[Cardiac myxoma. Clinical-pathological correlation].
OBJECTIVE
Myxomas are the most common type of primary cardiac tumors. The aim of this study was to analyze the clinical forms of presentation of cardiac myxoma, the postoperative evolution, and the possibility of recurrence and tumoral embolism.


METHODS
From July 1992 to March 1999, 31 patients with myxoma were studied. Cell cycles (ploidy pattern of the tumoral DNA) were studied in 12 patients to evaluate the risk of recurrence and tumoral embolism.


RESULTS
The most frequent clinical manifestations were constitutional symptoms (74%), dyspnea (45%), and embolism (41%). Smaller-diameter myxomas correlated independently with tumoral embolism (45%). The in-hospital mortality was 3.2%, no deaths were observed during follow-up (mean: 4.8 years). No patients had clinical or echocardiographic signs of tumoral recurrence. Patients with tumoral embolism (n = 8) were compared with patients without embolism (n = 4). Patients who suffered embolism had higher S phase > 7 and/or DNA index > 1.2 (4/4 patients [100%], p= 0.061) than patients without embolism (2/8 patients [25%]). Cytometry of the only recurrent tumor (second operation) revealed a diploid tumor with a significantly more frequent S phase (10%) than in sporadic myxomas (4.27 2.32%, p = 0.039).


CONCLUSIONS
Constitutional symptoms, dyspnea, and tumor embolism were the most frequent clinical manifestations. Clinical and anatomopathologic characteristics and the cell cycle were not significantly related to tumoral embolism, but there was a tendency toward a higher proportion of cells in S phase and a higher DNA index in tumors associated with embolism. The S phase was significantly more frequent in the only case of recurrent myxoma and could be a potential marker of recurrence.
Gabe
Eduardo D
ED
Departamentos de Cardiología, Instituto de Cardiología y Cirugía Cardiovascular, Fundación Favaloro, Buenos Aires, Argentina. gabe@cardioweb.net.ar
Rodríguez Correa
Carlos
C
Vigliano
Carlos
C
San Martino
Julio
J
Wisner
Jorge N
JN
González
Pedro
P
Boughen
Roberto P
RP
Torino
Augusto
A
Suárez
Luis D
LD
D000328:Adult; D000368:Aged; D004273:DNA, Neoplasm / Q000737:chemistry; D005260:Female; D006338:Heart Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology; D009232:Myxoma / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D009360:Neoplastic Cells, Circulating / Q000473:pathology; D012008:Recurrence; D012189:Retrospective Studies
D004273:DNA, Neoplasm