Atypical Left Ventricular Myxoma: Unusual Echocardiographic and Histopathological Features

Abstract

<jats:p> Cardiac myxomas are the most common primary cardiac tumors and are typically attached to the interatrial septum. Left ventricular myxomas are exceedingly rare and presentation in children is all the more uncommon. We report a case of left ventricular myxoma with very atypical cystic appearance raising an initial suspicion of a hydatid cyst. Subsequently, cardiac magnetic resonance imaging was done, which ruled out the diagnosis of hydatid cyst. Complete surgical excision was done through transaortic and transmitral route. Histopathological examination revealed it to be a cardiac myxoma with vascular proliferation, which on echocardiography had appeared as a polycystic lesion. This is a very unusual histopathological presentation of cardiac myxoma. </jats:p>

Left Ventricular Myxoma: Case Report

“…They are the most frequent cardiac tumors, happening around 40%-70% of all cases [1], appearing usually at adulthood and being rare in children [4,5]. More than 80% of myxomas emerge in the left atrium, the majority of them being solitary [1], 15% to 20% appear on the right atrium and only 4% to 2.5% occur on the left and right ventricle [6].…”

“…Myxomas usually have solid or papillary pattern even when located in an atypical position. Multilocular myxomas are rare and usually seen in recurrence [4].…”

“…interference in the functioning of the mitral and aortic valves; invasive tumors that can cause arrhythmias, pericardial effusion or even cardiac tamponade; systemic embolism is seen in 50% of cases [4,20]. Acute occlusion of the aorta can occur, being rare in the literature, and may present as paraplegia (due to spinal cord ischemia) in 50% of the cases and is incorrectly diagnosed as a neurological disorder [3].…”

A Unique Case of a Gigantic Left Ventricular Myxoma Resulting in Embolic Acute Lower Limb Ischemia in a Pediatric Patient

“…However, cases of childhood myxomas have been published in [3][4][5]. When present, myxomas are typically localized in the left atrium [6], but there are few cases of left ventricular myxomas present in the literature [3,[6][7][8][9].…”

“…In addition to this, systemic inflammatory syndrome has been seen in patients diagnosed with a cardiac myxoma, due to tumoral cytokine release [7,10]. Although in most cases the patients are symptomatic, thus prompting further cardiac investigations, there have been cases of asymptomatic patients reported in the literature, where the cardiac mass was an incidental finding [3,7]. The presence of a mass in the left heart chambers might lead to either an inflow or outflow obstruction.…”