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Sample records for atrial myxoma case

  1. Bilateral Atrial Myxoma: A Case Report.

    Science.gov (United States)

    Susupaus, Attapoom; Foofuengmonkolkit, Kumpoo

    2016-02-01

    Among the rare cardiac tumors, myxoma, which is mostly located in the left atrium, is the most common type. Bilateral atrial myxoma is extremely rare, and requires urgent surgery. The authors report the case of a 34-year-old male, who presented with one month of right hemiparesis and aphasia and subsequently diagnosed with bilateral atrial myxoma based on transthoracic echocardiography. An urgent operation for intra-cardiac tumor removal was performed with the biatrial approach. Once a diagnosis of myxoma has been made, an urgent operation for tumor removal is necessary due to the risk of serious complications, including sudden death from normal blood flow obstruction.

  2. Cerebral embolism complicating left atrial myxoma: a case report ...

    African Journals Online (AJOL)

    Cerebral embolism complicating left atrial myxoma: a case report. Zairi Ihsen, Mssaad Hela, Mzoughi Khadija, Jnifene Zouhayer. Abstract. Cardiac myxoma are the most common benign primary cardiac tumors that can lead to many complications as described in literature. Here we report the case of a boy aged 11 that was ...

  3. A Giant Left Atrial Myxoma

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    Medhat F. Zaher

    2014-01-01

    Full Text Available Atrial myxomas are the most common primary cardiac tumors. Patients with left atrial myxomas generally present with mechanical obstruction of blood flow, systemic embolization, and constitutional symptoms. We present a case of an unusually large left atrial myxoma discovered incidentally in a patient with longstanding dyspnea being managed as bronchial asthma.

  4. CT findings of atrial myxoma

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    Tsuchiya, F.; Kohno, A.; Saitoh, R.; Shigeta, A.

    1984-04-01

    The computed tomographic (CT) appearance of six atrial myxomas was analyzed. Five of the myxomas were located in the left atrium and one was in the right atrium. The margin of the myxoma was at least slightly lobulated in five cases and the content was inhomogeneous in all. Calcification was demonstrated in three cases. The site of attachment of the myxoma was demonstrated by CT to be the arial septum in all cases. The CT finding correlated well with the operative findings. It is concluded that it is possible with CT to diagnose atrial myxoma by the location and nature of the intracardiac mass and to differentiate it from thrombus.

  5. Cerebral ischemia as initial neurological manifestation of atrial myxoma: case report

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    Almeida Leila Azevedo de

    2006-01-01

    Full Text Available Cerebral infarctions of cardiac etiology are observed in around 20% of patients with ischemic stroke. Cerebral ischemia is the first clinical manifestation in 1/3 of cases of atrial myxomas. Although almost half of patients with atrial myxoma show changes at neurological exam, non-hemorrhagic cerebral infarction is seen in computed tomography in practically all cases. We present the case of a 40 year-old woman whose first clinical manifestation of atrial myxoma was an ischemic stroke. We point out to the possibility of silent cerebral infarction in atrial myxoma patients.

  6. Case of right atrial myxoma with right to left shunt

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    Nakai, Kenji; Suzuki, Tomoyuki; Ohzeki, Tetsuro (Iwate Medical Coll., Morioka (Japan). School of Medicine)

    1982-12-01

    A case of 49-year-old woman with right atrial myxoma resulting to right to left shunt, diagnosed by cardiac pool isotope image, was reported. She was admitted to our clinic because of progressive shortness of breath. At admission lip cyanosis was noted. Laboratory data included polycythemia, low O/sub 2/ saturation (89%) and high erythrocyte sedimentation rate (65 mm/1 h). Chest x-p showed slight right atrial enlargement, but no pulmonary congestion. The electrocardiogram showed sinus regular rhythm with biphasic p wave in leads II, III, aVf. Although 1st heart sound at the apex was splited, no heart murmur was heard. In usual echocardiographic approach, no abnormal echogram was obtained in the right ventricular region. Lung perfusion scintiscan with Tc-99 m-MAA showed visualization of thyroid gland and kidney, which suggested intracardiac right-to-left shunt. Cardiac pool image with Tc-99m-HSA revealed large photo-deficient area in the right atrium and early visualization of aortic arch. Computor tomography showed large round low density region 8 x 7 cm in size. Based on their findings, this patient was diagnosed as right atrial tumor. At operation a large tumor (diameter 8 x 7 x 7 cm, weight 160g) filled the lower part of the right atrium and was adherent to the anterolateral wall in the right atrium. As a cause of R-L shunt, streched foramen ovale (5 x 10 mm) was found. Tumor histology was typical of atrial myxoma. Post-operative gated cardiac isotope image showed no evidence of residual atrial tumor. Cardiac blood pool isotope imaging was a method for the noninvasive detection and assessment of right atrial myxoma.

  7. A Late Case of Ischemic Cerebral Event after Resection of a Left Atrial Myxoma

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    Reginald Lafleur

    2016-05-01

    Full Text Available Atrial myxoma is one of the most common primary cardiac tumors reported in the literature. In very rare instances, stroke has been the sequelae after a myxomatous tumor resection. We report this unique case of late ischemic cerebral event in a 46-year-old female some days after resection of a left atrial myxoma.

  8. Asymptomatic Left Atrial Myxoma in Elderly Patient: A Case Report

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    Seyhan Yilmaz

    2013-08-01

    Full Text Available Approximately 75% of cardiac tumors are benign and approximately 50% are constituted of myxomas. Myxomas are more common among women, and generally appear between the third and sixth decade of life. The most common symptom of myxomas is respiratory distress associated with obstruction. The main goal in the surgery of cardiac myxomas is the full excision of the tumor with minimal manipulation and disruption/fragmentation together with the aid of a cardiopulmonary bypass. This case report is reported a seventy years old patient with asymptomatic cardiac myxoma whom undergoing surgery with general anesthesia twice at different times and undiagnosed cardiac myxoma in past seven years.

  9. [Treatment of Right Atrial Myxoma Complicated with Pulmonary Embolism;Report of a Case].

    Science.gov (United States)

    Jinnouchi, Kouki; Rikitake, Kazuhisa; Furutachi, Akira; Yoshida, Nozomi

    2016-07-01

    Myxomas are account for approximately half of primary cardiac tumors, 75% of which originate in the left atrium. We report a case of a right atrial myxoma complicated with bilateral pulmonary embolism. A 54-year-old woman was admitted to the hospital with a complaint of dyspnea. Echocardiography and computed tomography angiography showed a right atrial tumor and bilateral pulmonary embolism. We performed an emergency surgery to remove both the right atrial tumor and the pulmonary emboli. Histopathologically, the tumor was revealed to be myxoma. The postoperative course was uneventful. She is now doing well without any symptoms.

  10. Massive right atrial myxoma presenting as syncope and exertional dyspnea: case report

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    Bartosch Carla

    2010-06-01

    Full Text Available Abstract Primary heart neoplasms are rare occurring with an estimated incidence of 0.0017-0.19%. Myxoma is the most prevalent primary heart tumor. The right atrium is an unusual localization, occurring only in 15-20% of myxoma cases. We report a rare case of a massive right atrial myxoma causing tricuspid valve obstruction and presenting as syncope and exertional dyspnea. This case illustrates the influence of myxoma's size, position and mobility as well as patient's body posture and respiration to the development of signs and symptoms. Three-dimensional echocardiography proved useful in surgery planning, allowing a better definition of the tumor outline and attachment.

  11. Cerebral embolism complicating left atrial myxoma: a case report.

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    Ihsen, Zairi; Hela, Mssaad; Khadija, Mzoughi; Zouhayer, Jnifene

    2016-01-01

    Cardiac myxoma are the most common benign primary cardiac tumors that can lead to many complications as described in literature. Here we report the case of a boy aged 11 that was referred for etiological diagnosis of ischemic stroke. Transthoracic echocardiography reveals a myxoma in the left atrium. Patient was referred to surgery. The diagnosis was confirmed and the mass was completely resected.

  12. Atrial mass: a myxoma?

    National Research Council Canada - National Science Library

    Chatzis, Andrew C; Kostopanagiotou, Kostas; Kousi, Theofili; Mitropoulos, Fotios

    2016-01-01

    A middle‐aged woman with a history of resected colorectal cancer and receiving chemotherapy presented with a right atrial mass and the provisional diagnosis of myxoma supported by echocardiography, computed...

  13. Right Atrial Myxoma and Syncope.

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    Babs Animashaun, Islamiyat; Akinseye, Oluwaseun A; Akinseye, Leah I; Akinboboye, Olakunle O

    2015-09-21

    Right atrial myxoma accounts for 15-20% of cardiac myxomas and syncope is a very rare manifestation. We present the case of an 89-year-old man with right atrial myxoma and syncope, and discuss the role of cardiac magnetic resonance imaging (MRI) in the diagnosis of myxomas. An 89-year-old man with a history of hypertension, hyperlipidemia, chronic kidney disease stage 4, mild dementia, and benign prostatic hyperplasia presented to the emergency department with an episode of syncope. Physical examination demonstrated normal and regular heart sounds, and normal respiratory rate and oxygen saturation. Echocardiogram described a well-circumscribed echo-dense mass in the right atrial cavity, which was attached to the septum but not obstructing the tricuspid annulus, measuring 1.7×2.2 cm at its widest diameter. Cardiac MRI revealed a mass with dark intensity which enhanced heterogeneously following intravenous administration of gadolinium-chelate, consistent with a myxoma. The location of this myxoma, coupled with the presence of a stalk allowing mobility, provides a clue to how this patient experienced transient obstruction of the tricuspid valve leading to syncope. Right heart tumors should be considered in the differential diagnosis of unexplained syncope. Cardiac MRI with gadolinium-chelate administration can help differentiate this tumor from a right-sided atrial thrombus, which can pose a diagnostic challenge.

  14. Value of intravenous digital substraction angiography in atrial myxomas. Report of two cases

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    Rovani, X.; Pernes, J.M.; D' Allaines, C.; Gaux, J.C.; Carcone, B.

    1986-01-01

    The authors report two cases of atrial myxoma (one in the right atrium and on in the left atrium) diagnosed by echocardiography completed by intravenous digital substraction angiography in both cases. In both cases, intravenous digital substraction angiography was able to demonstrate the myxoma, define the presence of a prolapse of the tumour into the ventricle during diastole (only observed in one case on echocardiography) and, in the case of the right atrial myxoma, it confirmed the integrity of the pulmonary blood supply together with the absence of a right-left shunt via a patent foramen ovale. The place of intravenous digital substraction angiography as a complement to echocardiography is discussed. The authors consider it to be superior to conventional angiography as it provides as much information with less risk.

  15. Mixoma atrial esquerdo múltiplo: relato de caso Multiple left atrial myxoma: case report

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    José Carlos Dorsa Vieira Pontes

    2011-09-01

    Full Text Available Os tumores primários cardíacos são infrequentes, apresentando incidência entre 0,001% a 0,2%, com características histológicas benignas em 75% dos casos. Os mixomas correspondem a aproximadamente 50% dessas neoplasias. Quanto à localização, 75 a 80% dos mixomas estão no átrio esquerdo, 18% no átrio direito, e mais raramente nos ventrículos. Relatamos o caso de um paciente em classe funcional (CF IV New York Heart Association (NYHA e diagnóstico anatomopatológico pós-operatório de mixoma multilobular originário na parede posterior atrial esquerda. À avaliação clínica no 3º mês pós-operatório se encontrava em CF I NYHA e a ecocardiográfica com ausência de massas intracardíacas.Primary cardiac tumors are infrequent, with an incidence between 0.001% and 0.2%, mostly comprising benign histological characteristics in 75% of these cases. Myxomas account for approximately 50% of these neoplasms. As regards location, 75-80% of myxomas are in the left atrium, 18% in the right atrium, and more rarely in the ventricles. We report a case of a patient in functional class (FC IV New York Heart Association (NYHA and postoperative histological diagnosis of multilobular myxoma originating in the posterior left atrial wall. Clinical evaluation 3 months after surgery suggested NYHA functional class I and echocardiographic absence of intracardiac masses.

  16. [Myocardial infarction as the first manifestation of an atrial myxoma: the bomb in the heart. Case report and literature review].

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    Cannarile, Pierpaolo; Cresti, Alberto; Stefanelli, Stefania; Calabria, Paolo; Pasqualini, Paola; Solinas, Marco; Limbruno, Ugo

    2016-12-01

    Atrial myxoma is a cardiac tumor often histologically benign but very insidious for its mechanical complications. Among these, myocardial infarction can be an expression of coronary embolism. Imaging techniques are essential for the diagnosis and the therapeutic steps. We describe the clinical case of a 52-year-old woman with acute myocardial infarction and normal coronary arteries with left atrial myxoma. We conducted a review of published case reports over the last 45 years on the rare association between atrial myxoma and acute myocardial infarction, to obtain pathogenic and epidemiological information from the real world.

  17. Left atrial myxoma with biventricular dysfunction.

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    Raut, Monish S; Shad, Sujay; Maheshwari, Arun

    2016-09-01

    Occurrence of left atrial myxoma with severe ventricular dysfunction without any obstructive coronary artery disease, as presented in our case, is very rare. It may be due to undiagnosed concomitant dilated cardiomyopathy or unknown cardiodepressant effect of myxoma which warrants further research. Copyright © 2016 Cardiological Society of India. Published by Elsevier B.V. All rights reserved.

  18. A case of large atrial myxoma presenting as an acute stroke

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    Praneet Iyer

    2016-02-01

    Full Text Available Left atrial myxomas are rare primary cardiac tumors. Their incidence is estimated to be about 0.1% of total cases. Neurological complications resulting from cardiac myxomas are seen in 20–35% of patients. Transesophageal echocardiogram (TEE is preferred over transthoracic echocardiogram for evaluation of left atrial myxoma. Three-dimensional (3D echocardiography ensures better visualization of intracardiac structures. It has been used prior to surgery for diagnostic support in the surgical treatment of cardiac masses. We present a case of a 46-year-old Hispanic male who developed acute ischemic stroke of left frontal lobe and was also found to have multiple ‘silent’ cerebral infarcts in the MRI of the brain. On further workup, he was found to have a left atrial myxoma on 3D TEE. This was resected with the assistance of intra-operative 3D TEE imaging. We present this case to increase awareness and to stress at early evaluation of secondary causes of ischemic cerebrovascular accident, outside the realm of hypercoagulability. This case also exhibits the need for basic cardiac workup in young individuals who present with symptoms of intermittent palpitations or chest pain to minimize significant morbidity or mortality.

  19. [Secondary pulmonary embolism to right atrial myxoma].

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    Vico Besó, L; Zúñiga Cedó, E

    2013-10-01

    A case of pulmonary thromboembolism secondary to atrial myxoma right. The myxoma is a primary cardiac tumor, namely, has his origin in the cardiac tissue. Primary cardiac tumors are rare, including myxomas, the most common type. Have a predilection for females and the most useful tool for diagnosis is echocardiography. About 75% of myxomas occur in the left atrium of the heart and rest are in the right atrium. Right atrial myxomas in some sometimes associated with tricuspid stenosis and atrial fibrillation. The most common clinical manifestations include symptoms of this neoplasm constitutional, and embolic phenomena resulting from the obstruction to the flow intracavitary. The treatment of this condition is surgical. Copyright © 2012 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  20. Heart failure due to giant left atrial myxoma: a case report

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    Giuston Mendoza-Chuctaya

    2016-04-01

    Full Text Available Myxomas are frequent cardiac tumors that are mostly located in the left atrium. Their signs and symptoms are very varied and nonspecific, and depend on their behavior. We report the case of a 41-year-old female patient with a disease period of approximately 3 months, and a clinical picture suggesting heart failure characterized by respiratory difficulty at rest, chest pain, general malaise and edema on lower limbs. The EKG suggested left atrial growth, where transthoracic echocardiography was a key test for the diagnosis of a myxoma filling the entire left atrium, which was later excised by surgery and confirmed by pathological anatomy

  1. Clinical Features and Surgical Results of Right Atrial Myxoma.

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    Li, Han; Guo, Hongwei; Xiong, Hui; Xu, Jianping; Wang, Wei; Hu, Shengshou

    2016-01-01

    We retrospectively analyzed 367 patients receiving surgical resection of cardiac myxomas in our center over six years, and analyzed the incidence and surgical results of 28 cases of right atrial myxomas. We also compared the age, gender, and attached sites between left atrial myxoma and right atrial myxoma. Between January 2007 and December 2012, 28 patients with right atrial myxomas underwent surgical resection. There were 16 males and 12 females. The mean age was 47.77 ± 13.20 years (range: 8.00-79.00 years). Associated cardiac lesions included moderate and severe tricuspid regurgitation in four, coronary atherosclerotic heart disease in five, and pulmonary embolism in one. Twenty-seven patients (96.43%) were followed from 26 to 94 months (mean 55.78 ± 21.10 months). There was no early death after operation. The incidence of right atrial myxomas among sporadic cardiac myxomas was 7.89%. One patient died of lung cancer 34 months after myxoma resection. Two patients underwent coronary artery stent implantation due to coronary atherosclerotic heart disease during the follow-up period. One patient underwent myxoma resection due to recurrence in the left atrium four years after the first operation. There was no significant difference in the age between left atrial myxoma and right atrial myxoma (p > 0.05). There was a significant difference in the gender between left atrial myxomas and right atrial myxomas (p myxomas and right atrial myxomas are the atrial septum. Surgical resection of the right atrial myxoma results in good clinical outcomes and a decreased incidence of recurrence. © 2015 Wiley Periodicals, Inc.

  2. A rare large right atrial myxoma with rapid growth rate.

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    Kelly, Shawn C; Steffen, Kelly; Stys, Adam T

    2014-10-01

    Atrial myxomas are the most common benign intracavitary cardiac neoplasms. They most frequently occur in the left atrium. Right atrial tumors are rare, comprising 20 percent of myxomas achieving an incidence of 0.02 percent. Due to their rarity, right atrial tumor development and associated clinical symptoms has not been well described. The classical clinical triad for the presentation of left atrial myxomas--heart failure, embolic events, and constitutional symptoms--may not be applicable to right sided tumors. Also, natural development of myxoma is not well described, as surgical resection is the common practice. Previously ascribed growth rates of myxomas refer mostly to left atrial ones, as right atrial tumors are rare. We present a case of right atrial myxoma with growth rates exceeding those previously described.

  3. Echocardiographic study of left atrial myxoma

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    Dalal J

    1979-01-01

    Full Text Available Four cases of left atrial myxoma were diagnosed pre-operatively by echocardiography. All cases showed characteristic echocardio-graphic features of variegated shadows behind the mitral valve in diastole and within the left atrium in systole. In two cases the my-xomas were surgically removed and confirmed on histology. In one case the post-operative echocardiogram showed complete dis-appearance of the abnormal shadows. Echocardiography is the most reliable method today for the diagnosis of a myxoma.

  4. Atrial myxoma presenting with orthostatic hypotension in an 84-year-old Hispanic man: a case report

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    Halstead Michael

    2009-12-01

    Full Text Available Abstract Introduction Left atrial myxomas remain the most common benign primary cardiac tumors, and these cardiac growths can masquerade as mitral stenosis, infective endocarditis and collagen vascular disease. Atrial myxomas are found in approximately 14-20% of the population and can lead to embolization, intercardiac obstructions, conduction disturbances and lethal valve obstructions. Case presentation An 84-year-old Hispanic man presented with complaints of dizziness upon standing, and with no prior history of heart murmurs, syncope, shortness of breath, or chest pain. Physical examination revealed evidence of orthostatic hypotension and a soft grade 1/6 systolic murmur at the left sternal border. A transthoracic echocardiogram revealed a large atrial myxoma occupying the majority of the left atrium, with the posterior border of the large atrial mass defined by eccentric mitral regurgitation identified during cardiac catheterization. Left atrial myxoma excision was performed, revealing a 7 × 6.5 × 4.5 cm atrial tumor attached to a 4 × 3 × 2 cm stalk of atrial septal tissue. Conclusion This patient didn't present with the common symptoms associated with an atrial myxoma, which may include chest pain, dyspnea, orthopnea, peripheral embolism or syncope. Two-dimensional echocardiography provides substantial advantages in detecting intracardiac tumors. We recommend a two-dimensional echocardiogram in the workup of orthostatic hypotension of unknown etiology after the common causes such as autonomic disorders, dehydration, and vasodilative dysfunctions have been ruled out. By illustrating this correlation between orthostasis and an atrial myxoma, we hope to facilitate earlier identification of these intracardiac growths.

  5. Left atrial myxoma: Case report and literature review | Nwiloh | East ...

    African Journals Online (AJOL)

    Myxomas are the most common cardiac neoplasm accounting for 50% of all tumours. Usually symptomatic at diagnosis, the advent of routine echocardiogram in clinical practice has enabled earlier diagnosis before onset of symptoms. There however have been few reports in black Africans, and so we are reporting a male ...

