Right ventricular cardiac myxoma. Diagnostic usefulness of cardiac magnetic resonance imaging.
BACKGROUND
Cardiac myxomas are the most common type of cardiac tumors. About 75-85% of cardiac myxomas originate in the left atrium, 15-20% in the right atrium. Most myxomas arise from the interatrial septum adjacent to the fossa ovalis. Only 3-4% are found in the left and right ventricle each. Although myxomas are histologically benign, they may be fatal because of their strategic position.


METHODS
The authors report on a 24-year-old patient with stabbing thoracic pain and dyspnea due to pulmonary thromboembolism that was caused by an atypically localized myxoma at the right ventricular apex originating from the interventricular septum. The diagnosis was based on cardiac magnetic resonance (CMR) imaging. Superior to echocardiography, CMR could strengthen the diagnostic accuracy by additional information on tissue characterization using different imaging sequences. Typically for cardiac myxomas, contrast enhancement was moderate and delayed enhancement was found in the outer circumferential tumor margins only.


CONCLUSIONS
High spatial resolution and multiplane imaging combined with different acquisition patterns of CMR achieve a global view of the heart that seems to be useful for diagnosing cardiac tumorous masses.
Alter
Peter
P
Department of Internal Medicine-Cardiology, Philipps University of Marburg, Germany.
Grimm
Wolfram
W
Rominger
Marga B
MB
Ritter
Michael
M
Klose
Klaus J
KJ
Moosdorf
Rainer
R
Maisch
Bernhard
B
D000328:Adult; D005260:Female; D006338:Heart Neoplasms / Q000473:pathology*; D006352:Heart Ventricles / Q000473:pathology; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D009232:Myxoma / Q000473:pathology*