Right atrial myxoma presenting as Budd-Chiari syndrome

A 25-year-old man experienced rapidly progressing Budd-Chiari syndrome. Despite extensive radiological investigations, no atrial mass could be identified. At operation, a right atrial myxoma was found that originated from the eustachian valve and prolapsed into the inferior vena cava. Following successful removal of the myxoma, the ascites and peripheral edema resolved completely. Right atrial myxoma is a rare cardiac tumor that may present with embolic, obstructive, or constitutional signs and symptoms and is a potentially curable cause of Budd-Chiari syndrome.     

Left atrial myxoma presenting as acute inferior wall infarction-a case report

Acute myocardial infarction is a rare form of presentation in patients with left atrial myxoma. With wider availability of echocardiography, more and more patients with atrial myxomas will be diagnosed. This report describes a patient with left atrial myxoma who presented features of acute myocardial infarction and had surgical removal of LA myxoma.     

Left atrial myxoma

8 patients with atrial myxoma were reviewed. They ranged from 5 years to 55 years. Recently echocardiography has been the most helpful diagnostic procedure. Hemodynamically they simulated mitral valve disease with severe pulmonary hypertension. Tumour was demonstrated by angiocardiography. One of these tumours presented into the right atrium through an associated atrial septal defect. All of them underwent open heart surgery and removal of the tumour. One died as a result of septicemia. Others have had excellent hemodynamic improvement.     

Entire left atrial myxoma presenting as a saddle embolus

A case is presented in which a complete left atrial myxoma became detached and lodged in the aortic bifurcation. Shortly after it had been removed the patient suffered cardiac arrest and could not be revived.     

Left atrial myxoma with cerebral emboli

Infarction of the central nervous system secondary to embolism from left atrial myxoma is a recognized phenomenon. However, myxoma as the source of an embolus may be overlooked if an index of suspicion is not present during the evaluation of the patient with a stroke without a known cause. We present a case report that illustrates some of the pitfalls and characteristic findings present in the evaluation of these patients. The magnetic resonance image of multiple cerebral aneurysms and infarction associated with this condition is presented along with a unique, arteriographically proven resolution of a fusiform cerebral aneurysm after the removal of the cardiac tumor. A review of published case reports suggests that, if the cardiac tumor is recognized and treated quickly, the ultimate prognosis, while uncertain, is usually good. However, because the potential exists for recurrence of the cardiac tumor, for enlargement of the cerebral lesions, or for late development of cerebral lesions, long term follow-up is mandatory and a vigorous work-up must be pursued if the patient again becomes symptomatic or develops central nervous system manifestations for the first time.     

Left atrial myxoma: Unusual presentation as a cystic tumor

Myxomas are the most common cardiac tumors, benign, and usually located in the left atrium. Typically echocardiography reveals a solid tumor, whereas cystic myxomas are rare with only a few cases documented in the literature. We describe the case of a 63-year-old, female patient with an unusual presentation of a left atrial myxoma as a cystic tumor.     

Left atrial myxoma with severe inflammatory response

A 59-year-old man was admitted for intermittent fever. His temperature was 38°C, white blood cell counts 19,800/mm³, C-reactive protein 17.9 mg/dL. Interleukin 6 (IL-6) serum level was 31.0 pg/mL. Transesophageal echocardiography showed a 6×4 cm left atrial tumor arising from the atrial septum. We strongly suspected that left atrial myxoma caused the fever. The tumor was excised with the aid of cardiopulmonary bypass. Tumor histology was typical of a cardiac myxoma. The serum IL-6 level decreased rapidly in postoperative two weeks (5.3 pg/mL). In this patient, IL-6 plasma level might be used as a marker of recurrence.     

Recurrent left atrial myxoma presenting as peripheral arterial embolus

Recurrence of left atrial myxoma is rare. A male aged 18 years developed recurrence of left atrial myxoma despite excision of the tumour along with an ample cuff of the atrial septum around the tumour stalk, two years earlier. The patient presented with peripheral arterial embolus and underwent right femoropopliteal embolectomy and excision of the recurrent atrial myxoma. The presentation of recurrent left atrial myxoma with peripheral arterial embolism has perhaps not been reported earlier. Etiopathology of recurrence of myxomas and surgical treatment are discussed.     

Left atrial myxoma in a 13-month-old infant

The presentation, diagnosis and management of a 13-month-old child with a left atrial myxoma is described. The value of echocardiography in confirming the diagnosis is emphasized.     

Left atrial myxoma associated with acute myocardial infarction

We describe a patient with left atrial myxoma associated with acute myocardial infarction. Since hemodynamics were impaired even with the support of an intra-aortic balloon pump, the patient underwent removal of the tumor concomitant with coronary artery bypass grafting to the right coronary artery on the fifth day from infarction onset. In circumstances of life-threatening of myxoma associated with acute myocardial infarction, removal of myxoma with coronary artery bypass should be performed in an acute phase of myocardial infarction.     

Left atrial myxoma associated with ruptured chordae tendineae

A rare case of left atrial myxoma associated with ruptured chordae tendineae is presented. The patient was 70-year-old woman, and was diagnosed to have a left atrial myxoma. The myxoma was extirpated together with the atrial septum from which tumor developed. After removal of the myxoma, a ruptured strut chordae tendineae of anterior leaflet was also detected and resutured to the original papillary muscle. The cause of the torn chordae is presumed to be so-called "wrecking ball effect", and to be myxomatous degeneration of the valve.     

Left atrial myxoma with extramedullary hematopoiesis and ossification

A 65-year-old female with palpitation was referred to our hospital for a further examination. Trans-esophageal and thoracic echocardiogram demonstrated a left atrial tumor with a patchy calcification, arising from the lower portion of the interatrial septum. It was completely extirpated together with its sessile pedicle and the related disc of interatrial septum. The tumor showed the extensive extramedullary hematopoiesis and ossification around scanty clusters of myxoma cells on light microscopy. These findings indicated further support to the belief that the primitive mesenchymal cell is the origin in cardiac myxoma.