  6. A Left Atrial Myxoma Case with a History of Stroke on whom a Coronary Bypass Surgery was Performed

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    Cihangir Kaymaz

    2009-12-01

    Full Text Available Cardiac myxomas are the most frequently encountered benign cardiac tumors in adult groups. Patients with myxoma may suffer from variety of clinical features. A patient who had suffered from stroke a yearago came to our hospital with a chest pain complaint. In the echocardiography of the patient suffering from acute coronary syndrome, left ventricular disfunction and left atrial mass was determined. In the coronary angiography, LAD and Cx critical stenosis, and an abnormal feeding artery which roots from Cxperformed was observed. LIMA-AD, Ao-RCA bypass and mass exision withleft atriotomy was made. Cardiac tumor embolism which makes up a rare cause of cerebral embolies should be considered especiallyin patients with sinus rhythm. In the coronary angiography the feeding artery of the myxoma was shown. A patient who has underwent coronary bypass operation and left atrial myxoma exision has beenpresented as a case.

  7. Case Report of a Left Atrial Myxoma Associated with Carney%u2019s Syndrome

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    Anil Ozen

    2016-05-01

    Full Text Available Primary cardiac neoplasms are very rare as compared to metastatic tumors. 70% to 80% of them are benign myxomas. Complications of myxomas include cyst and microabscess formation, embolization, syncope and sudden death. Rarely, cardiac myxomas are associated with primary nodular adrenal cortical disease, mammary fibroadenomas, testicular tumors or pitiutary adenomas with gigantism or acromegaly known as Carney%u2019s syndrome. We present a patient with a left atrial myxoma who underwent reoperation associated with Carney%u2019s syndrome.

  8. An intriguing co-existence: atrial myxoma and cerebral cavernous malformations: case report and review of literature.

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    Sharma, Shikha; Tsyvine, Daniel; Maldjian, Pierre D; Sambol, Justin T; Lovoulos, Constantinos J; Levy, Gal; Maghari, Amin; Klapholz, Marc; Saric, Muhamed

    2011-01-01

    It is commonly postulated that neurologic complications of atrial myxomas are due to either direct tumor embolization or mycotic aneurysm of cerebral vasculature or rupture of mycotic aneurysms of cerebral arteries. However, the authors report the case of 63-year-old woman with a large left atrial myxoma whose progressive left-sided weakness was due to a different neurologic mechanism, namely, multiple bleeding cavernous malformations, which were visualized by magnetic resonance imaging of the brain. Cerebral cavernous malformations coexist with mesenchymal anomalies of other organs, including the liver, kidneys, and retinas. To the best of the authors' knowledge, this is only the second reported case of coexistent cerebral cavernous malformations and atrial myxoma. Copyright © 2011 American Society of Echocardiography. Published by Mosby, Inc. All rights reserved.

  9. Atrial myxoma in a patient with hypertrophic cardiomyopathy.

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    Abdou, Mahmoud; Hayek, Salim; Williams, Byron R

    2013-01-01

    Atrial myxoma is the most common primary cardiac tumor. Patients with atrial myxoma typically present with obstructive, embolic, or systemic symptoms; asymptomatic presentation is very rare. To our knowledge, isolated association of atrial myxoma with hypertrophic cardiomyopathy has been reported only once in the English-language medical literature. We report the case of an asymptomatic 71-year-old woman with known hypertrophic cardiomyopathy in whom a left atrial mass was incidentally identified on cardiac magnetic resonance images. After surgical excision of the mass and partial excision of the left atrial septum, histopathologic analysis confirmed the diagnosis of atrial myxoma. The patient was placed on preventive implantable cardioverter-defibrillator therapy and remained asymptomatic. The management of asymptomatic cardiac myxoma is a topic of debate, because no reports definitively favor either conservative or surgical measures.

  10. Cardiac magnetic resonance imaging and a rare case of an atrial myxoma causing an atrial septal defect

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    Matthew Grant, MD

    2017-12-01

    Full Text Available A 40 year-old athletic woman presented with worsening dyspnea on exertion over the preceding several months. Chest radiograph showed borderline cardiomegaly and subsequent echocardiography demonstrated a 5.0-cm left atrial mass as well as left-to-right interatrial shunting through a patent foramen ovale. Cardiac magnetic resonance imaging was performed, which demonstrated signal characteristics consistent with an atrial myxoma. The patient then underwent urgent surgical treatment with good technical and clinical outcome. Histologic examination confirmed an atrial myxoma. Cardiac magnetic resonance imaging was valuable in characterizing the nature of the atrial mass and patent foramen ovale, helping guide the surgical approach.

  11. Herpes Simplex Virus Type 1 Infection Associated with Atrial Myxoma

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    Li, Yanwen; Pan, Zhigang; Ji, Yuan; Sheppard, Mary; Jeffries, Donald J.; Archard, Leonard C.; Zhang, Hongyi

    2003-01-01

    Some findings suggest an infectious factor in cardiac myxoma and certain histopathological features indicate herpes simplex virus type 1 (HSV-1) infection. We hypothesized that HSV-1 may be involved in the pathogenesis of cardiac myxoma. Paraffin-embedded tissue samples from 17 patients with atrial myxoma were investigated for HSV-1 antigen by immunohistochemistry and viral genomic DNA by nested polymerase chain reaction. The histogenesis and oncogenesis of atrial myxoma were assessed by the expression of calretinin, Ki67, and p53 protein, respectively. Autopsy myocardial samples, including endocardium from 12 patients who died by accident or other conditions, were used for comparison. HSV-1 antigen was detected in atrial myxoma from 12 of 17 patients: 8 of these 12 samples were positive also for HSV-1 DNA. No HSV-1 antigen or DNA was found in tissue from the comparison group. Antigens of HSV-2, varicella-zoster virus, Epstein-Barr virus, and cytomegalovirus were not found in atrial myxoma. Calretinin was found in myxoma cells of all 17 cases but Ki67 was present only in smooth muscle cells or infiltrating cells in some cases. p53 was not detectable in any myxoma. Most infiltrating cells were cytotoxic T lymphocytes. These data suggest that HSV-1 infection is associated with some cases of sporadic atrial myxoma and that these may result from a chronic inflammatory lesion of endocardium. PMID:14633612

  12. A rare case of classical Hodgkin's lymphoma in the setting of a newly diagnosed left atrial myxoma

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    Bolanos, Alexander Javier; Dibu, George; Burke, Floyd W; Klodell, Charles T; Li, Ying; Rand, Kenneth H; Lucas, Alexandra Rose

    2015-01-01

    We report a rare case of left atrial myxoma with concomitant classical Hodgkin's lymphoma in a 36-year-old woman with a non-significant medical history and 4 months of progressively worsening palpitations, dyspnoea on exertion, chest discomfort and fatigue. Outpatient echocardiography revealed functional mitral valve stenosis as a result of a large left atrial cardiac mass. Preoperative thoracic imaging revealed an anterior mediastinal mass with associated lymphadenopathy. The patient underwent successful resection of the anterior mediastinal mass and left atrial mass. Surgical pathology revealed myxoma in the left atrium and classical Hodgkin's lymphoma in the anterior mediastinum. Thus the patient was diagnosed with early-stage classical Hodgkin's lymphoma. This clinical vignette emphasises the importance of a comprehensive diagnostic evaluation in the setting of a newly discovered atrial tumour. PMID:26516250

  13. Rapid growth of left atrial myxoma after radiofrequency ablation.

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    Rubio Alvarez, José; Martinez de Alegria, Anxo; Sierra Quiroga, Juan; Adrio Nazar, Belen; Rubio Taboada, Carola; Martinez Comendador, José Manuel

    2013-01-01

    Atrial myxoma is the most common benign tumor of the heart, but its appearance after radiofrequency ablation is very rare. We report a case in which an asymptomatic, rapidly growing cardiac myxoma arose in the left atrium after radiofrequency ablation. Two months after the procedure, cardiovascular magnetic resonance, performed to evaluate the right ventricular anatomy, revealed a 10 × 10-mm mass (assumed to be a thrombus) attached to the patient's left atrial septum. Three months later, transthoracic echocardiography revealed a larger mass, and the patient was diagnosed with myxoma. Two days later, a 20 × 20-mm myxoma weighing 37 g was excised. To our knowledge, the appearance of an atrial myxoma after radiofrequency ablation has been reported only once before. Whether tumor development is related to such ablation or is merely a coincidence is uncertain, but myxomas have developed after other instances of cardiac trauma.

  14. Successful surgical resection of infected left atrial myxoma in a case complicated with disseminated intravascular coagulation and multiple cerebral infarctions: case report

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    2011-01-01

    Cardiac myxoma is the most common primary cardiac tumour, but infected cardiac myxoma is relatively rare. Infected cardiac myxoma is very fragile, and has a potential to lead to catastrophic disorder with systemic bacteremia, systemic mycotic embolism, and disseminated intravascular coagulation (DIC). We present here the successful surgical treatment of a case of infected left atrial myxoma with septic shock, DIC and cerebral infarction without hemorrahage. Collective review of 58 reported cases with infected cardiac myxoma revealed that surgical treatment for it were still challenging and its result was poor. Until date, only one successful surgical treatment for a case complicated by DIC and cerebral infarctions has been reported, and our report describes second such case of successful resection. Even though this report is limited to a case, only aggressive and prompt surgical intervention could relieve the intractable conditions in such a patient with extremely high risk. PMID:21569401

  15. Massive right atrial myxoma with dyspnea at rest in an elderly patient: A case report

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    Romanović Radoslav

    2015-01-01

    Full Text Available Introduction. Primary heart tumors are extremely rare and myxoma is the most common type of these tumors. Although intraatrial presentation is a predilection place, right atrial localization is atypical. The symptom triad is characteristic in the clinical presentation of the tumor: embolic complication, intracardiac blood flow obstruction and systemic manifestations like elevated erythrocyte sedimentation rate, fever, anemia, body weight loss. Case report. We presented an elderly female patient with massive myxoma in the right atrium, 77 × 44 mm in diameter, which filled the entire right atrium and spread into the right ventricle, causing the tricuspid valve obstruction and dyspnea. It was visualized by transthoracic echocardiography and small and insignificant pericardial effusion was also seen. After surgical removal of the tumor, the patient remained without any symptoms and pericardial effusion. Conclusion. Tumors of the right heart have to be considered in the differential diagnosis of unexplained dyspnea in elderly patients. Transthoracic echocardiography is certainly necessary and mostly available diagnostic tool that can be of great help in diagnosing heart tumor as well as planning cardiac surgery, as it provides in most cases excellent visualization of the tumor and its relationship with other parts of the heart.

  16. [Severe mitral regurgitation following resection of a giant atrial myxoma: Case report and literature review].

    Science.gov (United States)

    Orozco Vinasco, D M; Abello Sánchez, M; Osorio Esquivel, J E

    2013-01-01

    Evaluation of the competence of a mitral valve can often be impossible in the clinical setting of a giant atrial myxoma. A 50-year-old woman with severe mitral regurgitation in the post-bypass period following a myxoma resection was managed with a mitral valve replacement. The absence of mitral insufficiency in the preoperative examination should not be taken as a reliable predictor of normal valve function. So herein, we discuss the role of the intraoperative echocardiographic examination, the underlying mechanisms, and the proposed management of severe mitral regurgitation following the resection of an atrial myxoma. Copyright © 2011 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Published by Elsevier España. All rights reserved.

  17. Left atrial myxoma: a report of two cases and literature review | Fana ...

    African Journals Online (AJOL)

    Case I. Myxomas are the commonest primary cardiac tumours, and were initially described in 1845 by King TW.2-1 Myxomas are tumours of endocardial origin that usually project into the cardiac chambers from the endocardial surface. The clinical presentation is highly variable, ranging from asymptomatic to life threatening ...

  18. Endometrial Adenocarcinoma with Concomitant Left Atrial Myxoma

    Directory of Open Access Journals (Sweden)

    Lisa N. Abaid

    2009-08-01

    Full Text Available Background: Atrial myxomas are the most common primary heart tumors and predominantly considered to be benign lesions. Case Study: We report a case involving a 77-year-old woman who presented with a pelvic mass. She was found to have a primary endometrial cancer and primary lung cancer with concomitant metastatic adrenal gland and mesenteric lesions. Her prior medical history also included an untreated 4.0 × 2.0-cm left atrial myxoma which was identified on CT scan during the workup of her pelvic mass. Results: A clinical decision was made to proceed with surgery for the pelvic mass with a subsequent recommendation for left atrial mass resection. Currently, the patient is scheduled to begin chemotherapy for primary lung cancer. Conclusion: The reported incidence of uterine cancer and a concurrent atrial myxoma is very rare. Consequently, the manner and timing in which treatment should be provided is imprecise. In the present case, the risk for cardiac complications was high, but given the presence of a partial bowel obstruction and the need to diagnose the primary site of her metastatic malignancy, the decision was made to proceed with exploratory abdominal surgery.

  19. A giant right atrial myxoma with pulmonary arterial hypertension.

    Science.gov (United States)

    Zairi, Ihsen; Mzoughi, Khadija; Jnifene, Zouhayer; Fennira, Sana; Ben Moussa, Fathia; Kammoun, Sofiene; Dhiab, Mohamed Mounir; Kraiem, Sondos

    2015-01-01

    Here we report a case of a right atrial mass that morphology mimicking myxoma, in a young patient with no past medical history. The mass was pathologically confirmed to be symptomatic and surgical removal was successfully done.

  20. Recurrent non-aneurysmal, metastatic intraparenchymal haemorrhages following resection of atrial myxomacase report and literature review

    Science.gov (United States)

    Raza, Emmon; Kamal, Ayeesha Kamran

    2012-01-01

    Atrial myxomas are the commonest cardiac neoplasms. The most common extra-cardiac manifestations are embolic infarcts from tumour embolisation. Infrequently, aneurysm formation and intracranial haemorrhages also occur. Incredibly rare are space-occupying lesions and malignant transformation. The authors report a case of a previously healthy middle-aged lady who developed recurrent and expanding intraparenchymal haemorrhages following resection of a left atrial myxoma without any primary disease recurrence. The case described is completely different from the described literature in that her intracranial vasculature was free of aneurysms on angiography despite central nervous system haemorrhage and no myxomatous or malignant features were seen on histology of the resected symptomatic occipital lesion. The authors compare this case to the available literature and also provide a literature review. PMID:23104629

  1. Catastrophic Systemic Embolization from a Left Atrial Myxoma

    Science.gov (United States)

    Shirazi, Farheen; Swadley, Matthew J.; Williams, Byron R.; Kumar, Gautam; Rab, S. Tanveer

    2014-01-01

    We report the fatal course of a left atrial myxoma: its systemic embolization to the coronary, cerebral, renal, and peripheral vascular beds in a 39-year-old woman resulted in rapid clinical deterioration, multiorgan failure, and death. Among reported cases of left atrial myxoma, this degree of embolic burden is exceedingly rare. In addition to reporting the patient's case, we discuss the presentation and diagnosis of possible intracardiac sources of systemic emboli. PMID:24512404

  2. Cutaneous embolism of an atrial myxoma.

    Science.gov (United States)

    Rodríguez Bandera, Ana Isabel; Stewart, Nicholas Charles; Uribe, Pablo; Minocha, Rashi; Choi, James Young Joon

    2015-08-01

    Cardiac myxoma often presents with heterogeneous symptoms and signs and represents a challenging diagnosis. The cutaneous manifestations, if present, are often transient and non-specific and the clinician must possess a high degree of suspicion to secure the diagnosis. We present the case of a 36-year-old woman with a 6-month history of intermittent, painful, violaceous, non-blanching macules on the thumb and fingertips of the left hand and right ankle. A cutaneous embolic phenomenon was suspected and an urgent echocardiogram demonstrated an atrial mass, with subsequent histopathology confirming the clinical suspicion of atrial myxoma. Early diagnosis and excision of the tumour avoided serious complications. © 2015 The Australasian College of Dermatologists.

  3. Carney complex with right ventricular myxoma following second excision of left atrial myxoma.

    Science.gov (United States)

    Tamura, Yamato; Seki, Toshio

    2014-01-01

    We report a case of Carney complex with massive right ventricular myxoma after two-time excision of a left atrial myxoma. The patient was a 45-year-old woman with pyrexia. She temporarily lost consciousness during examination, and echocardiography and computed tomography (CT) showed a massive tumor in the right ventricle. Loss of consciousness was determined to be caused by intracardiac obstruction of blood flow due to the tumor, and corrective surgery was performed. Pathological findings indicated myxoma with no malignancy. Myxomas are benign, but there is frequent recurrence of tumors associated with Carney complex. Because her myxomas were accompanied by unusual skin pigmentation, she was diagnosed with Carney complex. Carney complex has a high rate of myxoma recurrence, and often runs in families. In all cases, it is necessary to observe the patient's course closely.

  4. Aspergillus infection in pulmonary cavitating lesions with right atrial myxoma.

    Science.gov (United States)

    Sharma, Divyesh; Dorgan, Eileen; Douglas, Hannah; Trouton, Tom; McMullan, Ronan; Parissis, Haralabos

    2014-11-01

    Cardiac myxomas are rare primary tumors with varied clinical presentations that may pose a diagnostic challenge. Here, we describe the case of a 21-year-old man with multiple cavitating lung lesions with aspergillosis and underlying right atrial myxoma, who presented with hemoptysis and weight loss. He was successfully treated with right atrial myxoma resection and antifungal agents, with no recurrence or complications after one year of follow-up. © The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  5. Case of anemia with left atrial myxoma suspected as late effect of an atomic bomb

    Energy Technology Data Exchange (ETDEWEB)

    Sugahara, H.; Aosaki, N.; Kurita, A. (National Defense Medical College, Tokorozawa, Saitama (Japan))

    1980-12-01

    A 43 years old housewife with a history of exposure to an atomic bomb at 8 years old, recently developed anemia and palpitation. The laboratory data showed accelerated ESR, anemia (Hb 10.0 g/dl), and hyper ..gamma..-globulinemia. Despite the suspicion of late effect of atomic radiation, further examinations confirmed the diagnosis of left atrial myxoma. The echocardiographic studies revealed the decrease of diastolic descent rate, and multiple echos reflected from the tumor within the mitral orifice during diastole. Cardiac catheterization demonstrated remarkably high value of PCWP (V-wave 38 mmHg) and space filling defect moving from left atrium to left ventricle by cineangiography. Phonecardiographic studies were similar to mitral stenosis. After left atrial myxoma was removed, her symptoms and laboratory data including all noninvasive findings were improved. Therefore we suspected that her symptoms was related with left atrial myxoma rather than the late effect of atomic bomb exposure. We have discussed its significance and usefulness of noninvasive diagnostic approaches as well as whole body computed tomography in heart tumor.

  6. Cardial myxoma associated with clinical weakness and thorombocytopenia: case report

    Directory of Open Access Journals (Sweden)

    Mahmoud Hosseinzadeh Maleki

    2013-02-01

    Full Text Available Atrial myxomas is the most prevalent benign heart tumor which is presented with a wide variety of symptoms. We introduce a case who suffered left atrial myxoma associated with clinical weakness and thorombocytopenia. The clinical symptoms of the patient rapidly disappeared one week after cardial myxoma resection.

  7. Radiation induced myxoma of superior vena cava origin presenting as a right atrial mass.

    Science.gov (United States)

    Sabzi, F; Faraji, R

    2014-01-01

    Myxomas are the most common benign cardiac tumors. Myxomas are more common in the left heart chamber than the right side chamber. An extracardiac origin presenting as a right atrial mass is very rare. Right-sided tumors are considerably less common than left-sided tumors, and however myxoma of great vessels origin presenting as right atrial masses are rare but radiation induced villous myxoma in superior vena cava (SVC) is exceedingly rare tumor. A case of radiation induced myxoma originating in a previously undescribed location and presenting as a right atrial mass is reported.

  8. [Recurrent left atrial myxoma].

    Science.gov (United States)

    Moreno Martínez, Francisco L; Lagomasino Hidalgo, Alvaro; Mirabal Rodríguez, Roger; López Bermúdez, Félix H; López Bernal, Omaida J

    2003-01-01

    Primary cardiac tumors are rare. Mixomas are the most common among them; 75% are located in the left atrium, 20% in the right atrium, and the rest in the ventricles. The seldom appear in atrio-ventricular valves. Recidivant mixoma are also rare, appearing in 1-5% of all patients that have undergone surgical treatment of a mixoma. In this paper we present our experience with a female patient, who 8 years after having been operated of a left atrial mixoma, began with symptoms of mild heart failure. Transthoracic echocardiography revealed recurrence of the tumor, and was therefore subjected to a second open-heart surgery from which she recovered without complications.

