A rare case of cardiac myxoma with light bulb–like cystic morphology: a case report

Abstract Background Cystic myxomas are quite rare. Moreover, few reports have evaluated the causes that constituted them. Case summary A 73-year-old Asian man presented for pre-operative examination of osteoarthritis, and transthoracic echocardiography (TTE) revealed an incidental intracardiac mass. Therefore, he was referred to our department for further evaluation. He had no specific symptoms or family history related to tumours and heart failure. The TTE showed a 32 × 24 mm spherical mass adherent to the left atrial septum. The upper part of the mass was cystic in formation and hypoechoic inside and resembled a light bulb. Transoesophageal echocardiography showed the feeding arteries flowing from the bottom into the cystic part. In addition, two jet strips drained from the cystic part in the direction of the mitral valve. Coronary angiography revealed the feeding arteries, which consisted mainly of the right coronary artery conus branch and the left circumflex branch, and the blood flowed into the saccular area from the feeding arteries and excreted towards the mitral valve. Surgical resection was performed due to the mobility, and the histopathology confirmed a cystic myxoma. Discussion We described the unique anatomical formation of a cystic myxoma, which consisted of an exquisite balance between the tumour-feeding arteries and the draining outlet vessels.

[1]  O. Dzemali,et al.  Left atrial myxoma: Unusual presentation as a cystic tumor , 2019, Journal of cardiac surgery.

[2]  J. Cui,et al.  Cardiac Myxoma: A Rare Case Series of 3 Patients and a Literature Review , 2017, Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine.

[3]  J. Woo,et al.  Left Atrial Myxoma Presenting with Unusual Cystic Form , 2013, The Korean journal of thoracic and cardiovascular surgery.

[4]  Jong-Min Song,et al.  Cystic cardiac mass in the left atrium: hemorrhage in myxoma. , 2011, Circulation.

[5]  J. Bronzwaer,et al.  Right coronary artery flow impairment in patients with pulmonary hypertension. , 2007, European heart journal.

[6]  L. Shapiro,et al.  Cardiac tumours: diagnosis and management , 2001, Heart.

[7]  J. Kuijer,et al.  Flow profiles in the left anterior descending and the right coronary artery assessed by MR velocity quantification: effects of through-plane and in-plane motion of the heart. , 1999, Journal of computer assisted tomography.

[8]  A. Singhal,et al.  A rare cystic degeneration of myxoma , 2017 .

[9]  K. J. Kairemo,et al.  Cardiac myxomas. , 1996, The New England journal of medicine.