Polypoid atrial myxoma.
Myxomas are by far the most common tumours of the heart. A 75-year-old man with no notable medical history presented with a 2-month progressive weight loss and dyspnoea on exertion. Physical examination revealed an opening snap and a diastolic decrescendo murmur at the apex. Transthoracic echocardiography showed a large, 85 × 30  mm, mobile, polypoid mass arising from the atrial fossa ovalis and protruding into the left ventricle during diastole. Irregular shape, multilobated surface and soft-tissue echogenicity were consistent with emboligenic myxoma. Surgical inspection confirmed a reddish gelatinous myxoma with villous, friable, thrombus-like surface prone to embolize. The mass was successfully removed and the histologic report confirmed the diagnosis.At 3-year follow-up, the patient is asymptomatic and no further mass has been detected. The case confirms that echocardiography remains a primary tool for the assessment of cardiac masses, providing morphological clues to define the potential risk of complications such as valve obstruction and systemic embolization.
Cardiovascular and Thoracic Department, San Raffaele Scientific Institute and Università Vita-Salute San Raffaele, Milan, Italy. grimaldi.antonio@hsr.it
Antonio
A
Grimaldi
Andrea
A
Fumero
Maurizio
M
Taramasso
Federico
F
Pappalardo
Francesca
F
Sanvito
Enrico
E
Ammirati
Elvia
E
Capritti
Alessandro
A
Castiglioni
Egidio
E
Collu
Maria Grazia
MG
Pala
Alberto
A
Zangrillo
Ottavio
O
Alfieri
D000368:Aged; D006325:Heart Atria; D006338:Heart Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D008297:Male; D009232:Myxoma / Q000000981:diagnostic imaging* / Q000601:surgery; D014463:Ultrasonography