  9. Acute Pulmonary Edema Caused by a Giant Atrial Myxoma

    Directory of Open Access Journals (Sweden)

    Andrea Fisicaro

    2013-01-01

    Full Text Available Atrial myxoma is the most common primary cardiac tumor. Its clinical presentation spreads from asymptomatic incidental mass to serious life-threatening cardiovascular complications. We report the case of a 44-year-old man with evening fever and worsening dyspnea in the last weeks, admitted to our hospital for acute pulmonary edema. The cardiac auscultation was very suspicious for mitral valve stenosis, but the echocardiography revealed a huge atrial mass with a diastolic prolapse into mitral valve orifice causing an extremely high transmitral gradient pressure. Awareness of this uncommon acute presentation of atrial myxoma is necessary for timely diagnosis and prompt surgical intervention.

  10. Endobronchial myxoma: Case report

    OpenAIRE

    Rolo, R; Pereira,R; Eisele, L; Ferreira, L.; Nogueira, R.; Cunha, J.

    2012-01-01

    INTRODUCTION: Pulmonary myxoma is an extremely rare benign neoplasm. It is mostly parenchymal but may occasionally occur within the tracheobronchial tree. There are very few reports of endobronchial myxoma. CASE REPORT: We describe a case of endobronchial myxoma in a 40-year-old female patient with a history of asthma and repeated right-sided pneumonia. Thoracic computed tomography (CT) showed medium lobe atelectasis. Fiber optic bronchoscopy revealed a polypoid, well-circumscribed tumor,...

  11. Retinal artery occlusion as the manifestation of left atrial myxoma: a case report

    OpenAIRE

    Yu, Yingying; Zhu, Ying; Dong, Aiqiang; Su, Zaoan

    2014-01-01

    Background Retinal artery occlusion caused by myxoma is relatively rare. There are several points that should be taken into consideration to avoid overlooking this disorder. Case presentation This case report describes a 43-year-old woman with sudden vision loss in her left eye for 20?days after single sudden syncope. Fundus examination of the left eye showed obscure boundary of optic disc with, reflective dispersion of the retina and poor light reflex of central fovea. A retinal artery occlu...

  12. The imaging features of neurologic complications of left atrial myxomas

    Energy Technology Data Exchange (ETDEWEB)

    Liao, Wei-Hua; Ramkalawan, Divya; Liu, Jian-Ling; Shi, Wei [Department of Radiology, Xiangya Hospital, Central South University, Changsha 410008, Hunan (China); Zee, Chi-Shing [Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033 (United States); Yang, Xiao-Su; Li, Guo-Liang; Li, Jing [Department of Neurology, Xiangya Hospital, Central South University, Changsha 410008, Hunan (China); Wang, Xiao-Yi, E-mail: cjr.wangxiaoyi@vip.163.com [Department of Radiology, Xiangya Hospital, Central South University, Changsha 410008, Hunan (China)

    2015-05-15

    Background: Neurologic complications may be the first symptoms of atrial myxomas. Understanding the imaging features of neurologic complications of atrial myxomas can be helpful for the prompt diagnosis. Objective: To identify neuroimaging features for patients with neurologic complications attributed to atrial myxoma. Methods: We retrospectively reviewed the medical records of 103 patients with pathologically confirmed atrial myxoma at Xiangya Hospital from January 2009 to January 2014. The neuroimaging data for patients with neurologic complications were analyzed. Results: Eight patients with atrial myxomas (7.77%) presented with neurologic manifestations, which constituted the initial symptoms for seven patients (87.5%). Neuroimaging showed five cases of cerebral infarctions and three cases of aneurysms. The main patterns of the infarctions were multiplicity (100.0%) and involvement of the middle cerebral artery territory (80.0%). The aneurysms were fusiform in shape, multiple in number (100.0%) and located in the distal middle cerebral artery (100.0%). More specifically, high-density in the vicinity of the aneurysms was observed on CT for two patients (66.7%), and homogenous enhancement surrounding the aneurysms was detected in the enhanced imaging for two patients (66.7%). Conclusion: Neurologic complications secondary to atrial myxoma consist of cerebral infarctions and aneurysms, which show certain characteristic features in neuroimaging. Echocardiography should be performed in patients with multiple cerebral infarctions, and multiple aneurysms, especially when aneurysms are distal in location. More importantly, greater attention should be paid to the imaging changes surrounding the aneurysms when myxomatous aneurysms are suspected and these are going to be the relevant features in our article.

  13. A heavy heart; A massive right atrial myxoma causing fatigue and shortness of breath.

    LENUS (Irish Health Repository)

    Leonard, S

    2010-03-01

    Cardiac myxomas are rare. The clinical diagnosis of an atrial myxoma may occur in an asymptomatic patient but may also present with cardiac failure, syncope, arrythmias, or with vascular evidence of tumour embolisation. The delay in diagnosis from presentation is approximately ten months. We present the case of a 53-year-old woman who attended our Emergency Department with dyspnoea, fatigue and left sided chest pain. Investigations revealed a massive right atrial myxoma. The tumour was resected successfully. Emergency Physicians should be aware of the subtle ways in which an atrial myxoma can present because of the potential for fatal outcomes.

  14. Giant left atrial myxoma in an elderly patient: natural history over a 7-year period.

    Science.gov (United States)

    Bajraktari, Gani; Emini, Merita; Berisha, Venera; Gashi, Fitnete; Beqiri, Arton; Zahiti, Bedri; Selmani, Hamza; Shatri, Faik; Manaj, Rexhep

    2006-01-01

    We present the case of a 71-year-old woman with a 7-year history of a giant left atrial myxoma. The myxoma was attached to the atrial septum and occupied almost the entire left atrial cavity. The patient was hospitalized 4 times because of dyspnea on exertion, palpitations, fatigue, general asthenia, and weight loss. During prior hospitalizations, the patient had refused cardiac surgery. She developed several complications, including atrial fibrillation, mitral and tricuspid regurgitation, mesenteric embolism, pulmonary edema, and thrombotic stroke. We herein describe the natural history of left atrial myxoma in an elderly patient over a 7-year period. Copyright 2006 Wiley Periodicals, Inc.

  15. Progressive wheeze: atrial myxoma masquerading as chronic obstructive pulmonary disease.

    Science.gov (United States)

    Sinha, Aish; Apps, Andrew; Liong, Wei Chuen; Firoozan, Soroosh

    2015-07-23

    Atrial myxoma, the commonest primary cardiac neoplasm, presents with symptoms of heart failure, embolic phenomena or constitutional upset. We present an atypical case, with wheeze and symptomatic exacerbations typical of chronic obstructive pulmonary disease. With no early clinical evidence of heart failure, the patient was managed with inhaled steroids and bronchodilators, with little relief. Only when the patient was in extremis requiring intubation, due to respiratory failure, did clinical evidence of left heart failure become apparent, with echocardiography demonstrating a massive left atrial myxoma obstructing the mitral valve annulus. Following successful surgical resection, the patient's symptoms fully abated. This case highlights the importance of considering cardiac wheeze in those initially managed as obstructive airway disease not responding in a typical fashion to initial bronchodilator therapy, and particularly in those with rapidly progressive symptoms. Such patients should be referred early for cardiac imaging. The excellent prognosis and quick recovery after timely surgical resection of a myxoma are also highlighted. 2015 BMJ Publishing Group Ltd.

  16. Detection of atrial myxoma by Fourier phase image

    Energy Technology Data Exchange (ETDEWEB)

    Tarolo, G.L.; Picozzi, R.; Zatta, G.; Baroffio, R.; Bossi, M.C.

    1982-12-01

    A case of left atrial myxoma shown on an equilibrium radionuclide ventriculography is presented. A peculiar abnormality of the Fourier phase image appears more reliable than the other findings previously revealed by first-pass or equilibrium studies. The findings were perfectly consistent with the gross anatomy of the tumour.

  17. Difficulty in moving around in a wheelchair as a presenting symptom of left atrial myxoma in a chronic paraplegic patient: a case report.

    Science.gov (United States)

    Kovindha, A; Saeng-Xuto, W

    2014-08-01

    CASE REPORT. To present and discuss a case of a chronic paraplegic patient who presented with difficulty in moving around in a wheelchair. Rehabilitation Ward, Maharaj Hospital, Faculty of Medicine, Chiang Mai University, Thailand. A chronic complete paraplegic T4 man complained of difficulty in moving around in a wheelchair. He had experienced this difficulty for a week. He also complained of pain in the finger pads, and blackening had occurred in his little toes. Buerger's disease was suspected, but Doppler ultrasound showed no evidence of arterial occlusion. During admission, his vision suddenly dropped and magnetic resonance imaging revealed an ischemic stroke in the posterior cerebral artery. Erythematous lesions in all toe pads and soles were actually embolic signs but painless due to his paraplegia. Echocardiography showed a large left atrial myxoma. Six weeks after removal of the left atrial myxoma, he was discharged when he could propel his wheelchair more than 100 m without difficulty or pain. Experiencing difficulty in moving around in a wheelchair in conjunction with painful finger pads can be presenting symptoms of a rare cardiac lesion--left atrial myxoma with arterial embolism. After surgical excision of the tumour, the arterial embolic symptoms and signs subsided and the patient regained basic wheelchair mobility skills within 6 weeks.

  18. Cerebral aneurysm associated with cardiac myxoma: Case Report

    Science.gov (United States)

    Ivanović, Branislava A.; Tadić, Marijana; Vraneš, Mile; Orbović, Bojana

    2011-01-01

    Left atrial myxomas are a rare but well known cause of cerebrovascular accidents in young people. Cerebral embolism is the most common cause of cerebral ischemic stroke. The intracranial aneurysm is rarely associated with myxoma. We report the case of a patient who had an operation of PICA aneurysm due to subarachnoid hemorrhage ten months before the discovery of the large left atrial myxoma. Fortunately, the untimely diagnosis of the myxoma did not have other consequences. In order to prevent possible complications of we should keep in mind that these two apparently different entities could be associated. PMID:21342146

  19. Cerebral aneurysm associated with cardiac myxoma: Case Report

    Directory of Open Access Journals (Sweden)

    Branislava A. Ivanović

    2011-02-01

    Full Text Available Left atrial myxomas are a rare but well known cause of cerebrovascular accidents in young people. Cerebral embolism is the most common cause of cerebral ischemic stroke. The intracranial aneurysm is rarely associated with myxoma. We report the case of a patient who had an operation of PICA aneurysm due to subarachnoid hemorrhage ten months before the discovery of the large left atrial myxoma. Fortunately, the untimely diagnosis of the myxoma did not have other consequences. In order to prevent possible complications of we should keep in mind that these two apparently different entities could be associated.

  20. Simultaneous occurrence of a large asymptomatic prolapsing left atrial myxoma with a cutaneous squamous cell carcinoma.

    Science.gov (United States)

    Iltumur, Kenan; Demir, Tolga; Ariturk, Zuhal; Toprak, Nizamettin; Oto, Oztekin

    2015-02-27

    Synchronous myxoma of the heart and other malignancies are extremely rare. We report a case of a 64-year-old man who had a large left atrial myxoma that obstructed the mitral valve, as well as an unrelated, coexistent cutaneous squamous cell carcinoma in the sacral area. During the preoperative evaluation for non-cardiac surgery, the tumor was diagnosed coincidentally by echocardiographic examination. Echocardiography findings were consistent with a large left atrial myxoma originating from the posterior wall and prolapsing into the left ventricular cavity through the mitral valve, causing mitral stenosis. The mass was successfully completely excised. Histologic examination of the mass confirmed the diagnosis of cardiac myxoma. We report a casual echocardiographic finding of a left atrial myxoma that obstructed the mitral valve outflow tract, and an unrelated, synchronous cutaneous squamous cell carcinoma in the sacral area.

  1. Delay in diagnosis of right atrial myxoma

    Energy Technology Data Exchange (ETDEWEB)

    Northcote, R.J.; Sethia, B.; Ballantyne, D.

    1985-02-01

    Clinical, echocardiographic, and nuclear angiographic findings in a 51-year-old woman who presented with a history of dyspnea are discussed. Initial echocardiography revealed no abnormality. However, a subsequent radionuclide angiogram revealed a filling defect on the right side of the heart. This represented a right atrial myxoma. Radionuclide angiography can provide a useful noninvasive tool in the diagnosis of intracardiac tumors when echocardiography has not been helpful.

  2. Concomitant percutaneous aortic embolectomy and excision of left atrial myxoma in a child.

    Science.gov (United States)

    Lee, Eun-Jung; Moon, Sena; Lee, Jae Young; Kang, Joon Kyu; Chang, Yun Hee

    2015-01-01

    Cardiac myxoma is rare in children and often associated with cerebrovascular events. Reported herein is the case of a 9-year-old boy who presented with acute obstruction of the aortic bifurcation associated with a huge left atrial (LA) myxoma, thereby leading to acute ischemia of the lower extremities. Immediate surgical removal of the LA myxoma with concomitant percutaneous embolectomy using a Forgathy catheter was done, with relief of ischemic symptoms. Cardiac myxoma should always be considered in the case of acute embolic events in children, given that it needs immediate intervention to prevent further complications. © 2015 Japan Pediatric Society.

  3. Ocular and Cerebral Emboli From an Atrial Myxoma.

    Science.gov (United States)

    Kuonen, Anne; Borruat, François-Xavier

    2017-09-01

    Emboli from an atrial myxoma resulted in asymptomatic segmental retinal and choroidal arterial hyperfluorescent lesions on retinal angiography, mimicking an arteritis. The retinal lesions disappeared after removal of the atrial myxoma. Endothelial trauma by embolic material appears to be the mechanism of the angiographic findings.

  4. Giant right atrial myxoma: characterization with cardiac magnetic resonance imaging.

    LENUS (Irish Health Repository)

    Ridge, Carole A

    2012-02-01

    A 53-year-old woman presented to the emergency department with a 2-week history of dyspnoea and chest pain. Computed tomography pulmonary angiography was performed to exclude acute pulmonary embolism (PE). This demonstrated a large right atrial mass and no evidence of PE. Transthoracic echocardiography followed by cardiac magnetic resonance imaging confirmed a mobile right atrial mass. Surgical resection was then performed confirming a giant right atrial myxoma. We describe the typical clinical, radiologic, and pathologic features of right atrial myxoma.

  5. A large left atrial myxoma causing multiple cerebral infarcts.

    Science.gov (United States)

    Kebede, Saba; Edmunds, Eiry; Raybould, Adrian

    2013-11-27

    A 52-year-old man presented with a history of sudden onset diplopia. On neurological examination, the only abnormality was a right-sided oculomotor (third nerve) palsy. A brain CT was performed and reported as showing no abnormality. He was discharged to be investigated as an outpatient. He presented 1 month later with a new expressive dysphasia and confusional state. MRI was performed which revealed multiple cerebral infarcts. He was discharged on secondary stroke prevention medication. Six months elapsed, before a transthoracic echocardiogram was performed. This showed a large left atrial myxoma. The patient underwent an emergency resection and made a good postoperative recovery. This case report showed the importance of considering a cardiogenic source of emboli in patients who present with cerebral infarcts. Performing echocardiography early will help to detect treatable conditions such as atrial myxoma, and prevent further complications.

  6. Fusiform aneurysms detected 5 years after removal of an atrial myxoma

    Energy Technology Data Exchange (ETDEWEB)

    Oguz, K.K.; Firat, M.M.; Cila, A. [Radiology Dept., Hacettepe Univ., Ankara (Turkey)

    2001-11-01

    Neurological signs frequently accompany atrial myxomas. Association of multiple cerebral aneurysms in patients with atrial myxomas are less common than embolic infarctions. The development of aneurysms years after the cardiac tumor removal is rare, and few MR images have been reported to date. A case of multiple peripheral fusiform aneurysms detected 5 years after tumor resection is presented in this report, together with MR images and CT and angiographic images. (orig.)

  7. A Giant Left Atrial Myxoma Neovascularized from the Right Coronary Artery

    Directory of Open Access Journals (Sweden)

    Demet Menekse Gerede

    2015-01-01

    Full Text Available Myxomas are benign and the most common tumors of the cardiac muscle (Reynen, 1995. They are predominantly located in the left atrium. Clinical manifestations may vary according to the localization and the size of the myxoma. On the other hand, imaging of a myxoma by contrast dye during coronary angiography is a rare sign, which displays the vascular supply of the tumor. Here, we report the case of a 51-year-old man presenting with presyncope and palpitations due to a giant left atrial myxoma having its vascular supply from the right coronary artery (RCA.

  8. Isquemia cerebral como manifestación inicial de un mixoma atrial izquierdo: Reporte de un caso Brain ischemia as initial sign of a left atrial myxoma: Report of one case

    Directory of Open Access Journals (Sweden)

    Luis F Osio

    2008-04-01

    Full Text Available Los tumores primarios del corazón son raros; 75% de éstos son benignos y cerca de la mitad de los benignos son mixomas que, en la mayoría de los casos, se encuentran en las cavidades izquierdas. Las manifestaciones clínicas de los mixomas dependen del sitio de localización del tumor. Sin embargo, se afirma que la isquemia cerebral es la manifestación clínica inicial en un tercio de los mixomas atriales. Se presenta el caso de un paciente de género masculino, de 65 años de edad, en quien la primera manifestación clínica de mixoma atrial fue un evento cerebral vascular isquémico.Primary heart tumors are rare; 75% of them are benign and almost half of the benign ones are mixomas that in most cases are located in the left cavities. Clinical manifestations of myxomas depend on its localization site. Nevertheless, it is accepted that brain ischemia is the initial clinical manifestation in a third of atrial myxomas. The case of a 65 years old male patient in whom the first clinical manifestation of an atrial myxoma was an ischemic cerebrovascular event, is presented.

  9. Magnetic resonance imaging and angiography of the brain in embolic left atrial myxoma

    Energy Technology Data Exchange (ETDEWEB)

    Marazuela, M.; Yebra, M.; Diego, J.; Durantez, A.; Garcia-Merino, A.; Brasa, J.M.

    1989-05-01

    A case of left atrial myxoma presenting exclusively with neurological symptoms, studies with magnetic resonance imaging (MRI) combined with cerebral angiography and computed tomography (CT) is reported. Typical angiographic findings suggested the diagnosis of myxoma. MRI showed multiple ischemic lesions disseminated throughout the entire brain, some of which had been clinically asymptomatic. Because of its sensitivity in identifying small cerebral infarcts, MRI should prove in the future to be a first-choice technique in the evaluation of the presence of an extent of cerebral involvement in embolic left atrial myxoma.

  10. Postoperative atrial fibrillation in patients with left atrial myxoma.

    Science.gov (United States)

    Sahin, Muslum; Tigen, Kursat; Dundar, Cihan; Ozben, Beste; Alici, Gokhan; Demir, Serdar; Kalkan, Mehmet Emin; Ozkan, Birol

    2015-01-01

    The aim of this study was to determine the factors associated with postoperative atrial fibrillation (AF) in patients with left atrial (LA) myxoma. Thirty-six consecutive patients with LA myxoma (10 men, mean age: 49.3 ± 15.7 years), who were operated on between March 2010 and July 2012, were included in this retrospective study. Pre-operative electrocardiograms and echocardiographic examinations of each patient were reviewed. Postoperative AF developed in 10 patients, whereas there was no evidence of paroxysmal AF after resection of the LA myxoma in the remaining 26 patients. The patients who developed AF postoperatively were significantly older than those who did not develop AF (median: 61.5 vs 46 years; p = 0.009). Among the electrocardiographic parameters, only P-wave dispersion differed significantly between postoperative AF and non-AF patients (median: 57.6 vs 39.8 ms, p = 0.004). Logistic regression analysis revealed P- wave dispersion (OR: 1.11, 95% CI: 1.003-1.224, p = 0.043) and age (OR: 1.13, 95% CI: 1.001-1.278, p = 0.048) as independent predictors of postoperative AF in our cohort of patients. P-wave dispersion is a simple and useful parameter for the prediction of postoperative AF in patients with LA myxoma.

  11. [Surgical results and monitoring of postoperative atrial myxomas].

    Science.gov (United States)

    Tarelo-Saucedo, Juan M; Peñaloza-Guadarrama, Mario; Villela-Caleti, Jorge; García-Cruz, Adriana; Arizmendi-Monroy, Dulce K; Reynada-Torres, Jose L; Martinez-Ramirez, Leonel

    2016-01-01

    To analyze the casuistics of left atrial myxoma with emphasis on results and follow-up. We reviewed the clinical records of patients operated in the Hospital Cardiac Myxomas South Central High Specialty (HCSAE) of PEMEX in the last 7 years, with an emphasis on results and follow-up. The analysis showed 10 patients, of whom 60% were female and 40% male, with ages from 12 to 76 years, with a mean age of 50 years. In the clinical characteristics of patients predominated dyspnea in 90%, followed by fatigue (80%) and chest pain (60%). The incidence was 90% for the left atrium and 10% for the right atrium, had tumors less than 3cm to up to over 10cm (average of 6 to 7cm). The pathology report was myxoma in the 100% of cases, the morbidity and early mortality was 0%, with a mean hospital stay of 6 days, and a patient of 12 years of age recurred and underwent surgery five months later. The 5-year survival was 100%. The incidence of myxomas is well known for rare presentation, the experience in this national medical center is one patient for every 350 operations, one case per year with no mortality and excellent survival. Copyright © 2015 Instituto Nacional de Cardiología Ignacio Chávez. Published by Masson Doyma México S.A. All rights reserved.

