Right Atrial Giant Myxoma Occupying the Right Ventricular Cavity

Abstract

Introduction: Atrial myxomas are the most common primary heart tumors. Because of nonspecific symptoms, early diagnosis may be a challenge [1] [2]. Left atrial myxoma may or may not produce characteristic findings on auscultation. Two-dimensional echocardiography is the diagnostic procedure of choice. Most atrial myxomas are benign and can be removed by surgical resection. Cardiac myxoma is located mostly in left atrium [3]. This was amazing huge mass of cardiac myxoma in unusual part of the heart with the patient showed significant response to anticoagulation after presumed recurrence of tumor. Case Presentation: A case of giant right atrial myxoma mimicking the right ventricular tumor is described. Surgery was performed in 41 years old female and the fist like tumor with its stalk was excised. Surprisingly it recurred after 2 month as the smaller tumor was completely resolved with anticoagulation therapy. In addition because of previous normal echocardiography that was done for another reasons, we estimated the speed of tumor's growth (3 millimeter/month). Conclusion: To sum up a very large myxoma in right ventricle may only present with occasional dyspnea and we can diagnose it with precise evaluation and with performing on time echocardiography.

Fast growth rate of a right atrial myxoma

“…Only clinical case reports with documented tumor growth of right atrial myxomas, with their calculated growth rate, were included in our analysis, and are summarized in table 1. (6)(7)(8)(9)(10) Metastatic tumors, malign tumors, recurrent myxomas, review articles and other studies without documented growth rate were excluded.…”

“…In calculating these growth rates, it is assumed that myxomas grow in a linear fashion. (8)(9)(10)(11)(12) No malignancy or glandular degeneration was found on microscopic examination, which could imply a faster growth rate. Cardiac myxomas can show cell atypia, high cellularity or mitosis, without affecting the patient prognosis.…”

“…(1)(2)(3)(4)(5) Just five cases of right atrial myxoma with documented growth rate have been reported in the medical literature, ranging from 0.07 to 1.36cm per month, with the first case reported only in 1994. (6)(7)(8)(9)(10) Very little is known about right atrial growth rate. In this report, our objective was to present the case of a rapidly growing right atrial myxoma, in an old female patient, with a previous echocardiographic history, who refused surgery upon diagnosis, enabling monitoring of myxoma growth.…”