daniel WG.Ervel R.et al.Diagnosis of heart tumors by transoesophageal echocardiography: a multicenter study in 154 patients. Eur Heart J 1993;14: 1223-8
Shinfeld A,Katsumata T,Westaby W.Recurrent cardiac myxoma:Seeding or multifocal diseas.Ann Thorac Surg 1998;66:285-288
Abdul Uloom MA.A rare case of massive systemic embolization secondary pulmonary to atrial myxoma: case report. Med J Malaysia 2013;68(6): 471-472
Manfroi W,Vieira SR,Saddi EK,e t al.Multiple recurrences of cardiac myxomas with acute tumoral pulmonary embolism. Arq Bras Cardiol. 2001;77(2):163-6
O’Rourke F,Dean N,Mouradian MS,et al.Atrial myxoma as a cause of stroke. Can Med Ass J 2003;169(10):1049-1051