  12. Renal myxoma: a case report

    Directory of Open Access Journals (Sweden)

    Carlos Henrique C Souza

    2015-04-01

    Full Text Available Myxomas are rare tumors that can appear in many anatomical locations. There are only 14 cases of renal involvement documented in the literature. This article reports a case of renal myxoma in an elderly woman with recurrent cystitis. After five years of follow-up, the computed tomography (CT revealed a large solid tumor mass in the left kidney. Tumor resection was performed preserving the affected kidney with histopathological diagnosis of renal myxoma. The objective of this study is to report a rare case of renal myxoma, emphasizing the importance of the differential diagnosis from other benign and malignant mesenchymal tumors.

  13. Cerebral ischemia as initial neurological manifestation of atrial myxoma: case report

    OpenAIRE

    Almeida Leila Azevedo de; Hueb João Carlos; Silva Marcos Augusto de Moraes; Bazan Rodrigo; Estrozi Bruna; Raffin Cesar N.

    2006-01-01

    Infartos cerebrais de etiologia cardíaca são observados em cerca de 20% dos pacientes com acidente vascular cerebral isquêmico. Infarto cerebral ocorre como manifestação clínica inicial em um terço dos casos de mixoma atrial. Embora quase metade dos pacientes com mixoma atrial apresente alteração ao exame neurológico, infarto cerebral não hemorrágico é visto na tomografia computadorizada em praticamente todos os casos. Os autores apresentam o caso de uma paciente, cuja primeira manifestação c...

  14. A Large Right Atrial Myxoma Associated with Atrial Flutter Rhythm

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    Onursal Buğra

    2010-04-01

    Full Text Available A 22 year-old man presented to the emergency unit with the complaint of difficulty in breathing. In the physical exam, dyspnea and orthopnea were found. In the electocardiographic exam (ECG atrial flutter rhythm was seen. The transthoracic echocardiographic exam revealed a large atrial mass that was originating from interatrial septum. During surgery, complete surgical removal of the right atrial mass was successfully performed under moderate hypothermia. Histological investigations revealed a mass of 15 x 3 cm in diameter and the pathological examination showed that the lesion is a myxoma. Twelve months after surgical excision, clinical and chocardiographicalfollow-up showed a satisfactory exercise tolerance, sinus rhythm in ECG exam, and cardiac functions within normal limits.

  15. Detection of right atrial myxoma by Fourier phase analysis

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    Depelchin, P.; Ibrahim, T.; Sarot, J.; Thirion, M.

    1987-09-01

    The usefulness of radionuclide imaging in the detection of cardiac tumors has been demonstrated previously in left atrial myxomas. We report a case of right sided mycoma successfully diagnosed by radionuclide imaging and evaluated by cine display, Fourier phase analysis and paradox image. These three techniques are now available in many computer programs for gated cardiac blood pool imaging and provide an additional tool for assessing cardiac tumors. Particularly, functional paradox and Fourier phase analysis seem promising tools in the detection of both left and right sided tumors.

  16. Anesthetic Management of a Patient With a Giant Right Atrial Myxoma.

    Science.gov (United States)

    Essandoh, Michael; Andritsos, Michael; Kilic, Ahmet; Crestanello, Juan

    2016-03-01

    Cardiac myxomas account for 50% of all benign primary cardiac tumors. Rarely, these tumors occur in the right atrium (RA; 10% to 20%), with a stalk frequently attached to the interatrial septum. Right atrial myxomas can lead to RA enlargement, arrhythmias, functional tricuspid stenosis, right heart failure, and catastophic pulmonary embolization resulting in sudden cardiac death. Anesthetic management of patients with RA myxomas can be complicated by the mass effect of the myxoma, preload limitations, and the potential for cardiovascular collapse. Multimodal cardiac imaging inclusive of echocardiography, computed tomography, and magnetic resonance imaging helps with the diagnosis, preoperative optimization, and formulation of anesthetic and surgical plans. We present a case report highlighting the importance of multimodal imaging, adequate preoperative patient optimization, and the anesthetic considerations in the successful management of a patient with a giant 8.3 × 4.7 cm RA myxoma. © The Author(s) 2015.

  17. Multicentric Biatrial Myxoma in a Young Female Patient: Case Report

    Science.gov (United States)

    Yoon, Sang Jeong; Park, Soon Chang; You, Yun Pyo; Kim, Bum Yong; Kim, Myong Kon; Jeong, Kyung Tae; Lee, Jae Won

    2000-01-01

    We report a case of multicentric, biatrial cardiac myxoma in a 29-year-old female who complained of exertional dyspnea, abdominal distension and peripheral edema. Any other associated skin lesions, breast mass or endocrine disorder presenting complex form were not seen on her. Also, there was no contributory medical history, hypertension and diabetes mellitus. By using transthoracic echocardiography, we identified a biatrial myxoma attached to the interatrial septum. During surgical excision, we found a large right atrial myxoma with extension through the fossa ovalis into the left atrium and small myxoma attached to the right atrial free wall. After successful resection of interatrial septum and free wall, atrial septal defect was created during the resection and safely repaired by bovine pericardial patch. PMID:11242813

  18. Quality of life after robotically assisted atrial myxoma excision.

    Science.gov (United States)

    Kesävuori, Risto; Raivio, Peter; Jokinen, Janne J; Sahlman, Antero; Vento, Antti

    2015-09-01

    The aim of this study was to evaluate the clinical outcome after robotically assisted myxoma surgery performed at our institution. Altogether nine patients underwent robotically assisted atrial myxoma excision. A control group was selected from 18 consecutive patients who underwent an isolated atrial myxoma excision via conventional sternotomy. Preoperative patient characteristics were similar between the two study groups. Postoperative health-related quality of life (HRQoL) was also evaluated. All robotic operations were completed successfully using the da Vinci™ telesurgical system. There was no mortality in either of the two study groups. Procedure, cardiopulmonary bypass, aortic occlusion, and ventilation times were shorter in the sternotomy group when compared to the robotic group. Length of stay was statistically significantly shorter in the robotically assisted group. Postoperative quality of life did not differ between the two study groups. We conclude that robotically assisted surgery is a feasible method for treating atrial myxomas.

  19. Imaging of cerebral infarction caused by atrial myxoma

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    Gee, G.T. (Neuroradology Section, Univ. of Texas Health Science Center, San Antonio, TX (United States)); Bazan, C. III (Neuroradology Section, Univ. of Texas Health Science Center, San Antonio, TX (United States)); Jinkins, J.R. (Neuroradology Section, Univ. of Texas Health Science Center, San Antonio, TX (United States))

    1994-05-01

    We describe the radiologic investigation of two patients with primary left atrial myxoma who presented with embolic manifestations in the brain. MRI and CT showed multiple infarcts, while the cardiac atrial mass was demonstrated in one of the patients by MRI and in both by echocardiography. (orig.)

  20. Acute myocardial infarction caused by left atrial myxoma: Role of intracoronary catheter aspiration.

    Science.gov (United States)

    Al-Fakhouri, Ahmad; Janjua, Muhammad; DeGregori, Michele

    2017-01-01

    Acute ST-segment elevation myocardial infarction (STEMI) caused by left atrial myxoma is very rare. Catheter-based approaches or thrombolytic therapy are mostly the first step in the management of STEMI with less time delay. We report a case of acute anterior/lateral STEMI caused by a left atrial myxoma. The patient was successfully treated by intracoronary aspiration with an Export aspiration catheter, with excellent distal coronary flow. Intracoronary catheter aspiration in acute myocardial infarction caused by a left atrial myxoma may help to salvage the infarcting myocardium with less time delay. Copyright © 2016 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.

  1. Cardiac Sarcoma Arising From Malignant Transformation of a Preexisting Atrial Myxoma.

    Science.gov (United States)

    Nguyen, Anita; Awad, Wael I

    2016-04-01

    A 49-year-old man presented with shortness of breath on exertion, orthopnea, and chest pain. On transthoracic echocardiography, a myxomatous mass was seen in the left atrium. A diagnosis of atrial myxoma was made and the patient underwent urgent surgical intervention. At operation, the mass, which extended into the anterior leaflet of the mitral valve, was excised. Histopathologic examination showed a primary cardiac sarcoma arising within a preexisting atrial myxoma. The patient received no further treatment and died 7 months postoperatively. We report the first case of a malignant transformation of an atrial myxoma to a cardiac sarcoma. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  2. Intravenous thrombolysis in a patient with left atrial myxoma with acute ischemic stroke

    Directory of Open Access Journals (Sweden)

    Girish Baburao Kulkarni

    2014-01-01

    Full Text Available Intravenous thrombolysis (IVT is an accepted therapy in patients with acute ischemic stroke presenting within 3-4.5 hours of symptom onset. Selection of the patient for thrombolysis depends on the careful assessment for the risk of post thrombolysis symptomatic haemorrhage (6.2-8.9% which may be fatal. Atrial myxomas which are the commonest tumors of the heart are associated with stroke due to tumor/clot embolism. There are very few case reports of IVT and its outcome in patients with atrial myxoma with stroke. Some have reported successful thrombolysis, while others have reported intracerebral bleeding. In this report we describe our experience of IVT in atrial myxoma patient with ischemic stroke and review the relevant literature.

  3. Patient in chronic hemodialysis with right atrial mass: thrombus, fungal endocarditis or atrial myxoma?

    Directory of Open Access Journals (Sweden)

    Talita G. Salani

    Full Text Available Abstract We present the case report of a 19-year-old patient with chronic kidney disease due to chronic glomerulonephritis, in hemodialysis (HD by central catheter, with the incidental finding of a mass of 28x16 mm in right atrium (RA. The diagnosis of thrombus, infective endocarditis or myxoma were considered. Given the context of immunosuppression and difficult access vascular therapeutic practice has proved complex. Although Doppler echocardiography suggested thrombus in RA, nuclear magnetic resonance imaging (MRI indicated for the diagnosis of myxoma in RA. In both conditions, the proposed surgical approach was limited by intense immunosuppression history and the risk of infectious complications. Throughout the treatment, the general state of K.M.F. remained satisfactory and revealed no signs or symptoms related to atrial dysfunction. The absence of fever and negative blood cultures excluded infective endocarditis. Prior echocardiogram report without masses in the RA decreased the chance of cardiac myxoma. The therapeutic response to anticoagulation confirmed the diagnosis of thrombosis. After 180 days of anticoagulation, there was significant reduction in mass. The patient developed asymptomatic. The diagnosis of mass in RA can be a challenge and only the evolution of the case was able to guide the appropriate conduit. While MRI has high sensitivity and specificity for the diagnosis of cardiac myxoma, the interpretation of images can be subjective. Controversial point is the removal of the catheter in such cases, which is subject discussed throughout the report.

  4. Atrial myxoma-related embolism resulting in acute limb ischaemia in ...

    African Journals Online (AJOL)

    Atrial myxoma-related embolism resulting in acute limb ischaemia in a critical care patient. M Knight, R D Wise. Abstract. This report presents an unusual case of limb ischaemia in the critical care setting, the cause of which was elucidated on echocardiography. Evaluation of the case highlights the importance of appropriate ...

  5. EBV+ diffuse large B-cell lymphoma arising within atrial myxoma in Chinese immunocompetent patient.

    Science.gov (United States)

    Liu, Xiaoyan; Liu, Pu; Li, Jun

    2015-01-01

    The incidence rate of Primary cardiac lymphoma is very low. Primary cardiac lymphoma within myxoma is extremely rare disease. So far, these cases have been reported only eight in the world, which has not reported in Chinese so far. Hence, we reported the unique Chinese case of 52-year-old immunocompetent male with primary Epstein-Barr virus positive diffuse large B-cell lymphoma arising within atrial myxoma, and had no evidence of systemic lymphoma. The patient presented right sided body numbness, arm weakness no incentive and mouth twitch. A transthoracic echocardiogram revealed a large intraatrial mass, attached to the left atrial wall. The mass was removed by open thoracic surgery and subsequently diagnosed as malignant diffuse large B-cell lymphoma with myxoma by histopathology. This was the fourth case of discovered Epstein-Barr virus positive diffuse large B-cell lymphoma in a cardiac myxoma reported so far. The patient has been well by followed up for 5 months without chemotherapy. Now we discuss the importance of histodiagnosis and the proper treatment. Epstein-Barr virus positive diffuse large B-cell lymphoma arising within atrial myxoma is an extraordinary lymphoma for better prognosis, avoiding excessive treatment.

  6. [Delayed diagnosis of ophthalmic artery obstruction due to atrial myxoma].

    Science.gov (United States)

    Sabater, N; Alforja, S; Rey, A; Giralt, J

    2013-08-01

    A 56 year old woman with atrial myxoma presented with a visual acuity of no light perception after acute ophthalmic artery obstruction (OAO) associated with stroke. She developed late retinal pigmentary changes due choroidal infarction, typical of the OAO. Simultaneous obstruction of the retinal and choroidal circulation was observed in the OAO. Atrial myxoma should be suspected in patients who suffer from OAO associated with stroke. Systemic studies should be performed to find the origin of OAO. Copyright © 2010 Sociedad Española de Oftalmología. Published by Elsevier Espana. All rights reserved.

  7. Myxoma of the Superior Vena Cava Origin Presented as a Right Atrial Mass

    Directory of Open Access Journals (Sweden)

    Feridoun Sabzi

    2015-10-01

    Full Text Available Myxomas are the most common benign cardiac tumors. Myxomas are more common in the left heart chamber than the right side chamber. An extracardiac origin presenting as a right atrial mass is very rare. We present a case of myxoma originating in the superior vena cava (SVC in a 24-year-old man, who underwent surgical resection. Preoperative two-dimensional echocardiography demonstrated a mass in the right atrium. Intraoperatively, the tumor was found to have originated from the SVC orifice. The tumor was excised from the SVC by opening the one-third proximal portion of the SVC. Pathological examination revealed a myxoma, and one-year follow-up showed no evidence of the recurrence of any tumors in the SVC.

  8. Intraoperative transesophageal echocardiography assessment of right atrial myxoma resulting in a change of the surgical plan

    Directory of Open Access Journals (Sweden)

    Sathish Kumar Dharmalingam

    2014-01-01

    Full Text Available Transesophageal echocardiography (TEE is an important diagnostic tool. It provides structural and functional assessment of cardiac structures which can improve the overall outcome of the patient. We present a case with right atrial myxoma in which TEE helped to find the attachment of the mass so that overall surgical plan was changed.

  9. Atrial myxoma-related embolism resulting in acute limb ischaemia in ...

    African Journals Online (AJOL)

    of the acute lower limb ischaemia and multiterritorial cerebral infarcts. Unfortunately, the embolic material was not removed during the operation, preventing histological confirmation. Several case reports have implicated atrial myxoma as the cause of acute myocardial infarction, and this may also have been a contributing ...

  10. Prevention of Cerebral Embolism Progression by Emergency Surgery of the Left Atrial Myxoma

    Directory of Open Access Journals (Sweden)

    Syuichi Tetsuka

    2015-01-01

    Full Text Available A 21-year-old woman developed left hemiparesis during work and was hospitalized. Her National Institutes of Health Stroke Scale score was 4. Hyperintense areas in the left basal ganglia, corona radiata, and cortex of the temporal lobe were found by brain diffusion-weighted magnetic resonance imaging, indicating acute cerebral infarction. Echocardiography showed a giant mass of diameter 7 × 4 cm in the left atrium. Therefore, she was diagnosed with cerebral embolism due to a left atrial myxoma. Currently, thrombolytic therapy may continue to be effective because the embolic source may be composed of tumor tissue itself. In case of atrial myxoma, we considered that the use of tPA as emergency treatment in all patients with infarction by atrial myxoma may be questioned. Thus, cardiac tumor extraction was performed the next day after hospitalization without thrombolytic therapy. The excised myxoma measured 7 × 6 × 4 cm. The patient recovered and her neurological symptoms also improved. Furthermore, her National Institutes of Health Stroke Scale score improved to 0. Thirteen days after admission, the patient was discharged from our hospital. Cardiac myxoma is often associated with a high risk of embolic episodes, which emphasizes the need for prompt surgical excision as soon as the diagnosis is confirmed.

  11. [Left atrial myxoma with repeated multiple cerebral emboli].

    Science.gov (United States)

    Yoshinaga, J; Morita, H; Sasaki, T; Okamoto, S; Hikiji, A

    1976-04-01

    A case of left atrial myxoma with repeated multiple cerebral emboli is reported. A-44-year-old man first developed a sudden right hemiparesis in October 1969. After intensive physical theraphy, strength improved and he was able to return to his work. In March 1970, he suddenly lost consciousness and remained comatose for a day. Upon waking, he had a profound right hemiparesis, motor aphasia and Gerstmann's syndrome. He was admitted to Hiroshima City Hospital on August 1, 1970. The cardiac examination, including an electrocardiogram, was entirely normal. Laboratory studies revealed a normal blood count and urinalysis; erythrocyte sedimentation rate was elevated (32mm/hour). On a left cerebral angiographic study, performed on September 6, 1971, multiple aneurysmal dilatations of the branches of the left middle cerebral artery were demonstrated. No specific diagnosis was made. In January 1973, he developed dysarthria, dysphagia and quadriplegia because of the recurrent cerebral attacks. He had a high temperature continuously for three days and died on May 30, 1974. At autopsy a myxoma with the peduncle was attached to the septal wall of left atrium, and there were old infarcts in the brain, the myocardium and the kidneys.

  12. Huge right atrial myxoma causing fixed tricuspid stenosis with constitutional symptoms.

    Science.gov (United States)

    Kuralay, Erkan; Cingöz, Faruk; Günay, Celalettin; Demirkiliç, Ufuk; Tatar, Harun

    2003-01-01

    Nonspecific constitutional symptoms are reported mostly in patients with left-atrial myxomas, which occur five times as often as its right-atrial counterpart. We present huge right-atrial myxoma, which obstructs tricuspid orifice with nonspecific constitutional symptoms without any pulmonary embolism attack.

  13. A rare case of biventricular myxoma.

    Science.gov (United States)

    Ermek, Tangsakar; Aybek, Naibi; Zhang, Wei-Min; Guo, Yong-Zhong; Guo, Sheng; Mamataly, Azze; Chang, Dong-Qing; Liu, Jun; Zhang, Zong-Gang

    2017-03-27

    Cardiac myxoma is the most common primary cardiac tumor. Approximately 75-80% of myxomas are located in the left atrium. Occurrence of multiple myxomas is extremely rare. We describe a rare case of biventricular myxomas resulting in right ventricular inflow and tricuspid valve obstruction. The lesions were detected by echocardiography and thoracic computerized tomography (CT) and confirmed on positron emission tomography-computed tomography. The patient underwent successful surgical resection of the multiple cardiac myxomas. This kind of biventricular case has not been previously reported. The patient is asymptomatic as of the 10-month follow-up.

  14. Incidental Epstein-Barr virus associated atypical lymphoid proliferation arising in a left atrial myxoma: a case of long survival without any postsurgical treatment and review of the literature.

    Science.gov (United States)

    Bartoloni, Giovanni; Pucci, Angela; Giorlandino, Alexandra; Berretta, Massimiliano; Mignosa, Carmelo; Italia, Fabrizio; Carbone, Antonino; Canzonieri, Vincenzo

    2013-01-01

    We report a case of left atrial cardiac myxoma harbouring an incidental atypical B-cell lymphoid proliferation. Histology disclosed classic myxoma cells embedded in a mucopolysaccharide-rich matrix and a micronodular atypical lymphoid proliferation under the surface of the mass. Myxoma cells were immunoreactive for calretinin, while lymphoid cells expressed B lineage markers (CD 20+, CD79a), without evidence of clonality. Moreover, they were LMP1 positive; EBNA2 negative; KSHV/HHV8 negative; and, by in situ hybridization, EBER/Epstein-Barr virus (EBV) positive and Kappa and Lambda negative. According to the 2008 WHO schemes, the present case shares close similarities either with diffuse large B-cell lymphomas growing in the context of long-standing chronic inflammation or with primary effusion lymphomas, solid variant, both associated with EBV infection. This is the sixth case of incidental atypical lymphoid proliferation discovered in a cardiac myxoma reported so far. The optimal treatment of such lesions remains undefined, but their clinical course is indolent. After an accurate staging workup, without any postsurgical treatment, the patient we observed has been well with no recurrence of the disease at 6 years of follow-up. Copyright © 2013 Elsevier Inc. All rights reserved.

