The variations in the immunologic features and interleukin-6 levels for the surgical treatment of cardiac myxomas.
OBJECTIVE
In this study, we propose the existence of a relationship between cardiac myxomas and the immunologic features or interleukin-6 (IL-6), while also considering the optimal treatment of cardiac myxoma, especially "familial myxoma."


METHODS
In a 19-year period at our hospital, 20 patients underwent 21 operations for cardiac myxomas. The immunologic features and the IL-6 levels were measured pre-operatively in 13 cases and post-operatively in 10 cases. A case of "familial myxoma" was diagnosed based on molecular genetic analyses.


RESULTS
No patients died in the hospital. The tumor size correlated with the preoperative IL-6 and/or alpha1-globulin values (P < 0.05). In addition, all of the immunologic features and IL-6 levels normalized by 4 weeks after surgery. "Familial myxoma" demonstrated recurrence without showing increases in either the immunologic features, inflammatory signs, or serum IL-6 levels.


CONCLUSIONS
Patients with cardiac myxoma should therefore be operated on immediately because the possibility that the tumor size might be large when IL-6 and/or alpha1-globulin values are high. In addition, cases of "familial myxoma" require careful observation and periodic echocardiography after surgery to identify any possible recurrence. Recently, molecular genetic analyses are therefore considered to be an important diagnostic tool for cardiac myxoma, especially "familial myxoma." Our "familial myxoma" case demonstrated a C769T PRKAR1a mutation, which has also been observed in other cases of "familial myxoma."
Yokomuro
Hiroki
H
Department of Surgery, Division of Cardiovascular Surgery, Toho University School of Medicine, 6-11-1 Omori-nishi, Tokyo 143-8541, Japan.
Yoshihara
Katsunori
K
Watanabe
Yoshinori
Y
Shiono
Noritsugu
N
Koyama
Nobuya
N
Takanashi
Yoshinori
Y
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D017548:Echocardiography, Transesophageal; D005260:Female; D006338:Heart Neoplasms / Q000000981:diagnostic imaging / Q000276:immunology* / Q000601:surgery; D006801:Humans; D015850:Interleukin-6 / Q000032:analysis*; D008297:Male; D008875:Middle Aged; D009154:Mutation; D009232:Myxoma / Q000000981:diagnostic imaging / Q000276:immunology* / Q000601:surgery; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
D015850:Interleukin-6
JAMA. 1983 May 27;249(20):2799-802
6842788
Surg Neurol. 1979 Jun;11(6):461-9
483155
Heart Lung. 1983 Nov;12(6):600-2
6556173
Br Heart J. 1985 Jun;53(6):645-9
4005088
J Clin Invest. 2000 Sep;106(5):R31-8
10974026
Acta Paediatr. 1992 Jan;81(1):91-2
1600314
Am J Cardiol. 1973 Sep 7;32(3):361-4
4725591
Medicine (Baltimore). 1985 Jul;64(4):270-83
4010501
Br J Dermatol. 1992 Apr;126(4):367-71
1571257
Cleve Clin J Med. 1991 May-Jun;58(3):248-50, 255-6
1893556
Am Heart J. 1992 Jan;123(1):243-4
1729840
Ann Surg. 1978 Aug;188(2):240-4
686891
Ann Thorac Surg. 1992 Mar;53(3):419-24
1540058
Am J Surg Pathol. 1985 Jan;9(1):53-5
3970298
Med J Aust. 1988 Jul 4;149(1):40-2
3386565
Ann Intern Med. 1975 Sep;83(3):358-60
1180432
J Thorac Cardiovasc Surg. 1979 May;77(5):782-8
431115
Ann Thorac Surg. 1990 Apr;49(4):612-7; discussion 617-8
2322057
Nihon Kyobu Geka Gakkai Zasshi. 1994 Mar;42(3):427-32
8176305
Am J Cardiol. 1976 Aug;38(2):252-6
133607
Kokyu To Junkan. 1993 Sep;41(9):891-5
8210750
J Thorac Cardiovasc Surg. 1976 Apr;71(4):605-8
1263542