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| Myxoma |
| Etiology •Unknown. |
| Pathogenesis •Unknown, |
| Epidemiology •Occurs in adolescence and all higher age groups. •This is the most common primary neoplasm of the heart in adults. |
| General Gross Description •90% occur in the atria with a 4:1 ratio of left:right involvement. •Remainder can occur anywhere, including the heart valves rarely. •Rarely multiple. •Typical lesion is a smooth glistening transluscent firm or soft variegated mass with a broad base attached to or near the fossa ovalis of the left atrium. •Some examples have a papillary structure with a villous surface. •Cut variegated surface jello-like in consistency with fields of gray and dark red shades due to hemorrhages. |
| General Microscopic Description •A relatively sparsely cellular lesion with a characteristic gel-like stroma of acid muco- polysaccharides containing individual small cells with sparse cytoplasm forming stellate protrusions into the stroma. •Cells are thought to be benign mesenchymal primitive anlage, which form other cellular elements of the tumor, including endothelial cells forming atypical vascular channels, fibroblasts, and smooth muscles. •Hemorrhages are common. |
| Clinical Correlation •The left atrial myxoma was the model of how a benign tumor can kill by mechanical means in the days before open heart surgery. It mimicked the diastolic murmur of mitral stenosis, and was an unexpected autopsy finding. •Papillary myxomas may present as emboli to a limb or a viscus. Pathology of excised embolus is diagnostic. •Some cases present with the non-specific effects of interleukin-6 secreted by the tumor, which include fever and malaise. |
| References • Cotran RS, Kumar V, Robbins SL: Robbins Pathologic Basis of Disease. 5th edition. Philadelphia, W.B. Saunders, 1994, pp. 569. |
| Myxoma |
| Synopsis by: J. Hasson M.D. (T32100M88400)[347] |
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