Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2016 Sep;68 Suppl 2(Suppl 2):S97-S101.
doi: 10.1016/j.ihj.2016.05.001. Epub 2016 May 21.

A rare case of right ventricular myxoma causing recurrent stroke

Prakash Aroor Sarvotham Rao  1 , S N Nagendra Prakash  2 , Somanath Vasudev  2 , M Girish  2 , Arun Srinivas  2 , H P Guru Prasad  2 , P Jayakumar  2 , Venu Gopal Anandaswamy  2
Affiliations
Case Reports

A rare case of right ventricular myxoma causing recurrent stroke

Prakash Aroor Sarvotham Rao et al. Indian Heart J. 2016 Sep.

Abstract

We present a 62-year-old lady admitted in our hospital with two episodes of acute ischemic stroke about 2 weeks apart. She was evaluated for acute ischemic stroke and was thrombolysed for recent stroke in right MCA territory first time. On further evaluation, she was found to have a RVOT mass. A transthoracic and transesophageal echocardiogram revealed a PFO and a large, 5.1cm×2.3cm, ovoid, well circumscribed, echogenic mass in the right ventricle outflow tract attached by small pedicle to the ventricular side of anterior tricuspid leaflet, partly obstructing the right ventricular outflow tract and protruding through the pulmonic valve during systole. She was scheduled for surgery (right ventricular mass excision and PFO closure) after 3 weeks due to the risk of secondary hemorrhage in the infarcted area following thrombolysis and anticoagulation and so was discharged with medications after full neurologic recovery after about a week of hospital stay. She was readmitted 7 days after discharge, before the scheduled date of surgery with history of weakness of right upper limb, slurred speech and mild breathing difficulty lasting for about 20min following which she improved slowly (transient ischemic attack). The tumor was completely removed with the stalk using cardiopulmonary bypass support. The histopathological findings confirmed the diagnosis of myxoma.

Keywords: Cerebral artery; Histopathologic examination; Magnetic resonance imaging; Patent foramen.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
MRI shows hyperintense signals in pre- and post-central gyri.
Fig. 2
Fig. 2
Deep transgastric RV outflow view: RV myxoma obstructing RVOT and protruding into pulmonary valve during systolae.
Fig. 3
Fig. 3
Modified bicaval view: PFO with RV myxoma attachment to tricuspid leaflet.
Fig. 4
Fig. 4
TEE-RV inflow–outflow view: large oval shape myxoma in RV extending from tricuspid valve to pulmonary valve.
Fig. 5
Fig. 5
Deep transgastric RV apical view: RV myxoma attachment to anterior tricuspid leaflet by a stalk.
Fig. 6
Fig. 6
Gross appearance: macroscopic specimen demonstrated the jelly like mass with hemorrhagic areas.
Fig. 7
Fig. 7
HPE of specimen HPE of the specimen showed loose myxoid areas, composed of spindle cells with myxomatous matrix around them. No evidence of pleomorphism, mitosis or other features suggestive of malignancy.
See this image and copyright information in PMC

References

    1. Thiene G., Valente M., Lombardi M., Basso C. Tumours of the heart. In: Camm A.J., Luscher T.F., Serruys P.W., editors. The ESC Textbook of Cardiovascular Medicine. 2nd ed. Oxford University Press; Oxford: 2009. pp. 735–762.
    1. Mc Allister H.A., Fenoglio J.J. Armed Forces Institute of Pathology; Washington, DC: 1978. Tumours of the Cardiovascular System. Atlas of Tumour Pathology. Second Series. Fascicle 15; pp. 1–25.
    1. Bjessmo S., Ivert T. Cardiac myxoma: 40 years’ experience in 63 patients. Ann Thorac Surg. 1997;63:697–700. - PubMed
    1. Gonzalez A., Altieri P.I., Marquez E.U., Cox R.A., Castillo M. Massive pulmonary embolism associated with a right ventricular myxoma. Am J Med. 1980;69(5):795–798. - PubMed
    1. Karagounis A., Sarasam M. Myxoma of free wall of the right ventricle: a case report. J Card Surg. 2005;20(1):73–76. - PubMed

Publication types