Abstract
Primary heart tumours are rare and 80% of them are benign. Fifty percent of these benign tumours are myxomas.
Up to date the histogenesis of intracardiac myxoma is not clear but they are thought to develop from
primitive endothelial or sub endocardial cells or in undifferentiated and totipotent mesenchymal stem cells.
Intracardiac myxomas can be classified as sporadic and familial. They are mainly located in the atria,
75–80% in the left atrium, 10–20% in the right atrium while 5–10% in other chambers and heart structures.
Sporadic myxomas make up to 90%, familial – 7–10% of patient cases. The literature reports that familial
myxomas have a higher tendency to recur than sporadic ones with recurrence rates of 30–40% and 1–4%
respectively and the causes have been suggested to be in adequate resection, intraoperative seeding, multicentricity,
emboli and malignancy changes.
We report on a second recurrence, a rare case of four recurrent myxoma in a 50-year-old female. The first
two operations were not done in our institution. She had a first resection of a single right atrial myxoma, then
six months later she underwent a reoperation to resect a myxoma from the left atrium. 6 years later she was
diagnosed with myxoma recurrence (two in the right atrium and one in the left atrium). She had a third open
heart surgery in Bakoulev National Scientific Practical Center for Cardiovascular Surgery (now Bakoulev
National Medical Research Center for Cardiovascular Surgery). Intraoperative a fourth myxoma was discovered
on the interatrial septum. All four were resected. Under controlled investigations, in two years there
is no recurrence.
Multiple biatrial intracardiac myxoma recurrence is rare and the exact mechanism of occurrence remains
unclear up to date. In patient management is important to take a radical approach for myxoma resection.
References
Samanidisa G., Perreasa K., Kalogrisa P. et al.
Surgical treatment of primary intracardiac myxoma:
19 years of experience. Interact. Cardiovasc.
Thorac. Surg. 2011; 13: 597–600.
DOI:
10.1510/icvts.2011.278705
Bjessmo S., Ivert T. Cardiac myxoma: 40 years'
experience in 63 patients – a 25-year experience.
Ann. Thorac. Surg. 1997; 63: 697–700.
Diaz A., Di Salvo C., Lawrence D., Hayward M.
Left atrial and right ventricular myxoma: an uncommon
presentation of a rare tumour. Interact.
Cardiovasc. Thorac. Surg. 2011; 12: 622–5.
DOI:
10.1510/icvts.2010.255661
Bockeria L.A.,
Malashenko A.I., Kavsadze V.E., Serov R.A. Heart
tumors. In: Cardioonkology. Moscow; 2003: 80–6
(in Russ.).
Vroomen M., Houthuizen P., Khamooshian A.
et al. Long-term follow-up of 82 patients after surgical
excision of atrial myxomas. Interact.
Cardiovasc. Thorac. Surg. 2015; 21: 183–8.
DOI:
10.1093/icvts/ivv125
Kestelli M., Yurekli I., Gokalp O., Gurbuz A.
Should we always perform radio-frequency ablation
while resecting atrial myxomas? Eur. J. Cardiothorac.
Surg. 2010; 37: 1237.
DOI: 10.1016/j.ejcts.
2009.12.001
About the authors
- Mironenko Vladimir Aleksandrovich, Dr. Med. Sc., Chief of Department of Reconstructive Surgery of the Aortic Root, orcid.org/0000-0003-1533-6212;
- Mutema Chileshe Alfred, Postgraduate, orcid.org/0000-0002-9132-737X;
- Maytesyan Shagen Aleksandrovich, Cand. Med. Sc., Researcher, orcid.org/0000-0001-6034-5359;
- Khugaev Georgiy Aleksandrovich, Junior Researcher, Physician-Pathologist, orcid.org/0000-0002-7392-4656