  15. Percutaneous ablation and retrieval of a right atrial myxoma.

    Science.gov (United States)

    Konecny, Tomas; Reeder, Guy; Noseworthy, Peter A; Konecny, Dana; Carney, J Aidan; Asirvatham, Samuel J

    2014-11-01

    We report the first case of percutaneous myxoma ablation and retrieval from the right atrium. This novel procedure may reduce the need for repeat surgical excisions in patients with Carney Complex and other recurrent myxoma syndromes. Copyright © 2014 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

  16. Odontogenic myxoma: report of 2 cases

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    Kim, Joo Yeon; Park, Geum Mee; Cho, Bong Hae; Nah, Kyung Soo [Department of Oral and Maxillofacial Radiology, College of Dentistry, Pusan National University, Seoul (Korea, Republic of)

    2002-12-15

    The odontogenic myxoma is an infiltrative benign tumor of bone that occurs almost exclusively in the jaw bones and comprises 3% to 6% of odontogenic tumors. This neoplasm is thought to arise from the primitive mesenchymal structures of a developing tooth, including the dental follicle, dental papilla, or periodontal ligament. Radiographically the odontogenic myxoma may produce several patterns: unicystic, multilocular, pericoronal, and radiolucent-radiopaque, making the differential diagnosis difficult. In this report, two cases of the odontogenic myxoma in the jaw bones are presented. The first case involved only the mandible, while the second case involved the maxilla. Both cases presented extensive multilocular radiolucencies characteristic of odontogenic myxoma.

  17. Left atrial myxoma, ruptured chordae tendinae causing mitral regurgitation and coronary artery disease

    Directory of Open Access Journals (Sweden)

    Bhupesh Kumar

    2014-01-01

    Full Text Available Mitral regurgitation is uncommon with left atrial myxoma. The echocardiographic assessment of presence of mitral regurgitation and its severity are impaired by the presence of left atrial myxoma. We describe an uncommon association of left atrial myxoma with coronary artery disease and mitral regurgitation. MR was reported as mild on pre-operative transthoracic echocardiography but found to be severe due to ruptured chordae tendinae during intra-operative transesophageal echocardiography, which lead to change in the surgical plan to mitral valve replacement in addition to excision of myxoma.

  18. Left atrial myxoma, ruptured chordae tendinae causing mitral regurgitation and coronary artery disease.

    Science.gov (United States)

    Kumar, Bhupesh; Raj, Ravi; Jayant, Aveek; Kuthe, Sachin

    2014-01-01

    Mitral regurgitation is uncommon with left atrial myxoma. The echocardiographic assessment of presence of mitral regurgitation and its severity are impaired by the presence of left atrial myxoma. We describe an uncommon association of left atrial myxoma with coronary artery disease and mitral regurgitation. MR was reported as mild on pre-operative transthoracic echocardiography but found to be severe due to ruptured chordae tendinae during intra-operative transesophageal echocardiography, which lead to change in the surgical plan to mitral valve replacement in addition to excision of myxoma.

  19. Left Atrial Myxoma Following Coronary Artery Bypass Grafting with Patient Coronary Arterial Grafts: a Rarity.

    Science.gov (United States)

    Patel, Kartik; Rahul, Kumar; Tarsaria, Malkesh; Malhotra, Amber

    2017-01-01

    The development of left atrial myxoma after coronary artery bypass graft surgery is a rare entity. A 60-year-old man with previous off-pump coronary artery bypass grafting four years ago with patent coronary grafts was diagnosed with left atrial mass. The patient underwent successful resection of the same through minimally invasive right anterolateral thoracotomy. Histopathology of the atrial mass confirmed the diagnosis of atrial myxoma.

  20. Giant left atrial myxoma causing acute ischemic stroke in a child.

    Science.gov (United States)

    Ise, Hayato; Ishikawa, Natsuya; Nakanishi, Sentaro; Kamiya, Hiroyuki

    2018-01-12

    Ischemic stroke is uncommon in pediatric populations and is sometimes caused by cardiac myxoma. In such cases, neurological deficits initially present in ischemic stroke due to emboli or thrombi of the myxoma. Echocardiography is helpful to diagnose myxoma in a timely manner and allows urgent surgical resection of the myxoma. We report a successful case of myxoma in a 7-year-old boy who initially presented with left-sided hemiparesis.

  1. [Resection of intracardiac myxoma. Case report].

    Science.gov (United States)

    Carmona-Delgado, Víctor Manuel; Deloya-Maldonado, Angélica María; Carranza-Bernal, María Lourdes; Hinojosa-Pérez, Arturo; Farías-Mayene, Leobardo

    2017-01-01

    Myxomas are the most common benign cardiac tumors, which are considered emergency surgery. The resection should not be delayed because 8-9% of affected patients may die due to intracardiac blood flow obstruction. We presente a clinical case of a 47 year old female, history of dyslipidemia. Disease starts with retrosternal oppression feeling, dyspnea on moderate exercise, dizziness, pain in joints hands. Arrhytmic heart sounds, diastolic mitral murmur II/IV, breth sounds present, no lymph. Laboratory: hemoglobin 11.0, leucocyte 9000, glucose 96 mg/dL, chest RX medium arch prominence cardiac silhouette. ECO transthoracic LVEF 60 %, with left atrial intracardiac tumor 13x11 cm, pedicle fixed the interatrial septum, the mitral valve bulges, with mild mitral valve. Half sternotomy is performed intracardiac tumor resection, pericardial placement interatrial with extracorporeal circulation support 65', aortic clamping time of 40'. Intracardiac tumor surgical findings interatrial septum fixed to left side, pedicle, rounded, yellow, multiloculated, soft, 13x10 cm in diameter. Histopathological diagnosis cardiac myxoma. We conclude that the tumor resection was carried in a timely manner with satisfactory evolution.

  2. [Atrial myxoma: a challenge for the pneumologist].

    Science.gov (United States)

    Potre, Rodica; Ularu, D; Tudorache, V; Bertici, Nicoleta

    2003-01-01

    It presents a 59 years old woman with atypical symptoms, which orientated the diagnostic thinking during one year to a reccurrent pneumonitis, bronchial asthma, colagenosis, interstitial pulmonary fibrosis and so on. The appearance of pulmonary edema determined a couple of cardiologic exams which came to obiectivate as the main cause, the existence of a left atrial mixoma who was invaginated in left mitral cusp. Surgical intervention permitted not only specific determination of histological type of tumor, but lead to healing of the patient. It is a discussion over epidemiology, clinical areas of manifestation and methods of diagnostic of atrial tumors.

  3. [Role of intraoperative transesophageal echocardiography in patients undergoing robotic atrial myxoma excision].

    Science.gov (United States)

    Wang, Yao; Gao, Changqing; Wang, Gang; Wang, Jiali; Shen, Yansong

    2013-11-01

    To evaluate the role of intraoperative transesophageal echocardiography (TEE) during robotic atrial myxoma excision. Thirty-eight consecutive patients undergoing robotic atrial myxoma excision from September 2007 to August 2012 were enrolled in the study. During the procedure, TEE was performed to document the myxoma position, its attachment, and hemodynamic information before cardiopulmonary bypass (CPB). During establishment of peripheral CPB, TEE was used to guide placement of the cannulae in the inferior vena cava (IVC), superior vena cava (SVC), and ascending aorta (AAO). After weaning from CPB, TEE was performed to evaluate the effect of the procedure. The accuracy of TEE for the position or its attachment of the myxoma was 100%. All the cannulae in the SVC, IVC and AAO were located in correct position. In all patients, TEE confirmed successful excision. Intraoperative TEE is a valuable adjunct in patients undergoing robotic atrial myxoma excision.

  4. Serial MRI of cerebral infarcts before and after removal of an atrial myxoma

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    Kawamura, T.; Muratani, H.; Inamura, T.; Fukui, M. [Department of Neurosurgery, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka (Japan); Horiuchi, I. [Department of Neurology, Neurological Institute, Kyushu University, Fukuoka (Japan); Oe, M. [Division of Cardiovascular Surgery, Research Institute of Angiocardiology, Faculty of Medicine, Kyushu University (Japan)

    1999-08-01

    We describe a cerebral infarct caused by atrial myxoma. A 30-year-old woman with an atrial myxoma presented with a right hemisensory deficit. MRI carried out before and after removal of the myxoma, showed multiple small bilateral white-matter infarcts which increased in number up to the surgery. A lesion in the left thalamus, which enlarged and showed contrast enhancement 4 months before surgery, resembled an old cerebral infarct by the time the myxoma was removed. The number of lesions stopped increasing after surgery. We suggest that atrial myxomas should be removed even in asymptomatic patients, to prevent cerebral infarcts due to embolism of tumour or thrombus. (orig.) With 4 figs., 8 refs.

  5. A very rare association between giant right atrial myxoma and patent foramen ovale. Extracellular matrix and morphological aspects: a case report.

    Science.gov (United States)

    Molnar, Adrian; Encică, Svetlana; Săcui, Diana Maria; Mureşan, Ioan; Trifan, Aurelian Cătălin

    2016-01-01

    We report a case of sporadic giant cardiac myxoma with a rare localization in the right atrium, operated in our Service, in a 73-year-old female patient who also presented a patent foramen ovale and a history of ischemic stroke in the year prior to current admission. Intra-operatively, the tumor had a very friable, gelatinous aspect, with a high potential for embolization due to its reduced consistency. The present paper refers to clinical, histochemical and immunohistochemical particularities, as well as to macroscopic and microscopic characteristics of the cardiac myxoma, emphasizing the extracellular matrix aspects, and without leaving out the cellular components of this rare tumor, with possible inference in the management of this disease. The authors present their own observations related to the data from the literature. Also, there are some particularities of the case which justify the current presentation.

  6. Maxillary myxoma: A case report and review.

    Science.gov (United States)

    Connor, Matthew P; Neilson, Michael; Schmalbach, Cecelia E

    2015-06-01

    An odontogenic myxoma is a rare, benign tumor that is found almost exclusively in the facial bones, usually the mandible. The diagnosis poses a challenge because its features overlap with those of other benign and malignant neoplasms. We present an unusual case of odontogenic myxoma that involved the maxilla, and we review the clinical, radiographic, and histologic characteristics of this case. Even though it is benign, odontogenic myxoma can be locally invasive and cause significant morbidity. Complete surgical excision is the treatment of choice, but it can be challenging because of the tumor's indistinct margins.

  7. Coronary Embolization from a Left Atrial Myxoma Containing Malignant Lymphoma Cells.

    Science.gov (United States)

    Pineda, Andrés M; Mihos, Christos G; Nascimento, Francisco O; Santana, Orlando; Lamelas, Joseph; Beohar, Nirat

    2015-12-01

    Systemic embolization from a primary cardiac tumor is a relatively frequent presentation. However, an acute myocardial infarction due to coronary embolization is rarely seen. We offer an unusual case of a 50-year-old man who presented with severe angina and was diagnosed with an inferolateral ST-segment-elevation myocardial infarction. Aside from otherwise healthy coronary arteries, his coronary angiogram revealed an acute occlusion of the first obtuse marginal branch, which was treated with balloon angioplasty. Because no residual plaque or dissection was found after the angioplasty, an embolic source was suspected. An echocardiogram then revealed a large mobile left atrial myxoma prolapsing into the left ventricle, so the patient underwent minimally invasive resection. Detailed pathologic examination of the myxoma revealed a concomitant high-grade B-cell lymphoma.

  8. A case report of intramuscular myxoma in the paraspinal space

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Mi Jin; Cho, Woo Ho; Kim, Soung Hee [Sanggye Paik Hospitl, Inje University College of Medicine, Seoul (Korea, Republic of)

    2008-07-15

    Myxomas rare benign mesenchymal neoplasms composed of undifferentiated stellate cells in the myxoid stroma and can affect the heart, subcutaneous tissues, bone and skin. Myxomas arising from muscle tissue are called intramuscular myxomas, and account for 17% of all myxomas. Intramuscular myxomas are most commonly located in the large muscles of the thigh, shoulder, and buttocks. However, intramuscular myxomas of the head and neck region are rarely reported. In this study, we report a case of intramuscular myxoma arising from the paraspinal space of the head and neck region.

  9. Recurrent right ventricular cardiac myxoma in a patient with Carney complex: a case report.

    Science.gov (United States)

    Sardar, Muhammad Rizwan; Lahoti, Ankush; Khaji, Amanulla; Saeed, Wajeeha; Maqsood, Khawar; Zegel, Harry G; Romanelli, Jeanine E; McGeehin, Frank C

    2014-05-02

    Carney complex is a multiple neoplasia syndrome involving cardiac, endocrine, neural and cutaneous tumors with a variety of pigmented skin lesions. It has an autosomal dominant mode of inheritance. Approximately 7% of cardiac myxomas are related to the Carney complex. Myxomas that occur as part of the Carney complex affect both sexes with equal frequency. Cardiac myxomas with Carney complex are reported mostly in the left side of the heart and are less common on the right side. As per our review, this is the first reported case of Carney complex with right ventricle cardiac myxoma. We present a rare case of recurrent cardiac myxoma in a patient later diagnosed to have Carney complex. A 46-year-old Caucasian man with a history of thyroid hyperplasia came to out-patient cardiology department with new onset atrial fibrillation. A transthoracic echocardiogram revealed a right ventricular mass attached to his interventricular septum, which was later seen on a transesophageal echocardiogram and cardiac magnetic resonance imaging. He underwent resection of the ventricular mass which on pathology revealed myxoma. He later developed skin lesions, pituitary adenoma and Sertoli cell tumor suggesting Carney complex. Two years later he developed a new mass within his right atrium which was later resected. Carney complex is a rare autosomal dominant disease with variable penetrance. Since it involves multiple organs, patients diagnosed with Carney complex should undergo serial endocrine workup, neural assessments, echocardiograms and testicular ultrasounds. Of the total number of cases of Carney complex, 65% are linked to PRKAR1A gene mutation. It is important for clinicians to be cognizant of a link between cardiac myxoma and Carney complex. The use of multi-imaging modalities allows better delineation of the mass before planned resection. Carney complex-related cardiac myxoma comprises 7% of all cardiac myxomas. Right ventricular cardiac myxomas are rare. This case report is

  10. Extended vertical transatrial septal approach for the removal of left atrial myxoma

    NARCIS (Netherlands)

    Zeebregts, CJAM; Schepens, MAAM; Knaepen, PJ

    Objective: Optimal exposure greatly facilitates left atrial myxomectomy and is mandatory for safe and efficacious tumour removal. The purpose of this study was to evaluate one institutions experience, with an alternative to the classical approach, for the removal of left atrial myxoma. Methods: In

  11. Right-atrial myxoma clinically mimicking recurrence of rheumatic valve disease long time after mitral valve repair.

    Science.gov (United States)

    Majumdar, Gauranga; Agarwal, Surendra; Pande, Shantanu; Tewari, Satyendra

    2016-09-01

    Right atrial myxomas are rare. Its occurrence in a previously operated patient of rheumatic mitral stenosis posed clinical diagnostic challenge. We herein report a case of right atrial myxoma who had undergone mitral valve repair 20 years ago and now presented in congestive heart failure. The tumor was arising from the ostium of the coronary sinus and prolapsed into the right ventricle causing significant right ventricular inflow and outflow obstruction. Urgent repeat cardiac surgery was successfully performed to remove the tumor along with mitral valve replacement. We review the diagnostic and therapeutic problems resulting from this unusual association. Copyright © 2016 Cardiological Society of India. Published by Elsevier B.V. All rights reserved.

  12. Left atrial myxoma with versus without cerebral embolism: length of symptoms, morphologic characteristics, and outcomes.

    Science.gov (United States)

    Zheng, Zhi; Guo, Guojun; Xu, Li; Lei, Lei; Wei, Xiang; Pan, Youmin

    2014-12-01

    The aim of this study was to evaluate the embolic sequelae of left atrial myxomas and their influence on diagnosis, treatment, and prognosis. Seventy-eight patients were retrospectively investigated. According to their symptoms and neurologic-imaging findings, these patients were classified into 2 groups: embolism (15 patients, 19%) and nonembolism (63 patients, 81%). The time from the first onset of symptoms to diagnosis (that is, the duration of symptoms) was significantly longer in the embolism group than in the nonembolism group (105 ± 190 vs 23 ± 18 d; P myxomas were divided into 2 types on the basis of clinicopathologic findings: type 1, with an irregular or villous surface and a soft consistency, and type 2, with a smooth surface and a compact consistency. There were 42 patients with type 1 myxoma and 36 with type 2. Type 1 myxoma was more frequently found in the embolism group (12 patients, 29%) than was type 2 myxoma (3 patients, 8%). The difference was significant (P=0.04). There were 2 perioperative deaths in the nonembolism group. No recurrence of cardiac myxoma or death was recorded in either group during follow-up. In the embolism group, neurologic symptoms were relieved by surgery, and no subsequent neurologic event was reported. Because surgical resection is highly effective in left atrial myxoma, we should strive for early diagnosis in order to shorten the duration of symptoms and to avoid worse neurologic damage in patients in whom an embolic event is the initial manifestation.

  13. CYTOGENETICS OF A CASE OF CARDIAC MYXOMA

    NARCIS (Netherlands)

    DIJKHUIZEN, T; VANDENBERG, E; MOLENAAR, WM; MEUZELAAR, JJ; DEJONG, B

    1992-01-01

    The cytogenetic study of a case of cardiac myxoma revealed a 46,XY,der(7)t(7;17) (p21;p11),+der(10)t(10;?)(q22;?),+der(12)t(12;?)(p12;?),del(17)(p11) chromosomal pattern. This case adds a new example of chromosomal abnormalities in benign neoplasms.

  14. Preoperative assessment of mitral valve abnormalities in left atrial myxoma patients using cardiac CT

    Science.gov (United States)

    Chen, Jing; Yang, Zhi-Gang; Ma, En-Sen; Zhang, Qin; Liu, Xi; Guo, Ying-Kun

    2017-01-01

    Background To retrospectively evaluate mitral valve abnormality in left atrial myxoma patients by using cardiac computed tomography (CT). Material and methods Cardiac CT was performed in 56 patients with left atrial myxoma and 50 controls. Tumor and mitral valve characteristics were analyzed. The mitral valve parameters differences were compared between patients with myxoma and controls, myxoma with or without mitral valve obstruction, different obstruction degrees, respectively. Receiver operating characteristic analysis was performed to determine the cut-off values of abnormal mitral valve parameters for myxoma patients. Multiple linear regression, logistic regression models and cox regression analysis were used to determine factors associated with mitral valve abnormalities, mitral obstruction, mitral regurgitation and postoperative recovery, respectively. Results Myxoma induced the dilation of mitral valve, with different results among different degrees of obstruction (pmyxoma parameters. The cut-off values for discriminating mitral valve abnormalities in myxoma patients were found. Some significant predictors for mitral obstruction were tumor pedicle-tumor volume and patient age (HR, 0.886-30.811; p = 0.011-0.043). Moreover, the predictor for mitral regurgitation was mitral annulus diameter in diastolic phase (HR, 20.862; 95%CI,1.331-327.100; p = 0.031). Some predictors associated with postoperative recovery of mitral regurgitation were age, mitral annulus area, mitral annulus diameter and mitral valve diameter cutoff value for diastolic phase (HR, 0.001-119.160; p = 0.012-0.028). Conclusion Cardiac CT is capable of quantitatively assessing myxoma characteristic and mitral valve abnormality induced by myxoma, thus providing guidance of operative management and postoperative evaluation. PMID:28915697

  15. A case of right ventricular myxoma

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young Goo; Huh, Seung Jae; Han, Man Chung; Choo, Dong Woon [College of Medicine, Seoul National University, Seoul (Korea, Republic of)

    1980-12-15

    A case of right ventricular myxoma is reported with brief review of literatures. The tumor was located in the outflow tract of the right ventricle and prolapsed into the pulmonary artery during the ventricular systole. It was diagnosed by the echocardiography and cineangiography prior to open heart surgery.

  16. Concomitant Left Atrial Myxoma and Patent Foramen Ovale: Is It an Evolutional Synergy for a Cerebrovascular Event?

    Science.gov (United States)

    Lasam, Glenmore; Ramirez, Roberto

    2017-02-01

    We report a case of a 48-year-old female who presented initially with an abrupt onset of left facial and hand numbness after her routine yoga with no associated syncope, palpitation, chest pain or dyspnea. She consulted her primary care physician and recommended hospital care for possible stroke. On the day of admission, she complained of left facial and hand hemiparesthesia. Cranial imaging and angiography were unremarkable but echocardiography and cardiac computed tomography revealed left atrial mass. She underwent resection of the left atrial mass with an incidental finding of patent foramen ovale intraoperatively. The left atrial mass was confirmed to be an atrial myxoma. Patient's neurologic complaints resolved towards the end of her hospital course. She was discharged stable with no recurrence of neurologic symptoms on health maintenance evaluation.

