1/415. Intra-atrial myxomas, clinical-pathologic correlation based on two case studies including historical review.The two cases of left-sided myxomas are reported with both patients having had uneventful cardiac surgery. One patient had an uneventful recovery and is doing well, whereas the second patient (female) had a complicating cerebrovascular accident. This patient was thought to have myxoma embolization; however, histopathologic verification could not be obtained. This latter patient had of course a higher risk of developing thromboembolization, due to the concomitant valve surgery procedure. The clinical, operative and pathologic studies confirm the lesions as primary myxomas and support and amplify the diagnostic concept of those lesions being of neoplastic nature, and countermand the previously commonly held concept of the thrombotic nature of myxomas. The nature of the myxoma is the primitive mesenchymal vasoformative cells of the atrial subendocardium, which is equivalent to the subendocardial cushion cell.- - - - - - - - - - ranking = 1keywords = cardiac (Clic here for more details about this article) |
2/415. Detection of cardiac myxoma by F-18 FDG PET.Intracardiac tumors occur infrequently and are difficult to diagnose with CT and MRI. The authors describe the successful imaging of a right atrial myxoma with F-18 FDG PET.- - - - - - - - - - ranking = 5keywords = cardiac (Clic here for more details about this article) |
3/415. Cardiac myxoma with glandular component: case report and review of the literature.A 7 cm diameter tumor of the left atrium is reported in a 78 year-old woman with a past history of pT3N1M0 colonic adenocarcinoma. The histological examination of the atrial tumor disclosed areas of highly vascularized myxoid stroma with cells strongly reactive for vimentin. Multiple mucoid spaces lined by a single layer of goblet cells were scattered among those typical areas of myxoma. No nuclear atypia was observed. cytoplasm of the glandular cells was immunoreactive for epithelial antisera (keratin, EMA), CEA and CA19.9. Two years later, the patient was doing well, with no local recurrence of the cardiac myxoma and no secondary location of the colonic adenocarcinoma. The histological characteristics, the absence of atypia, the absence of tumoral extension or neoplastic lymphatic vascular thrombi in the pedicle or in the interatrial septum, and the finding of typical myxomatous areas supported the diagnosis of cardiac myxoma with glandular component. To our knowledge, 21 cases of myxoma with glandular mucinous component, focal or prominent, have been previously published in the literature. These myxoma were generally sporadic cases with the same clinical features and prognosis as typical myxoma. Immunoreactivity of these glandular structures was constant for epithelial markers. The positive immunostaining by CEA, and by CA19.9 in our case, reflects the histogenetic endodermal origin.- - - - - - - - - - ranking = 2keywords = cardiac (Clic here for more details about this article) |
4/415. Left atrial myxomas presenting with right hand weakness.A 63-year-old man with multiple left atrial myxomas presenting with right hand weakness is described. Two-dimensional echocardiography obtained during the evaluation for his stroke showed a large left atrial mass. At surgery, two separate left atrial myxomas were excised. pathology confirmed the diagnosis. Although left atrial myxomas are uncommon, they should be included in the differential diagnosis of stroke, especially in patients who present without cardiovascular or cerebrovascular risk factors. The absence of cardiac symptoms and signs does not rule out a cardiac myxoma.- - - - - - - - - - ranking = 2keywords = cardiac (Clic here for more details about this article) |
5/415. Minimally invasive extirpation of a left-ventricular myxoma.As myxomas usually are benign neoplasms a minimally invasive technique would be an interesting alternative for their extirpation because the surgical trauma is reduced. In one male patient with a diagnosed left-ventricular myxoma minimally invasive surgery was carried out using the Port-Access method. 2D echocardiography, EBT, and MRI were performed preoperatively to obtain exact information about topography, calcifications, and malignity. Minimally invasive extirpation was successful and the mitral valve could be preserved. Histopathological examination revealed a cardiac myxoma extirpated in toto. At one-year follow-up there was no recurrence of the tumor.- - - - - - - - - - ranking = 1keywords = cardiac (Clic here for more details about this article) |
