Paroxysmal Nocturnal Dyspnea Secondary to Right Ventricular Myxoma: A Novel Presentation of an Unusual Tumor

Knight, Tristan; Shiramizu, Bruce; Ly, Princeton; Thompson, Karen; Reddy, Venu

doi:10.1155/2018/4791379

Cited by 1 publication

(2 citation statements)

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“…Furthermore, the use of anticoagulation may potentially be harmful, increasing the risk of peripheral embolization in the presence of a cardiac tumor [ 14 , 15 ]. On the other hand, cardiac mass biopsy prior to surgical removal may lead to catastrophic embolization when it proves to have actually been thrombus [ 3 ].…”

Section: ⧉ Discussionmentioning

confidence: 99%

“…Of all primary heart tumors, approximately 75% are benign, with myxoma accounting for at least half of these. Approximately 75% of myxomas arise from the left atrium [ 2 ], and only a very few cases of right ventricular (RV) myxoma have been described in the literature thus far [ 1 , 3 ]. Depending on the size and location of the tumor, presenting symptoms may vary.…”

Section: ⧉ Introductionmentioning

confidence: 99%

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The riddle of the right ventricle

Enache³

et al. 2021

Rom J Morphol Embryol

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Right ventricular (RV) myxoma is a very rare finding. Its differential diagnosis includes cardiac thrombus, and its risk of life-threatening complications mandates early diagnosis followed by surgical resection. We report the case of a patient with an incidental RV mass and a difficult differential diagnosis. A 66-year-old woman, first assessed in neurosurgery due to a lumbar herniated disc, was referred to cardiology for examination before proceeding to surgery. She complained of dyspnea on exertion present for the last few months and reported no fainting or syncope. Clinical examination showed intermittent pulmonary systolic murmur. Transthoracic echocardiography revealed an oval-shaped sessile mobile mass (42/18 mm) attached to the anterior RV wall. Computed tomography confirmed the presence of a RV mass with lower attenuation than the myocardium and extension towards the pulmonary trunk, without other abdominal or pulmonary masses that would suggest a thrombus. Cardiac magnetic resonance imaging described an ovoid mass (47/16 mm) in the right ventricle, “clinging” to the apical trabeculae, swinging during the cardiac cycle, causing partial obstruction of the pulmonary valve during systole. The patient underwent surgical resection of the tumor. Macroscopic specimen showed a translucent polypoid mass with hemorrhagic areas. Microscopy confirmed the diagnosis of RV myxoma. The case illustrates the difficulty of establishing the correct etiological diagnosis of a cardiac mass, especially when located in the right ventricle. Multimodality imaging remains the cornerstone of noninvasive tissue characterization of cardiac masses, still requiring histopathological confirmation, particularly in the setting of conflicting imaging results.

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Section: ⧉ Discussionmentioning

confidence: 99%