  17. Simulation of right atrial cardiac myxoma by silent hepatocellular carcinoma.

    Science.gov (United States)

    Giacalone, A; Suriani, A; Monga, G

    1996-12-01

    A clinically silent hepatocellular carcinoma presenting as a mixoma of the right atrium is described. Intra-atrial growth has been reported in advanced, clinically manifested cases of liver carcinomas in African and Japanese subjects, but very occasionally in Caucasian people. Our case further suggests that this occurrence should also be considered in Western Countries.

  18. Atrial myxoma in a primigravida presenting as Raynaud’s phenomenon

    Directory of Open Access Journals (Sweden)

    Mansoor C. Abdulla

    2015-10-01

    Full Text Available A 32-year-old primigravida at 8 weeks of gestation presented with gangrene of both great toe for 10 days. Two years back, she had an episode of Raynaud’s phenomenon involving left ring finger diagnosed as primary Raynaud’s phenomenon and was treated with nifedipine following which she improved. In the following months, she had 2-3 similar episodes of Raynaud’s phenomenon in the upper extremity which were less severe. On diagnostic evaluation she was found to have an intra cardiac mass arising from mitral leaflet. We present a case of atrial myxoma initially presenting as an isolated Raynaud’s phenomenon with a long asymptomatic period before the next clinical manifestation which to our knowledge is the first such report.

  19. Right atrial myxoma as a possible cause of hemorrhagic stroke and ...

    African Journals Online (AJOL)

    A clinical diagnosis of hypertensive hemorrhagic cerebrovascular accident was made. The patient died suddenly a few hours after presentation. Post‑mortem examination revealed a small intracerebral hemorrhage in the left superior temporal lobe as well as a large right atrial myxoma, a ventricular septal defect in the ...

  20. Identification of Stem-Like Cells in Atrial Myxoma by Markers CD44, CD19, and CD45

    Science.gov (United States)

    Song, Xianghe; Liu, Danni; Cui, Jian; Zhou, Manqian; Liu, Na

    2016-01-01

    Atrial myxoma is the most frequent tumor arising mainly in atrial septum and its origin remains uncertain. It has been reported that a subpopulation of stem-like cells are present in benign tumors and responsible for tumor initiation and maintenance. In this study, we investigated whether stem-like cells could contribute to the atrial cardiac myxoma. Immunohistology data confirmed that a population of cells bearing the surface markers CD19, CD45, and CD44 resided in a mucopolysaccharide-rich matrix of myxoma. Moreover, we isolated myxoma cells with phase-bright culture method and confirmed that myxoma derived cells express robust level of CD19, CD45, and CD44. Furthermore, the pluripotency of this population of cells also was validated by cardiomyocytes and smooth muscle cells differentiation in vitro. Our results indicate that primary cardiac myxoma may arise from mesenchymal stem cells with the ability to generate tumors with multilineage differentiation. In conclusion, this study for the first time verified that stem-like cells are present in atrial myxoma and this population of cells may have the capacity for myxoma initiation and progression. PMID:28115941

  1. Mixoma de átrio direito com prolapso para o ventrículo direito Right atrial myxoma prolapsing into the right ventricle

    Directory of Open Access Journals (Sweden)

    José Glauco Lobo Filho

    2006-06-01

    Full Text Available Relatamos o caso raro de uma paciente de 67 anos, apresentando mixoma de átrio direito, com prolapso para o ventrículo direito. Estes tumores correspondem a cerca de 18% dos casos de mixoma, que por sua vez têm uma incidência de 0,0017% na população em geral.We report on a rare case of a 67-year-old woman with a right atrial myxoma prolapsing into the right ventricle in the diastolic phase. These tumors comprise approximately 18% of all cardiac myxomas, which occur in 0.0017% of collected autopsy series.

  2. [Myxoma involving posterolateral leaflet: about a case].

    Science.gov (United States)

    Nya, Fouad; Abdou, Abdessamad; Bamous, Mehdi; Moutakiallah, Younes; Atmani, Noureddine; Seghrouchni, Aniss; Aithoussa, Mahdi; Boulahya, Abdellatif

    2017-01-01

    Cardiac myxomas are the most common type of primary cardiac tumors. They mainly affect the interatrial septum and exceptionally the heart valves. Surgical excision remains the only therapeutic alternative. We here report the case of a 69-year old patient with no significant pathological history suffering from NYHA class II-III dyspnea associated with lipothymia. Transthoracic echocardiography showed a tight calcified aortic narrowing with aortic valve gradient of 58 mmHg. A sessile mass of 15mm diameter inserted into the posterolateral leaflet, without stenosis or mitral regurgitation evoking an atypical localization of myxomaor or fibroelastoma was detected at the level of the mitral valve. The examination was supplemented by ETO which confirmed the diagnosis of a mass involving the posterolateral leaflet. The patient underwent surgery via median sternotomy, under conventional extracorporeal circulation. Left atriotomy allowed to objectify a sessile mass of 15mm of diameter involving the auricular wall of the friable and easily cleavable posterolateral leaflet. Cauterization of the implant base via electric scalpel was then performed without any additional gesture on the posterolateral leaflet. Anatomopathologic analysis of the surgical specimen confirmed the diagnosis of myxoma. The patient also underwent aortic valve replacement with mechanical prosthesis. The postoperative course was uneventful. The patient was discharged on postoperative day 8. Cardiac myxoma involving the mitral leaflet is very rare. Surgical procedure attempting to resect the widest possible surgical margins remains the only therapeutic option to avoid the risk of recurrence.

  3. Detection and evaluation of left atrial myxoma by gated radionuclide imaging

    Energy Technology Data Exchange (ETDEWEB)

    Sugihara, Hiroki; Adachi, Haruhiko; Nakagawa, Hiroaki

    1985-05-01

    Radionuclide imaging plays an important role in diagnosising left atrial myxoma (LAM). We discussed diagnostic value of Fourier analysis with phase image and evaluated left ventricular filling function using indices such as 1/3 Filling Fraction, Rapid Filling Fraction and Peak Filling Rate derived from left ventricular volume curve. Equillibrium radionuclide angiocardiography was performed in 6 LAM patients. Phase delay in the basal portion of the left ventricle was shown in 5 of 6 LAM patients, and standard deviation of left ventricular phase was larger than these of controls. Left ventricular filling disturbance was suggested in 5 of 6 LAM patients. After surgical remove of myxoma phase delay was disappeared and standard deviation was normalized. And left ventricular filling was improved. We concluded that the phase image of Fourier analysis revealed a left atrial mass prolapsing in the left ventricule during the diastole, and that diastolic indices were useful for left ventricular filling disturbance due to LAM. (author).

  4. Intra-Arterial Treatment in a Child with Embolic Stroke Due to Atrial Myxoma

    Science.gov (United States)

    van den Wijngaard, Ido; Wermer, Marieke; van Walderveen, Marianne; Wiendels, Natalie; Peeters-Scholte, Cacha; Lycklama à Nijeholt, Geert

    2014-01-01

    Summary Arterial ischaemic stroke is an important cause of morbidity in children. Timely diagnosis is necessary for acute stroke treatment but can be challenging in clinical practice. Due to a paucity of data there are no specific recommendations regarding the use of mechanical thrombectomy devices in current paediatric stroke guidelines. A 14-year-old boy presented with a severe acute left hemisphere stroke due to a proximal middle cerebral artery occlusion caused by emboli from an atrial myxoma. No clinical improvement was seen after administration of intravenous thrombolysis. Subsequent mechanical thrombectomy with a second-generation stent-based thrombectomy device resulted in successful recanalization and clinical improvement. To our knowledge, this is the first report of mechanical thrombectomy in a child with acute embolic stroke caused by atrial myxoma. PMID:24976098

  5. Diagnosis of left atrial masses with computed tomography. With special reference to comparison of computed tomographic findings between mural thrombi and myxomas

    Energy Technology Data Exchange (ETDEWEB)

    Hongo, Minoru; Amemiya, Hiroshi; Yamada, Hiroyoshi; Matsuoka, Ken; Okubo, Shinichi (Shinshu Univ., Matsumoto, Nagano (Japan). Faculty of Medicine)

    1984-01-01

    Computed tomographic findings between left atrial mural thrombi associated with valvular disease (especially mitral stenosis) and left atrial myxomas were compared. Differential diagnosis might be possible by comprehensive evaluation on the shape and inside structure of the left pulmonary atrium, CT values, the presence of calcification and the movement of mitral valve. It is recommended that CT and postoperative findings should be compared and evaluated to determine the presence of thrombi in cases of valvular disease associated with hypervascularity in the left cardiac auricle detected by coronary arteriography.

  6. Mixoma de átrio direito associado a cor pulmonale agudo: relato de caso Mixoma de atrio derecho asociado a cor pulmonale agudo: relato de caso Right atrial myxoma associated with acute cor pulmonale: case report

    Directory of Open Access Journals (Sweden)

    Michelle Nacur Lorentz

    2008-02-01

    ó embolización intraoperatoria de parte del tumor y avisar a los anestesiólogos para la posibilidad de esta complicación, además de discutir la conducta anestésica. RELATO DEL CASO: Paciente del sexo masculino, 42 años, portador de gran masa en atrio derecho, sometido a la retirada del tumor. La inducción de la anestesia fue hecha con etomidato, fentanil y bromuro de rocuronio y el mantenimiento con isoflurano y fentanil. En el intraoperatorio el paciente presentó un cuadro de cor pulmonale agudo debido a la embolización de parte del tumor siendo realizadas medidas de soporte e iniciada rápidamente la circulación extra-corpórea. El resto de la operación transcurrió bien y el paciente tuvo alta al 7º día del postoperatorio en buenas condiciones. CONCLUSIONES: A pesar del mixoma intracardiaco ser un tumor de características benignas, puede estar asociado a complicaciones graves y a veces fatales. El conocimiento de la enfermedad es importante para que el anestesiólogo pueda manosear adecuadamente esos pacientes, y diagnosticar y tratar las posibles complicaciones intraoperatorias.BACKGROUND AND OBJECTIVES: Atrial myxomas are the most common type of primary intracardiac tumors. Although they are benign, it is recommended its immediate removal as soon as the diagnosis is confirmed, since they are associated with tumor embolization and their harmful consequences. The objective of this report was to present the case of an intracardiac tumor of rare location (right atrium that developed intraoperative embolization and to alert anesthesiologists for the possibility of this complication, besides discussing the anesthetic conduct. CASE REPORT: A male patient, 42 years old, presented with a large mass in the right atrium, being scheduled for removal of the tumor. Anesthetic induction consisted of ethomidate, fentanyl and rocuronium bromide and it was maintained with isoflurane and fentanyl. Intraoperatively, the patient developed acute cor pulmonale secondary to tumor

  7. The prevention of circulatory collapse in left atrial myxoma or left atrail thrombus patients.

    Science.gov (United States)

    Sun, Jie; Ding, Zhengnian

    2016-05-01

    Some patients with myxoma or thrombus may develop to severe hypotension or sudden death. In this article, we hypothesize a clinical scenario that when the myxoma or thrombus blocks in the mitral valve and causes significant hypotension during anesthesia or surgery. Increasing cardiac preload will be an effective preventive method to increasing the mitral valve annulus and decreasing the severity of stenosis, as a result it will prevent circulatory collapse. Our hypothesis will decrease the possibility of lethal mitral valve stenosis induced by left atrial mass blocking the mitral valve area. In addition, we should also maintain a relative slow heart rate and a relative high systemic vascular resistance. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. [A late diagnosis of left atrial myxoma: how to gain time?

    Science.gov (United States)

    Massari, Ferdinando Maria; Tonella, Tatiana; Pomè, Giuseppe; Di Mauro, Alessandra; Clemente, Claudio; Lombardi, Federico

    2016-12-01

    A 56-year-old man presented to the Outpatient Cardiology Unit for dyspnea that had been lasting 6 months and an occasional episode of cold perspiration on climbing a flight of stairs. In the suspicion of coronary artery disease, he was prescribed a complete blood panel, an echocardiogram and a treadmill stress test. The echocardiogram, performed as late as 78 days after the first evaluation and only by chance scheduled 2 days before the stress test, enabled a diagnosis of left atrial myxoma for which the patient successfully underwent cardiac surgery. The authors discuss the aspecific and potentially misleading nature of myxoma symptoms and highlight the latency between cardiological evaluation and diagnostic echocardiography.

  9. Complicated Sporadic Cardiac Myxomas: A Second Recurrence and Myxomatous Cerebral Aneurysms in One Patient

    Directory of Open Access Journals (Sweden)

    Mazen E. Iskandar

    2013-01-01

    Full Text Available A second recurrence of an excised nonfamilial cardiac myxoma is rare. Myxomatous cerebral aneurysms as a complication of cardiac myxomas are equally rare. A unique case of a patient with a total of 4 myxomas over a 20-year interval is presented. Her most recent presentation was a second recurrence of a left atrial myxoma, a de novo right atrial myxoma, and multiple cerebral myxomatous aneurysms. The challenging reconstruction of the normal anatomy was achieved with the use of porcine extracellular matrix patches. A diagnostic cerebral angiogram was later performed, and the aneurysms will be monitored for growth and possible intervention.

  10. Right ventricular myxoma originating from a papillary muscle: a case report.

    Science.gov (United States)

    Hajsadeghi, Shokoufeh; Pazoki, Mahboubeh; Moradians, Vahan; Iranpour, Aida; Jebeli, Mohammad; Babaheidarian, Pegah

    2016-12-01

    Very few cases of ventricular myxoma originate from a papillary muscle. Patients with a cardiac myxoma and a history of colorectal carcinoma are also rare. Here, we present a case of an extremely large right ventricular myxoma that originated from the posteromedial papillary muscle in a patient with a history of colorectal carcinoma. © 2016, Wiley Periodicals, Inc.

  11. Infiltrative intramuscular myxoma of the cervical spine: a case report.

    Science.gov (United States)

    Manoharan, Sakthivel Rajan Rajaram; Shaw, Andrew B; Arnold, Christina A; Farhadi, H Francis

    2015-01-01

    Myxomas are benign tumors of mesenchymal cell origin that usually present as solitary lesions. They are infrequently associated with fibrous dysplasia, as in McCune-Albright or Mazabraud syndrome. Myxomas can develop in a variety of locations, although the most frequent sites are the thigh, buttocks, shoulder, and upper arm. Intramuscular myxomas (IMs) refer to lesions that occur within muscle compartments. They have been infrequently reported in the neck musculature. To date, only five cases have been reported within the posterior neck muscles without associated intraspinal extension. To our knowledge, this is the first case of an IM presenting with extension into the spinal canal. We report a case of posterior cervical IM with intraspinal extension presenting in a 63-year-old woman as a palpable mass. Complete intralesional resection of the tumor was achieved by standard midline posterior approach. Meticulous resection of the entire capsule was achieved and all margins were confirmed to be free of neoplasm. A diagnosis of myxoma was provided on pathologic evaluation. Follow-up at 1.5 years confirmed maintained complete resolution of the preoperative symptoms, with no evidence of local recurrence on imaging. Intramuscular myxomas should be included in the differential diagnosis of cervical paraspinal tumors. Furthermore, we suggest that masses involving the axial muscles should be closely monitored and the patient counseled regarding potential neurologic sequelae. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Dumb-bell in the heart: rare case of biatrial myxoma with mitral regurgitation.

    Science.gov (United States)

    Ananthanarayanan, Chandrasekaran; Bishnoi, Arvind Kumar; Ramani, Jayadip; Gandhi, Hemang

    2016-10-01

    Cardiac myxomas are rare intracardiac tumors, and the majority are benign myxomas involving the left atrium. We report a case of the very rare occurrence of biatrial myxoma associated with mitral regurgitation, which was successfully treated. © The Author(s) 2016.

  13. Stroke associated with left atrial mass: Association of cerebral aneurysm with left atrial myxoma!

    Directory of Open Access Journals (Sweden)

    Shashi Srivastava

    2014-01-01

    Full Text Available Association of LA myxoma with cerebral aneurysm is rare. We describe a patient who had LA mass and cerebral aneurysm and developed stroke. The patient underwent clipping of the cerebral aneurysm. We discuss the pathology of the association and the anesthetic management.

  14. A case report of odontogenic myxoma with characteristic multilocular lesion

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Byung Do; Lee, Wan; Paeng, Jun Young [Department of Oral and Maxillofacial Radiology, School of Dentistry, Wonkwang University, Iksan (Korea, Republic of); Son, Hyun Jin [Department of Pathology, Eulji University School of Medicine, Daejeon (Korea, Republic of)

    2009-03-15

    Although odontogenic myxoma (OM) has various radiographic appearances, the characteristic features of OM are the multilocular radiolucent lesion, straight bony septa along the margin forming either square or triangular spaces. We present a case of OM in a 25-year old-male patient. Multilocular radiolucent lesion on the left mandible body showed tennis racket appearance. Cone beam computed tomography (CBCT) showed straight bony septa along the margin and cortical perforation. This CBCT features would have significantly contributed to allowing a diagnosis of OM. We think that this case shows characteristic radiographic features of odontogenic myxoma.

  15. Comparison of postoperative quality of life for patients who undergo atrial myxoma excision with robotically assisted versus conventional surgery.

    Science.gov (United States)

    Yang, Ming; Yao, Minghui; Wang, Gang; Xiao, Cangsong; Wu, Yang; Zhang, Huajun; Gao, Changqing

    2015-07-01

    Robotically assisted cardiac surgery is an alternative to conventional, open-chest surgery. Although studies have been done on the clinical effect, morbidity, and mortality of robotically assisted atrial myxoma excision, few have addressed surgical outcomes, such as pain, quality of life (QOL), and length of sick leave from work. In this study, our aim was to evaluate these clinical variables among patients after they undergo robotically assisted atrial myxoma excision surgery. Between January 2007 and January 2013, a total of 93 patients underwent either conventional sternotomy or robotically assisted atrial myxoma excision in our unit. The 36-item Medical Outcomes Study Short Form Survey was used to assess the clinical outcomes in these patients postoperatively, at day 30 and 6 months. The QOL scores for 7 of 8 variables in the robotically assisted group were significantly higher than those in the conventional group at postoperative day 30 (P myxoma surgery is excellent with the robotically assisted approach, which may enable early return to employment and satisfactory recovery. Copyright © 2015 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

  16. Right atrial myxosarcoma in a dog : case report

    Directory of Open Access Journals (Sweden)

    O.M. Briggs

    1997-07-01

    Full Text Available A case of right atrial myxosarcoma is described in a Staffordshire bull terrier with a history of weight loss, exercise intolerance and collapse. The diagnosis of an intracavitary cardiac tumour was made on echocardiography. The dog was euthanased. Secondary spread to the lungs and lymph nodes was present. Myxoma is one of the rare intracavitary cardiac tumours and this case is believed to be the 1st report of its more malignant form in the dog.

  17. Mechanical thrombectomy in cardiac myxoma stroke: a case report and review of the literature.

    Science.gov (United States)

    Chung, Yoon Sang; Lee, Woong Jae; Hong, Joonhwa; Byun, Jun Soo; Kim, Jae Kyun; Chae, Soo Ahn

    2016-06-01

    Cardiac myxoma is the most common primary tumor of the heart. It is a rare cause of acute ischemic stroke and commonly not detected until after the stroke. There is no current guideline for the treatment of cardiac myxoma stroke and only a few cases of mechanical thrombectomy have been reported. We present a case of cardiac myxoma stroke in a 4-year-old boy treated with a stent-retrieval device and review the literature describing the safety and efficacy of mechanical thrombectomy in cardiac myxoma stroke. We also describe imaging features of the myxoma clot on susceptibility weighted images.

  18. Odontogenic myxoma: a clinicopathological study of 33 cases.

    NARCIS (Netherlands)

    Simon, E.N.; Merkx, M.A.W.; Vuhahula, E.; Ngassapa, D.; Stoelinga, P.J.W.

    2004-01-01

    Odontogenic myxoma, a rare tumour that occurs in the jaws, has been reported to be the second commonest odontogenic tumour in many countries. Few studies, however, provide detailed clinicopathological findings of a large series of cases and no study so far has attempted to calculate the incidence of

  19. Right atrial myxoma with glandular differentiation: A rare entity in pediatric age group

    Directory of Open Access Journals (Sweden)

    Das Prasenjit

    2010-01-01

    Full Text Available Cardiac myxomas (CMs account for nearly half of the primary cardiac tumors in the elderly. They arise from sub-endocardial "reserve" or "lepidic" cells, which may show divergent differentiation. We describe a CM with glandular differentiation in the right atrium of a 10-year-old child who presented with respiratory distress on exertion, of 2 months duration. On echocardiography, two large interconnected masses measuring 34Χ30 mm and 20Χ17 mm were seen to arise from the free wall of the right atrium. Cut surface of the excised mass was myxoid with areas of calcification. On microscopy, there were typical features of a myxoma with prominent glandular differentiation and characteristic immunophenotype. The case is being reported due to its rarity in pediatric age group as well as its glandular differentiation, which must be recognized as a spectrum of histomorphologic diversity and must not be mistaken for a metastatic adenocarcinoma.

