Cardiac myxoma - 2 years experience at a tertiary care center
Keywords:Cardiac tumor, Immunohistochemistry, Myxoma
Background: Cardiac myxomas are the most common primary neoplasms of the heart. The current study aims to ascertain the clinical relevance of histomorphological classification and to postulate the possible cell of origin of cardiac myxomas.
Methods: A total of 7 cases were analysed and reviewed with the assessment of the clinical presentations and gross and microscopic pathology along with immunohistochemical findings. All these patients were followed up to look for recurrence.
Results: Of the total cases there were 5 women and 2 men. The mean age at presentation was 49 years. The most common presenting complaint was dyspnoea. On microscopy all the cases had a myxoid stroma with cells arranged in a predominantly single stellate cell pattern subtype. The tumor cells in all the cases were diffusely and strongly positive for vimentin with variable expression of S 100, CD 34, CD 68 and desmin.
Conclusions: The identification of histological variability of cardiac myxoma has no significant clinical impact. Our study confirms the postulation that myxomas develop from multipotent mesenchymal stem cells.
Amano J, Kono T, Wada Y, Zhang T, Koide N, Fujimori M et al. Cardiac myxoma: its origin and tumor characteristics. Ann Thorac cardiovasc Surg. 2003;9:215-21.
Rahman MT, Ali MZ, Kabir MH, Azam STMA, Majumder AAS, Rahman A et al .Clinical profile of cardiac myxoma: 11years experience of 90 cases. Bangladesh Heart J. 2016:31;18-22.
Herbst M, Wattjes MP, Urbach H, Hutter CI, Becker D, Klockgether T et al. Cerebral embolism from left atrial myxoma leading to cerebral and retinal aneurysms: a case report. AJNR. 2005;26:666-9.
Burke AP, Viramani R. Cardiac myxoma: a clinicopathologic study. AJCP.1993:100;671-80.
Wang JG, Li YJ, Liu H, Li NN, Zha J, Xing XM. Clinicopathologic analysis of cardiac myxomas: seven years experience with 61 patients. J Thorac Dis. 4:272-283.
D’Alfonso A, Catania S, Pierri MD, Matteucci S L, Rescigno G, Munch S et al . Atrial myxoma: a 25-year single-institutional follow-up study. J Cardiovasc Med. 2008;9:178-81.
Goldman BI, Frydman C, Harpaz N, Ryan SF, Loiterman D. Glandular cardiac myxomas. Histologic, immunohisto-chemical and ultrastructural evidence of epithelial differentiation. Cancer. 1987;59:1767-75.
Amano J, Kono T, Wada Y, Zhang T, Koide N, Fujimori M et al. Cardiac myxoma: its origin and tumor characteristics. Ann Thorac Cardiovasc Surg. 2003; 9:215-21.
Acebo E, Val -Bernal JF, Gomez-Roman JJ. Thrombomodulin, calretinin and c-kit (CD117) expression in cardiac myxoma. Histol Histopathol 2001;16:1031-6.
Pucci A, Gagliardotto P, Zanini C, Pansini S, Summa M, Mollo F. Histopathologic and clinical characterization of cardiac myxoma. Review of 53 cases from a single institution. AHJ. 2000;140:134-8.
Sakamoto H, Sakamaki T, Sumino H, Sawada Y, Sato H, Sato M et al. Production of endothelin-1 and big endothelin-1 by human cardiac myxoma cells-implications of the origin of myxomas. Circ J. 2004;68:1230-32.
Boikos S.A., Stratakis C.A. Carney complex: pathology and molecular genetics. Neuroendocrinology. 2006;83:189-99.
Fogt F., Zimmerman R.L., Hartmann C.J., Brown C.A., Narula N. Genetic alterations of carney complex are not present in sporadic cardiac myxomas. Int. J. Mol. Med. 2002;9:59-60.
Barh D., Kumar A., Chatterjee S., Liloglou T. Molecular features, markers, drug targets and prospective targeted therapeutics in cardiac myxomas. Curr. Cancer Drug Targets. 2009;9:705-16.