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Case Reports
. 2010 Jun 18:8:23.
doi: 10.1186/1476-7120-8-23.

Massive right atrial myxoma presenting as syncope and exertional dyspnea: case report

Olga Azevedo  1 , Jorge Almeida, Tânia Nolasco, Rosa Medeiros, Jorge Casanova, Carla Bartosch, João Almeida, Paulo Pinho
Affiliations
Case Reports

Massive right atrial myxoma presenting as syncope and exertional dyspnea: case report

Olga Azevedo et al. Cardiovasc Ultrasound. .

Abstract

Primary heart neoplasms are rare occurring with an estimated incidence of 0.0017-0.19%. Myxoma is the most prevalent primary heart tumor. The right atrium is an unusual localization, occurring only in 15-20% of myxoma cases. We report a rare case of a massive right atrial myxoma causing tricuspid valve obstruction and presenting as syncope and exertional dyspnea. This case illustrates the influence of myxoma's size, position and mobility as well as patient's body posture and respiration to the development of signs and symptoms. Three-dimensional echocardiography proved useful in surgery planning, allowing a better definition of the tumor outline and attachment.

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Figures

Figure 1
Figure 1
M-mode of the right atrial mass. M-mode obtained from a subcostal view showing a huge mass in the right atrium prolapsing into the right ventricle during diastole.
Figure 2
Figure 2
Right atrial mass on 2D-echocardiography. A subcostal view showing a huge echogenic mass in the right atrium, prolapsing through the tricuspid valve.
Figure 3
Figure 3
Right atrial mass on 3D-echocardiography. 3 D full volume image reconstruction better defined the mass contour and confirmed its attachment (arrow) in the interatrial septum below the fossa ovalis.
Figure 4
Figure 4
Histopathological analysis of the atrial mass. (A) Explanted mass, measuring 4 × 6 cm, and its attachment remnant; (B) Histological section showing the typical myxoid stroma and embedded polygonal cells, blood vessels and areas of hemorrhage (Hematoxylin and Eosin, × 100).
See this image and copyright information in PMC

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