6/415. Primary brain myxoma, an unusual tumor of meningeal origin: case report.OBJECTIVE AND IMPORTANCE: Primary myxoma of the central nervous system is an extremely rare tumor arising from cells of primitive mesenchymal origin. Only two cases of primary intracranial myxoma have been described previously. We report a patient with a primary myxoma originating from the right frontoparietal convexity dura, which we studied in detail with diagnostic imaging and pathological analysis. CLINICAL PRESENTATION: A female adolescent presented to the emergency department with a 3-day history of mild headache, abdominal pain, and intermittent left-sided focal motor seizures. Neurological examination was remarkable for left leg hyperreflexia and difficulty with tandem gait. Cranial computed tomography and magnetic resonance imaging demonstrated an inhomogeneously enhancing mass in the right frontoparietal region. INTERVENTION: A right frontoparietal craniotomy was performed. During surgery, a tumor appearing similar to a typical convexity meningioma was completely removed along with the dural attachment. CONCLUSION: The patient had an uneventful recovery and returned to normal activity. Primary intracranial myxoma should be distinguished from other meningeal tumors and metastatic cardiac myxoma by appropriate pathological analysis and cardiac evaluation. A circumscribed myxoma completely excised with adequate dural margin carries a good prognosis for surgical cure.- - - - - - - - - - ranking = 2keywords = cardiac (Clic here for more details about this article) |
7/415. A case of large cell calcifying sertoli cell tumor in a child with a history of nasal myxoid tumor in infancy.A case of an 8-year-old Japanese boy with a testicular large cell calcifying sertoli cell tumor (LCCSCT) is presented. This report appears to be the first Japanese case of LCCSCT. The patient presented with left testicular swelling and gynecomastia. His family history was not contributory; however, his past history was remarkable for a benign myxoid tumor in the nasal cavity, which was removed at the age of 2 months. After removal of the testicular tumor, the gynecomastia disappeared gradually and no recurrence or metastasis developed during a 15 month follow-up period. Although the tumor was initially interpreted as a leydig cell tumor, a review of the slides after the patient's past history of nasal myxoid tumor was revealed led us to the diagnosis of LCCSCT. An accurate diagnosis of LCCSCT is crucial because this tumor is occasionally associated with carney complex, which can comprise various pathological conditions, including cardiac myxoma, that may be life-threatening. myxoma of carney complex has been described to occur in the heart, skin, oral cavity and breast in a wide age range, but there have been no reports referring to nasal myxoid tumor associated with carney complex.- - - - - - - - - - ranking = 1keywords = cardiac (Clic here for more details about this article) |
8/415. carney complex: in a patient with multiple blue naevi and lentigines, suspect cardiac myxoma.carney complex is characterized by spotty pigmentation (blue naevi and lentigines), myxomas (cardiac, cutaneous, mammary), endocrine over-activity (Cushing's syndrome, acromegaly), testicular tumours, and schwannomas. We report a male with multiple blue naevi, lentigines, testicular large cell calcifying Sertoli-cell tumour and four cardiac myxomas. The myxomas caused two cerebrovascular accidents and a myocardial infarction. All patients with multiple blue naevi or lentigines should be investigated for the life-threatening association of cardiac myxomas.- - - - - - - - - - ranking = 7keywords = cardiac (Clic here for more details about this article) |
9/415. Molecular genetic diagnosis of the familial myxoma syndrome (carney complex).We describe an individual in whom molecular genetic testing provided a diagnosis of the carney complex, an autosomal dominant syndrome comprising cutaneous and cardiac myxomas, spotty pigmentation of the skin, and endocrinopathy. Recently, we localized the carney complex disease gene to chromosome region 17q2. Our patient was a member of a family segregating the carney complex, but was not, himself, initially thought to be affected. Haplotype analysis based on genotyping studies with 17q2 microsatellites predicted that this individual was, in fact, affected by carney complex and was at risk for development of myxomas. Further clinical evaluation and re-review of prior pathologic studies, then, confirmed the dna-based diagnosis. This report highlights the difficulty in establishing a diagnosis of carney complex based on clinical and pathologic findings alone, and we suggest that molecular genetic analyses provide an important diagnostic method for this familial myxoma syndrome.- - - - - - - - - - ranking = 1keywords = cardiac (Clic here for more details about this article) |
10/415. A left atrial myxoma presenting as a cerebrovascular accident.A 14-year-old female presented with common clinical findings for a rare primary intracardiac tumor. Primary cardiac tumors are rare in all age groups, occurring in 0.05% of routine postmortem examinations. Pediatric primary cardiac tumors are likewise uncommon, with the most common being a rhabdomyoma. Atrial myxomas occur infrequently in the pediatric age group. They occur primarily between the third and sixth decade, making them the most common adult primary cardiac tumor. The following case presentation demonstrates a common clinical presentation for an intracardiac mass rarely diagnosed in the pediatric population. This patient's acute neurologic symptoms required prompt recognition of an intracardiac etiology. This recognition proved critical for the acute and long-term medical and surgical management of this patient.- - - - - - - - - - ranking = 6keywords = cardiac (Clic here for more details about this article) |
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