  20. An Interesting Case of Intramuscular Myxoma with Scapular Bone Lysis

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    Jérôme Tirefort

    2017-01-01

    Full Text Available Introduction. Intramuscular myxoma is a rare benign primitive tumor of the mesenchyme founded at the skeletal muscle level; it presents itself like an unpainful, slow-growing mass. Myxomas with bone lysis are even more rare; only 7 cases have been reported in the English literature, but never at the shoulder level. Case Presentation. We describe an 83-year-old patient with a growing mass in the deltoid muscle with unique scapular lysis, without any symptom. Magnetic resonance imaging (MRI and a biopsy were performed and the diagnosis of intramuscular myxoma has been retained. In front of this diagnosis of nonmalignant lesion, the decision of a simple follow-up was taken. One year after this decision, the patient was still asymptomatic. Conclusion. In the presence of an intramuscular growing mass with associated bone lysis, intramuscular myxoma as well as malignant tumor should be evoked. MRI has to be part of the initial radiologic appraisal but biopsy is essential to confirm the diagnosis. By consensus, the standard treatment is surgical excision but conservative treatment with simple follow-up can be an option.

  1. Detection of left atrial myxoma by gated radionuclide cardiac imaging. [/sup 99m/Tc tracer technique

    Energy Technology Data Exchange (ETDEWEB)

    Pohost, G.M.; Pastore, J.O.; McKusick, K.A.; Chiotellis, P.N.; Kapellakis, G.Z.; Myers, G.S.; Dinsmore, R.E.; Block, P.C.

    1977-01-01

    Gated radionuclide cardiac blood pool scans (GCS) of end-systole and end-diastole or eight images subtending the entire cardiac cycle were performed on seven patients with left artrial myxomas documented by pulmonary cineangiography with left atrial follow-through. The echocardiogram was either suggestive or diagnostic in all patients. In addition to demonstration of the tumor (6 patients), the GCS detected three patterns of tumor motion: a defect which moved from the left atrium in end systole to the left ventricle in end diastole (2 patients); a defect which remained within the region of the left atrium but decreased in size between end diastole and end systole (3); and a defect which was observed within the region of the left ventricle in end diastole but disappeared in end systole (1). Thus, the GCS is a noninvasive method for detection and evaluation of motion of left atrial myxomas.

  2. Cardiac Myxoma With Unusual Obstructive and Embolic Presentations: Concurrent Stroke and Angiography-Negative Myocardial Infarction--A Case Report.

    Science.gov (United States)

    Chen, Robert Jeen-Chen; Chou, Hsin-Hua; Tsai, Kuei-Ton; Shen, Ta-Chung; Hu, Chin-Yuan

    2015-09-01

    We present a case of cardiac myxoma with atypical presentations of concurrent stroke and angiography-negative myocardial infarction. The case emphasizes the importance of basic echocardiography and timely surgery in the management of cardiac myxoma. An elderly woman presented to the emergency department in an unconscious state. Electrocardiogram and elevated cardiac enzymes suggested acute myocardial infarction; however, immediate coronary angiography proved patency. Basic echocardiography revealed an oscillating left atrial myxoma obstructing inflow through the mitral valve. After regaining consciousness while in the intensive care unit, the patient developed respiratory distress and shock, and emergent en bloc resection was performed. Ataxia was noted in her postoperative course and multiple small cerebellar infarcts were found on magnetic resonance imaging. After a 1-month period of rehabilitation, the patient recovered well and continues to be followed as an outpatient. Cardiac myxoma requires timely management and may be missed if not included in the differential diagnoses. Basic echocardiography, also called focused cardiac ultrasound, may aid in the diagnosing of perplexing cardiac cases.

  3. MIXOMA BIAURICULAR: PRESENTACIÓN DEL PRIMER CASO OPERADO EN EL CARDIOCENTRO ERNESTO CHE GUEVARA / Biatrial myxoma: presentation of the first case operated on at the Ernesto Che Guevara Cardiology Hospital

    Directory of Open Access Journals (Sweden)

    Roberto Bermúdez Yera

    2010-06-01

    Full Text Available Left atrial myxoma is the most common primary cardiac tumor in clinical practice. However, the myxomas that grow at both sides of the interatrial septum are rare. The case of a 65-year-old white patient is presented here. The transthoracic echocardiogram showed a large mass in the right atrium which was compatible with an atrial myxoma; therefore, a surgical treatment was decided. A right atriotomy with resection of the tumor was carried out. The interatrial septum was opened and its pedicle was resected with an oncologic security margin. The presence of the tumor mass, also on the left surface of the septum, was confirmed. The septal defect was closed with a patch of autologous pericardium. The myxoma was polylobulated with arborescent aspect, and measured about 10 x 8 cm, weighing 89 grams. The patient evolved satisfactorily and was discharged 11 days after the surgical intervention.

  4. Atrial myxoma

    Science.gov (United States)

    ... change color upon pressure or with cold or stress General discomfort ( malaise ) Joint pain Swelling in any part of the body Weight loss without trying Exams and Tests The health care provider will perform ...

  5. A Case of Odontogenic Myxoma with Unusual Histological Features Mimicking a Fibro-Osseous Process

    Science.gov (United States)

    Basile, John R.

    2010-01-01

    Odontogenic myxoma is a rare benign but locally aggressive odontogenic tumor. This report describes a case of odontogenic myxoma producing diffusely dispersed calcified products in a pattern reminiscent of a fibro-osseous lesion of the jaw. Differential diagnoses for myxoid lesions of the jaws also are discussed. This paper highlights how an odontogenic myxoma can produce a large amount of calcified products to mimic a fibro-osseous process. PMID:20607463

  6. Condyloma acuminatum associated with odontogenic myxoma: a case report.

    Science.gov (United States)

    Rajasekhar, G; Mushtaq, Mohammed; Vura, Nanda Gopal; Shekar, Ravi; Kumar, Sravan

    2009-12-01

    Condylomata acuminatum is a sexually transmitted infectious disease caused by human papiloma virus on the skin. The transmission is mainly by close contact with infected person and autoinoculation. In oral cavity the condition manifests as soft pink nodules which proliferate and coalesce rapidly to form diffuse papillomatous clusters of varying size. Odontogenic myxoma is a rare tumor of jaws which occurs in the tooth-bearing areas of the mandible and maxilla. It is an uncommon, benign, but locally aggressive neoplasm. This case report highlights a 17-year-old girl with two lesions in oral cavity with soft tissue growth on the palate which has been diagnosed as Condyloma Acuminatum, treated by surgical excision and a large swelling on the right side of the mandible in the same patient diagnosed as odontogenic myxoma where marginal resection was performed.

  7. Cardiac myxoma causing acute ischemic stroke in a pediatric patient and a review of literature.

    Science.gov (United States)

    Fuchs, Jennifer; Leszczyszyn, David; Mathew, Don

    2014-05-01

    Ischemic stroke in the pediatric population is a rare occurrence, and its possible causes span a wide differential that includes atrial myxomas. Myxomas are friable cardiac tumors that produce "showers" of emboli resulting in transient neurological deficits, cutaneous eruptions, and ophthalmologic deficits. We present an 11-year-old boy with a months-long history of an intermittent spotted "rash" who presented with acute ischemic stroke caused by a left atrial myxoma. We also review clinical features in all 16 other cases of cardiac myxoma causing pediatric stroke reported in the literature. Our case, along with the review of the literature, highlights the fact that myxomas often initially present as stroke with acute hemiplegia and transient cutaneous eruptions due to fragmentation of the tumor. Cardiac myxoma should be considered in any child presenting with ischemic stroke, and transient skin findings may provide an important diagnostic clue prior to onset of neurological symptoms. Copyright © 2014 Elsevier Inc. All rights reserved.

  8. Case report 557: Solitary intramuscular myxoma in a patient with polyostotic fibrous dysplacia

    Energy Technology Data Exchange (ETDEWEB)

    Glass-Royal, M.C.; Nelson, M.C.; Albert, F.; Lack, E.E.; Bogumill, G.P. (Georgetown Univ., Washington, DC (USA). Medical Center)

    1989-08-01

    We report a case of solitary intramuscular myxoma in a patient with polyostotic fibrous dysplasia and pigmented macules. MR played an important role in the patient's pre-operative evaluation. It has been demonstrated in a review of the literature that a definite relationship exists between myxoma of soft tissues and fibrous dysplasia of the skeleton. Multiple myxomas in a patient with fibrous dysplasia are common and a relationship also exists between myxoma of the soft tissues and the McCune-Albright syndrome. (orig./GDG).

  9. Odontogenic myxoma: a case report with recent image modalities

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jae Duk; Kim, Kwang Won; Lim, Sung Hoon [Chosun University College of Medicine, Gwangju (Korea, Republic of)

    2004-12-15

    The odontogenic myxoma is an benign, slow growing neoplasm which is of ectomesenchymal origin. This neoplasm occurs almost exclusively in the jaw bones and comprises 0.2% to 17.7% of odontogenic tumors. The odontogenic myxoma may show a wide spectrum of radiographic appearances, unilocular, multilocular radiolucency and a distinct or diffuse border, making the differential diagnosis difficult. We present a case of the odontogenic myxoma in the maxilla with conventional and recent image modalities. Occlusal film revealed a medially extended multilocular lesion with intralesional fine and straight trabeculations from the scalloped margin and buccal expansion and thinning of cortical bone. Computed tomogram revealed lesion showed equivalent density to the muscles in the left maxillary sinus with partial cortical discontinuity of medical wall and the tennis-racket pattern with internal straight trabeculations. MRI revealed intermediate signal intensity on T1 weighted image and high signal intensity on T2 weighted image. In Gd enhanced MR image, the peripheral portions of the lesion were enhanced.

  10. Rearrangements involving 12p12 in two cases of cardiac myxoma

    NARCIS (Netherlands)

    Dijkhuizen, T; van den Berg, Eva; Molenaar, W M; Meuzelaar, J J; de Jong, Bauke

    1995-01-01

    Recently, we reported on the cytogenetic analysis of a case of cardiac myxoma, revealing a 46,XY,der(7)t(7;17)(p21;p11), add (10) (q22), add (12) (p12), del(17)(p11) chromosomal pattern. In this article we present the cytogenetic analysis of another case of cardiac myxoma, in which we found several

  11. Atrial myxoma: a rare but well-described cause of increased erythrocyte sedimentation rate and anaemia

    Science.gov (United States)

    Ekström, Mattias; Svenarud, Peter

    2015-01-01

    A 56-year-old woman visited her general practitioner 12 months prior with eczema. Blood samples showed anaemia, a haemoglobin level of 105 g/L and a high erythrocyte sedimentation rate (ESR) of 80 mm. Her eczema was diagnosed as discoid lupus erythaematosus but there were no signs of systemic lupus erythaematosus. Extensive investigations were made including testing of serial blood samples, repeated examinations by specialists in dermatology, rheumatology and gynaecology, and several X-rays including CT of the chest and the abdomen, all without finding a reasonable underlying diagnosis. One year later, the patient presented with dyspnoea associated with effort and body position; she was sent for echocardiography, which showed an atrial myxoma filling almost the whole left atrium and affecting the mitral valve. She was treated with urgent surgical removal and now, 6 weeks postsurgery, has fully recovered. She no longer has dyspnoea, her haemoglobin level and ESR have normalised, and the eczema has almost disappeared. PMID:25969498

  12. Recurrent left ventricular myxoma presenting as cerebrovascular accidents in a teenage girl.

    Science.gov (United States)

    Vermeulen, Tom; Conraads, Viviane M; Vrints, Christiaan; Rodrigus, Inez E

    2009-12-01

    Myxoma cordis is the most frequent primary cardiac tumour in adults. Paediatric primary cardiac tumours are rare, the most common type being rhabdomyoma. Atrial and ventricular myxomas occur infrequently in the paediatric age group. Intracardiac myxomas are seen with an estimated incidence of 0.5 per million population per year. Approximately 70% of the affected patients are of female gender. Recurrences are rare (1.3%). Asymptomatic recurrences are observed in young patients who have a familial history of tumour or multifocal myxomas. Although rare, cardiac aetiology (atrial fibrillation, intracardiac thrombi, patent foramen ovale, myxoma, endocarditis) should be considered. In children presenting with central neurological symptoms, a cardiac aetiology has to be considered. We describe a rare case of an 18-year-old girl presenting with a recurrent left ventricular myxoma, accompanied by neurological deficits.

  13. Fibrous dysplasia associated with intramuscular myxoma(mazabraud's syndrome) : a case report

    Energy Technology Data Exchange (ETDEWEB)

    Chun, Kyung Ah; Kim, Ki Tae; Kim, Young Joo; Maeng, Lee So; Lee, Eun Jung [The Catholic Univ. of Korea, College of Medicine, Seoul (Korea, Republic of)

    1999-05-01

    Mazabraud's syndrome, the etiology of which is unknown, is a rare benign disease, characterized by the association of intramuscular myxoma and fibrous dysplasia of bone, usually polyostotic. We describe a case of Mazabraud's syndrome in which with two intramuscular myxomas of the forearm were associated with polyostotic fibrous dysplasia.

  14. Report of a Rare Case of an Odontogenic Myxoma of the Maxilla ...

    African Journals Online (AJOL)

    Report of a Rare Case of an Odontogenic Myxoma of the Maxilla and Review of Literature. SM Manjunath, AA Gupta, P Swetha, NJ Moon, S Singh, A Singh. Abstract. Odontogenic myxoma (OM) is a mesenchymal tissue benign neoplasia, being relatively rare which is almost exclusively seen in tooth‑bearing areas.

  15. Finger Nerve Sheath Myxoma: A Rare Case Report

    Directory of Open Access Journals (Sweden)

    Tina Shooshtarizadeh

    2017-01-01

    Full Text Available Introduction Nerve sheath myxoma (NSM is a rare benign neoplasm of nerve sheath origin with Schwann cell differentiation. NSM and neurothekeoma were considered one single phenomenon in the past. Case Presentation A 28-year-old woman presented to our hospital clinic with pain and a fixed firm mass in the proximal phalanx of the right second finger. Excisional biopsy was performed and histological examination revealed NSM. Conclusions Based on the findings, NSM should be considered in the differential diagnosis of firm and tender masses in the upper extremities of young adults.

  16. [A case of cerebral embolism due to cardiac myxoma presenting with multiple cerebral microaneurysms detected on first MRI scans].

    Science.gov (United States)

    Sato, Takahiro; Saji, Naoki; Kobayashi, Kazuto; Shibazaki, Kensaku; Kimura, Kazumi

    2016-01-01

    A 64-year-old man developed right arm weakness and dysarthria, and was admitted to our hospital. Diffusion-weighted magnetic resonance imaging of the brain showed a high intensity area in the frontal lobe. T2*-weighted images showed multiple spotty low intensity lesions in bilateral cerebral hemispheres, mimicking cerebral microbleeds. Cerebral angiography showed multiple aneurysms in the anterior, middle, posterior cerebral arteries and cerebellar arteries. Transthoracic echocardiography revealed a floating structure in the left atrial chamber, indicating cardiac myxoma. We diagnosed cardioembolic ischemic stroke due to left atrial myxoma. Cardiac surgery for excision of a left atrial myxoma was performed on the 3rd hospital day. Multiple aneurysms should be taken into account for differential diagnosis in patients with cardiac myxoma and with atypical spotty low intensity on T2*-weighted images.

  17. Myxoma of the zygomatic bone--a case report.

    Science.gov (United States)

    Braut, Tamara; Marijić, Blažen; Sokolić, Žana; Kžundić, Milodar; Maržić, Diana; Starčević, Radan

    2015-03-01

    Myxoma is a benign tumor composed of primitive connective tissue cells and mesenchymal mucousal stroma. Also referred to as, a gelationus or colloidal tumor. Although rare, it can be found in the atrium of the heart, and it is the most common heart tumor. It has also been described in other body sites, one of which is the bone. We report a case of a 57-year-old female patient, with recurrent headaches located in the area of the right half of the face. Radiological analysis (Multislice Computed Tomography of the paranasal sinuses and viscerocranium) was performed, and a formation of irregular contours, destroying the right zygomatic bone, was described, measuring 25 x 17 x 20 mm in its widest diameters. Its me- dial border was adjacent to the lateral wall of the right maxillary sinus and the cortical bone in this segment was thinned, but preserved. A probatory excision was performed in general anesthesia, and the histopathological finding showed, star-like tumor cells embedded in mucoid stroma and infiltrating the bone. After pathohistological confirmation of myxoma, the tumor was excised in total, using infraorbital surgical approach to the zygomatic bone. During the follow-up, the patient was symptom free, without headaches, and there were no signs of local tumor recurrence. Despite of the fact that myxoma behaves as a benign disease in its nature, it can cause destruction of the tissue in the vicinity of the tumor itself and thus major health issues for the patient. A timely proper diagnosis and the right choice of a surgical treatment can help avoid more extensive surgery procedures, as shown in our case report.

  18. TRATAMIENTO QUIRÚRGICO URGENTE EN PACIENTE CON MIXOMA AURICULAR IZQUIERDO PEDICULADO / Emergency surgery in a patient with a pedunculated left atrial myxoma

    Directory of Open Access Journals (Sweden)

    Gustavo de Jesús Bermúdez Yera

    2009-12-01

    Full Text Available The intracavitary cardiac tumors have a special place in cardiac surgery due to their peculiar characteristics. Some of them are considered surgical emergencies. The resection must not be delayed because 8 to 10 percent of the affected patients can die, while waiting for surgery, as a result of an intracardiac obstruction of the blood flow. In everyday practice it is not common that patients with cardiac tumors undergo surgery just a few hours after the confirmation of the diagnosis by means of echocardiographic studies. The case of a patient, who had a diagnosis of a large pedunculated left atrial myxoma, with incursion into the left ventricle during diastole, and underwent an emergency surgery due to the threat of fragmentation and embolization resulting from the morphologic characteristics of the tumor, is presented in this article.

  19. Endobronchial myxoma – Case report

    Directory of Open Access Journals (Sweden)

    R. Rolo

    2012-05-01

    Full Text Available Introduction: Pulmonary myxoma is an extremely rare benign neoplasm. It is mostly parenchymal but may occasionally occur within the tracheobronchial tree. There are very few reports of endobronchial myxoma. Case report: We describe a case of endobronchial myxoma in a 40-year-old female patient with a history of asthma and repeated right-sided pneumonia. Thoracic computed tomography (CT showed medium lobe atelectasis. Fiber optic bronchoscopy revealed a polypoid, well-circumscribed tumor, causing total obstruction of the medium lobe bronchus. Biopsy of the mass was non-diagnostic. Further study included a positron emission tomography (PET which demonstrated low metabolic activity of the tumor and no evidence of neoplasia in other location. The patient was submitted to a medium lobectomy and microscopic examination of the tumor revealed myxoid stroma with lobulated pattern, elongated and stellate cells, compatible with myxoma. Conclusion: Pulmonary myxoma is extraordinary rare and endobronchial location is very few reported in medical literature. Resumo: Introdução: Os mixomas pulmonares são tumores benignos muito raros e quase sempre de localização parenquimatosa, mas ocasionalmente podem ocorrer na árvore traqueo-brônquica. Estão descritos raros casos de mixomas pulmonares endobrônquicos na literatura médica. Caso clínico: Doente do sexo feminino, de 40 anos, com história de asma e pneumonias de repetição à direita. A tomografia computadorizada (TC do tórax revelou atelectasia do lobo médio. A broncofibroscopia revelou lesão tumoral polipóide, de limites bem definidos, causando obstrução total do brônquio lobar médio. A biopsia do tumor não foi diagnóstica. A tomografia por emissão de positrões (PET demonstrou atividade metabólica baixa do tumor e ausência de evidência de malignidade noutros locais. A doente foi submetida a lobectomia média e o exame

  20. Surgical management of odontogenic myxoma: a case report and review of the literature.

    Science.gov (United States)

    Kawase-Koga, Yoko; Saijo, Hideto; Hoshi, Kazuhito; Takato, Tsuyoshi; Mori, Yoshiyuki

    2014-04-05

    Odontogenic myxoma is a benign odontogenic tumor with locally aggressive behavior, and is relatively rare in the oral cavity. There are currently no clear surgical management guidelines for odontogenic myxoma, and a variety of approaches may be used. This study evaluated the literature concerning the surgical management of odontogenic myxoma, and reports the long-term outcome of a case managed by using a more conservative surgical approach. We managed a 40-year-old Japanese man with odontogenic myxoma in the right mandible by enucleation and curettage, a relatively conservative approach that has proved to have been justified by a lack of recurrence over 10 years. Our strategy was compared with others reported in the literature, which was identified by a PubMed search using the term "odontogenic myxoma". Articles without full text or with missing data were excluded. The age and sex of patients, the tumor location (maxilla/mandible), treatment (conservative/radical), recurrence, and follow-up period were compared in the reported cases that we evaluated. From the initial 211 studies identified, 20 studies qualified as mandibular cases of odontogenic myxoma. Recurrence was reported in three cases that had been treated with a more conservative surgical approach. Enucleation and curettage has proved an effective approach in several cases in ours there has been no recurrence more than 10 years after surgery but the risk of recurrence appears to be higher. We discuss the important factors that must be considered when determining the correct management approach to odontogenic myxoma.

