New Diagnosis of Left Atrial Myxoma in a 93‐Year‐Old Woman

Abstract

A 93-year-old woman with a history of hypertension was noted to have a mass in the left atrium prolapsing partially through the mitral valve on a routine surface echocardiogram in 2002. A transesophageal echocardiogram was then performed revealing an irregular mass with an appearance of protruding fronds of tissue. The echogenicity of the mass was inhomogeneous with some areas of punctate calcification, and the mass was attached to the interatrial septum. The echocardiographic appearance of the mass was almost pathognomic of atrial myxoma, and this is the oldest patient yet to have been diagnosed with a probable myxoma. The patient did not want surgical removal of the mass. She is still asymptomatic at the age of 95 years.

Single-Institutional 22 Years Experience on Cardiac Myxomas

“…Myxomas may take origin from any cardiac structures; however, the majority are located in the left atrium with the tumor base on the atrial septum. [1][2][3][4][5][6] Tumor may also occur in the right atrium, on the atrioventricular valves, in the ventricles, or may even originate from the atrial or ventricular free wall or appendages. 7,8 Association with intracardiac defects is rare and in a large series Newman et al 9 noted 2 atrial septal defects in 312 patients with myxoma.…”

“…2 The youngest diagnosed patient in the literature was a stillborn infant 3 and the oldest was a 95-year-old woman. 4 Women predominate in most series. 1 Myxomas usually occur sporadically, but familial myxomas have also been reported.…”

“…5 Although constitutional symptoms such as fever, malasie, weight loss, fatigue of any tumor of the body are true for myxomas, specifically the myxomas have the hazards of systemic embolization, cerebral or peripheral infarction, intracardiac obstruction, syncope, and sudden death. [1][2][3][4][5][6] We herein report our institutional experience with 24 patients who underwent open heart surgery for cardiac myxomas between 1985 and 2007.…”