  1. A Rare Presentation of Conjunctival Myxoma with Pain and Redness: Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Yu-Po Chen

    2012-04-01

    Full Text Available Background: Conjunctival myxoma is a type of rare, benign tumor of mesenchymal cells, with fewer than 30 reported cases in the English literature. It is mostly an isolated occurrence but can sometimes be associated with systemic diseases such as Carney complex or Zollinger-Ellison syndrome. It is necessary in clinical practice to differentiate it from other similar lesions, such as amelanotic nevus, lymphangioma, myxoid liposarcoma, spindle-cell lipoma, myxoid neurofibroma, and rhabdomyosarcoma. Case Presentation: The usual presentation of conjunctival myxoma is a translucent, well-circumscribed, and painless conjunctival mass, but in this report we discuss an unusual case of conjunctival myxoma in a 47-year-old Taiwanese woman who presented initially with pain and redness. This atypical presentation complicated the diagnosis and the management at first. Surgical excision of the mass was performed. The mass was found to be a conjunctival myxoma. The patient subsequently underwent extensive evaluation but was found not to have any systemic diseases with known association with conjunctival myxoma. Conclusions: In summary, we present a case of conjunctival myxoma in a 47-year-old Taiwanese woman. The initial presentation with pain and redness was atypical for conjunctival myxoma. The lesion was successfully managed with complete excisional biopsy.

  2. Myxoma of the kidney - an unusual benign renal tumor: a case report.

    Science.gov (United States)

    Tenkorang, Somuah; Kharbach, Youssef; Omana, Jean-Paul; Efared, Boubacar; Mellas, Soufiane; Tazi, Mohammed Fadl; Sekal, Mohamed; Harmouch, Taoufik; Khallouk, Abdelhak; El Fassi, Jamal Mohammed; El Ammari, Jalal Eddine; Farih, Moulay Hassan

    2017-02-14

    Myxomas are rare benign soft tissue tumors. The kidney is an unusual location for this tumor. For this reason, less than 15 cases of renal myxoma have been reported in the English literature. There are no specific clinical and radiological features reported for this tumor that allow a preoperative diagnosis enabling a conservative treatment. We report another case of renal myxoma found in a 50-year-old Moroccan woman who presented with a right dull flank pain. An abdominal computed tomography scan objectified a suspected malignant renal mass. Thus, radical nephrectomy was performed. Histopathology of the specimen revealed the typical appearance of a myxoma. The objective of this report is to add another case report of this rare benign renal tumor to the literature. This benign tumor with excellent prognosis has no specific preoperative features that could justify a conservative management; a radical approach remains the therapeutic option for now.

  3. Intramuscular myxoma associated with an increased carbohydrate antigen 19.9 level in a woman: a case report

    OpenAIRE

    Toutouzas Kostas; Larentzakis Andreas; Drimousis Panagiotis G; Doulami Georgia I; Kleidi Eleftheria S; Theodorou Dimitrios; Katsaragakis Stylianos

    2011-01-01

    Abstract Introduction Intramuscular myxoma is a rare benign soft tissue tumor. The lack of specific symptoms and widely used laboratory tests makes the diagnosis quite difficult. We present a case of an Intramuscular myxoma associated with an increased carbohydrate antigen 19.9 level. To the best of our knowledge, there have not been any reported cases of an association of Intramuscular myxoma with tumor markers in the literature. Case presentation A 45-year-old Caucasian woman presented to o...

  4. Atypical vessels as an early sign of intracardiac myxoma?

    Science.gov (United States)

    Dübel, Hans-Peter; Knebel, Fabian; Gliech, Volker; Konertz, Wolfgang; Rutsch, Wolfgang; Baumann, Gert; Borges, Adrian Constantin

    2004-01-01

    We report on a woman with previously unknown left atrial myxoma, who underwent percutaneous coronary intervention. 45 months after the initial coronary angiography, echocardiography demonstrated a large atrial myxoma, which was not seen echocardiographically before. The retrospective analysis of the pre-intervention coronary angiography revealed atypical vessels in the atrial septum, which are interpreted as early signs of myxoma. PMID:15310408

  5. Oncologic profile of maxillary odontogenic myxoma: A rare case

    Directory of Open Access Journals (Sweden)

    Reena Radhikaprasad Sarkar

    2013-01-01

    Full Text Available Odontogenic myxoma (OM is an ectomesenchyme derived neoplasm, almost exclusively found in jaws. This article presents a maxillary OM with a brief review of the molecular and proteomic antecedents of OMs, capturing its histopathogenesis.

  6. Odontogenic myxoma with diffuse calcifications: a case report and review of a rare histologic feature.

    Science.gov (United States)

    Hammad, Huda M; Hasen, Yousef M; Odat, Abd-Albaset M; Mikdadi, Abeer M; Safadi, Rima A

    2016-10-01

    Calcifications have been rarely reported in odontogenic myxoma. We describe here an additional case and review all reported cases. A 45-year-old female patient presented with a gingival swelling around a mobile mandibular left second molar. Radiographic investigation revealed a large multilocular radiolucent lesion of the posterior mandible. Microscopic examination revealed an odontogenic myxoma with numerous newly formed trabeculae of bone or cementum-like material present throughout the specimen, reminiscent of those seen in fibro-osseous lesions of the jaws. After total excision, regular follow-up of the patient showed gradual healing of the surgical defect. To our knowledge, only a few documented cases of odontogenic myxoma with calcifications have been reported in the literature. This histopathologic finding is rare but should not lead to the misdiagnosis of a central odontogenic fibroma, cemento-ossifying fibroma, fibro-osseous lesion, or low-grade osteosarcoma. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Clinical manifestation and surgical treatment analysis of five cases with biatrial myxoma.

    Science.gov (United States)

    Liu, Dong; Dong, Ran

    2017-02-01

    Cardiac myxomas (CMs) are a major primary heart tumor which often causes unexpected symptoms or sudden death. Among CMs, biatrial myxomas are even rare. This study was designed to investigate the clinical characteristics and surgical treatment of 5 cases with biatrial myxoma, to summarize the treatment experience and the effect of short-to-mid-term prognosis. Five patients with biatrial myxoma were included in this study. The patients' relative literature, chest X-ray, body-surface electrocardiogram, and ultrasonic cardiogram (UCG) were used to investigate the clinical characteristics. The experience of surgical treatment and perioperative treatment were analyzed. Among the 5 cases, patients had presented discomfort of precordial area and cardiac insufficiency symptoms such as dyspnea and chest discomfort. There were characteristic changes on echocardiography (ECG). All patients accepted resection of both tumor and its basement tissue. Their symptoms were all improved after surgery, no deaths occurred. In conjunction with clinical features, diagnostic clue and echocardiography, the detectable rate of biatrial myxoma could be significantly improved. Early diagnosis showed good effect on prognosis. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  8. Asymptomatic Left Ventricular Myxoma in a 12-Year-Old Male.

    Science.gov (United States)

    Chlebowski, Meghan; O'Brien, James; Hertzenberg, Casey; Wagner, Jonathan

    2016-06-01

    Cardiac myxoma is the most common cardiac tumor in patients of all ages; the majority are encountered as single left atrial tumors. Left ventricular myxomas are exceedingly rare, having been recorded in a small number of case reports involving children worldwide. We report a case of a left ventricular myxoma with left ventricular outflow tract obstruction in a previously healthy, asymptomatic adolescent black male. Transthoracic echocardiograms revealed a single, large (2.5 × 5-cm), lobulated, mobile mass within the left ventricular cavity that oscillated into the outflow tract, thereby causing moderate obstruction during systole. Advanced images delineated the location and tissue composition of the mass, characterizing it as a myxoma. Complete surgical excision of the mass was accomplished via aortotomy. Gross examination and histology confirmed the diagnosis of myxoma.

  9. Intramuscular myxoma

    Energy Technology Data Exchange (ETDEWEB)

    McCook, T.A.; Martinez, S.; Korobkin, M.; Ram, P.C.; Breiman, R.S.; Gehweiler, J.A.; Bowen, J.H.; Harrelson, J.M.; Harrelson, J.M.

    1981-10-01

    Two patients with intramuscular myxoma (IMM) were evaluated preoperatively using radiography and computed tomography (CT). In both patients CT demonstrated a homogeneous mass with an attenuation value (density) slightly greater than water but less than surrounding muscle. Dystrophic amorphous calcification, previously unreported in this condition, was present in one case. The differential diagnosis of low density intramuscular masses is discussed.

  10. Arrhythmias are not to blame for all cardiac syncope patients: left atrial myxoma causing syncope in a middle-aged man.

    Science.gov (United States)

    Rajani, Ali Raza; Muaz, Reem Naif; Govindaswamy, Pushpa Rani; Mian, Muhammad Hamid

    2015-04-15

    A 47-year-old man presented with a history of syncope that lasted for 3 min and was not accompanied by jerky movement of limbs or incontinence. After regaining consciousness, he felt generalised weakness. There was no history of chest pain or palpitation. ECG showed normal sinus rhythm. All blood investigations were normal. Transthoracic echocardiography showed a large multilobulated echo dense mass in the left atrium. The mass was prolapsing through the mitral valve during diastole. Transoesophageal echocardiography verified these findings and also showed the stalk of the mass attached to the interatrial septum near the fossa ovalis. The mass was highly suggestive of myxoma. The patient underwent surgical resection of the mass and histopathology confirmed the diagnosis of left atrial myxoma. 2015 BMJ Publishing Group Ltd.

  11. Fibrous dysplasia of bone associated with soft-tissue myxomas as well as an intra-osseous myxoma in a woman with Mazabraud's syndrome: a case report

    NARCIS (Netherlands)

    Wal, W.A. van der; Unal, H.; Rooy, J.W.J. de; Flucke, U.E.; Veth, R.P.H.

    2011-01-01

    ABSTRACT: INTRODUCTION: Mazabraud's syndrome is a rare but well-described disorder characterized by fibrous dysplasia in single or multiple bones associated with one or more soft-tissue myxomas. In this report, we describe what is, to the best of our knowledge, the first case involving an

  12. [Myxoma Originating from the Tricuspid Annulus Requiring Annular Reconstruction and Valve Replacement;Report of a Case].

    Science.gov (United States)

    Hattori, Masashi; Matsumura, Yu; Yamaki, Fumitaka

    2016-07-01

    A 66-year-old woman who had had coughing and worsening dyspnea for 3 weeks was admitted to our hospital. Echocardiography showed a solid round mass (72×49 mm in diameter) attached to the tricuspid septal annulus with a short stalk. A right atrial myxoma was suspected and operation was performed under cardiopulmonary bypass after heart failure symptoms subsided. The tumor was extirpated along with the tricuspid valve annulus. We performed reconstruction of the tricuspid annulus, tricuspid valve replacement with a bioprosthetic valve and pacemaker implantation. The histopathologic diagnosis was myxoma. The postoperative course was uneventful, and no recurrence has been noted for 1 year after surgery.

  13. An unusual case of mesenteric ischemia in a patient with cardiac myxoma.

    Science.gov (United States)

    Pérez Baztarrica, Gabriel; Bornancini, Norberto; Salvaggio, Flavio; Porcile, Rafael

    2013-01-01

    Symptoms related to peripheral embolism are experienced in 2%-15% of cases of cardiac myxoma. We present a rare case of a 54-year-old man admitted due to sudden abdominal pain. A computed tomography (CT) scan showed occlusion of the superior mesenteric artery (SMA). As the patient's response to support treatment was favorable, a non-invasive approach was adopted, with prescription of oral anticoagulation (OAC) therapy. Transesophageal echocardiography revealed a tumor in the left atrium. The cardiac mass was completely removed and diagnosed as myxoma by histopathological analysis. As periodic CT scans showed progressive improvement of blood flow through the SMA, OAC was continued. OAC may have been beneficial due to the nature of emboli originating from a cardiac myxoma: thrombi covering the surface of the tumor. At present, there is no explanation in the literature for the benefits of OAC in patients with embolism associated with cardiac myxoma. Copyright © 2012 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

  14. Mixossarcoma atrial esquerdo: relato de caso Left atrial myxosarcoma: case report

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    Vinicius José da Silva Nina

    2006-03-01

    Full Text Available O mixossarcoma é uma forma rara de neoplasia cardíaca primária de difícil diferenciação clínica e patológica com o mixoma. Até onde os autores têm conhecimento, este é o primeiro relato de caso na literatura nacional indexada com o tratamento cirúrgico do mixossarcoma atrial esquerdo, em paciente do sexo feminino, de 36 anos de idade, cuja evolução pós-operatória tem sido satisfatória, encontrando-se em classe funcional I (NYHA e em remissão do processo tumoral há mais de 180 dias.Primary cardiac myxosarcoma is a very rare disease and is difficult to differentiate from myxoma, both clinically and pathologically. In this study, the authors report the first case of surgical excision of left atrial myxosarcoma in Brazil, in a 36-year-old woman. The operation was sucessful, and the patient remains asymptomatic for more than 180 postoperative days (Functional Class I - NYHA, with no signs of relapse of the tumor.

  15. Conjunctival myxoma - atypical presentation of a rare tumour: case report and review of literature.

    Science.gov (United States)

    Sharma, Neharika; O'Hagan, Stephen; Phillips, Gael

    2016-05-13

    Conjunctival myxomas are rare, benign, connective tissue tumours that classically present as slow-growing, painless, well-circumscribed masses (Arch Ophthalmol 124:735-8, 2006; Case Rep Ophthalmol 3:145-50, 2012). There have been 29 cases reported in the literature (Arch Ophthalmol 124:735-8, 2006; Malays J Med Sci 20(1):92-4, 2013; Case Rep Ophthalmol 3:145-50, 2012; Middle East Afr J Ophthalmol 19(3):353-3, 2012). We present a case with atypical features, and emphasize the importance of excisional biopsies for diagnosing indeterminate conjunctival lesions. A 32 year old Korean woman presented with a 5 mm × 7 mm × 3 mm pedunculated firm cystic lesion on the inferior palpebral conjunctiva of her right lower eyelid. The lesion had rapidly enlarged over the course of a week. She gave a history of uncomplicated bilateral epiblepharon correction performed in Korea three months prior. There were no systemic features, or family history of genetic conditions. The lesion was excised under local anaesthesia and reported to be a conjunctival myxoma. The clinical and histopathological features of this lesion were consistent with previous reports on conjunctival myxoma (Arch Ophthalmol 124:735-8, 2006; Arch Ophthalmol 101:1416-20, 1983; Case Rep Ophthalmol 3:145-50, 2012; Am J Ophthalmol 102(1):80-84, 1986). The unusual features of this case were, the rapid growth of the lesion - with the previously documented mean time before presentation being 34 months (range 3 months - 24 years) (Arch Ophthalmol 124:735-8, 2006; Case Rep Ophthalmol 3:145-50, 2012); the location of the lesion in the inferior palpebral conjunctiva - 93 % of previously reported cases had occurred in the bulbar conjunctiva (Arch Ophthalmol 124:735-8, 2006; Case Rep Ophthalmol 3:145-50, 2012); and its occurrence in association with recent eyelid surgery - which has never been reported. This case of conjunctival myxoma adds to the small number of documented cases, by demonstrating an atypical

  16. Case report

    African Journals Online (AJOL)

    ebutamanya

    2016-06-14

    Jun 14, 2016 ... Cerebral embolism complicating left atrial myxoma: a case report. Zairi Ihsen1,&, Mssaad Hela2, Mzoughi ... Key words: Cardiac tumor, surgery, pediatric, atrium. Received: 03/05/2016 - Accepted: ... large tumor occupying the left atrium, very mobile, measuring 5cm long strongly mimicking a myxoma ...

  17. Cardiac myxoma with glandular elements: a clinicopathological and immunohistochemical study of five new cases with an emphasis on differential diagnosis.

    Science.gov (United States)

    Zhang, Minghui; Ding, Li; Liu, Yanhui; Xue, Ling

    2014-01-01

    This paper reported five new cases of cardiac myxoma with glandular components, known as glandular cardiac myxoma. The goals of this study were to analyze the clinicopathological features of this disease and to explore new features for differential diagnosis. The patient series included three women and two men. All tumors were located in the left atrium without invasion of the adjacent myocardium. Patients presented with cardiac-related or embolization symptoms. Histologically, neoplasms consisted of well-formed glandular structures and typical myxoma areas. No nuclear atypia, mitosis, or necrosis was identified in the glandular structures. Glandular lining cells were strongly positive for pan-cytokeratin, epithelial membrane antigen, CAM5.2 and cytokeratin 7, but were negative for some organ-specific markers, such as thyroid transcription factor-1, calretinin, estrogen receptor, progesterone receptor, gross cystic disease fluid protein, prostate-specific antigen, prostate-specific acid phosphatase, cytokeratin 20 and caudal type homeobox 2. In conclusion, glandular cardiac myxoma is a rare disease which shows characteristics similar to those of classical cardiac myxoma. Because of its rarity, glandular cardiac myxoma must be distinguished from adenocarcinoma metastatic to the heart. The combination of histopathological features and immunohistochemical profiles should improve the diagnostic accuracy of glandular cardiac myxoma. Copyright © 2013 Elsevier GmbH. All rights reserved.

  18. Myxoma of the orbit.

    Directory of Open Access Journals (Sweden)

    Rambhatla Saptagirish

    2003-01-01

    Full Text Available Myxomas are rare, benign neoplasms of mesenchymal origin that usually develop in soft tissues. As the clinical manifestations are non-specific, it is difficult to diagnose the tumour without biopsy and histopathological examination. We report a case of orbital myxoma with histopathological correlation.

  19. LEFT ATRIAL MYXOMA: CASE REPORT AND LITERATURE REVIEW

    African Journals Online (AJOL)

    2011-02-02

    Feb 2, 2011 ... across the mitral valve during diastole, moderate pulmonary hypertension and normal left ventricular systolic function. Patient underwent surgery with cardiopulmonary bypass under moderate systemic hypothermia, with a tumour measuring 9 x 6 x 5 cm. (Fig 1) resected via a transseptal approach, following.

  20. A case of a resected benign myxoma-like hemorrhagic cyst, which later recurred as undifferentiated pleomorphic sarcoma in the left atrium.

    Science.gov (United States)

    Kim, Eunju; Choi, Seo-Won; Min, Daniel; Kim, Sang Hoon; Yang, Woo-In; Moon, Jae Youn; Sung, Jung Hoon; Kim, In Jai; Lim, Sang-Wook; Cha, Dong-Hun; Moon, Byung; Cho, Sang-Ho; Kim, Won-Jang

    2017-04-01

    An intracardiac cystic mass is a rare type of mass found in the left atrium. The differential diagnosis of an intracardiac cystic mass includes hydatid cysts, bronchogenic cysts, intracardiac varices, and hemorrhages in some tumor types, including myxoma. We present the case of a 68-year-old woman who presented with episodic dyspnea. Transthoracic echocardiography (TTE) revealed the presence of a left atrial mass mimicking myxoma. However, in postoperative findings, it was determined that the mass was actually a hemorrhagic cyst. Eighteen months later, the patient presented with recurrent exertional dyspnea and TTE revealed the recurrence of a left atrial mass. Computed tomography showed that the mass extended into the right atrium, inferior vena cava, and coronary sinus. After re-operation, the final histological diagnosis was determined to be an undifferentiated pleomorphic sarcoma in the left atrium. An intracardiac hemorrhagic cyst was suspected during the operation of a benign-looking LA mass. As such, we recommend that other rare etiologies be considered and more biopsies be performed when possible.

  1. Mixoma em átrio esquerdo associado a doença arterial coronariana obstrutiva Left atrial myxoma associated with obstructive coronary artery disease

    Directory of Open Access Journals (Sweden)

    Ronaldo Altenburg Odebrecht Curi Gismondi

    2007-01-01

    Full Text Available Descrevemos o caso de um paciente de 67 anos, portador de doença arterial coronariana obstrutiva, o qual, em avaliação pré-operatória para cirurgia de herniorrafia inguinal, realizou ecocardiograma demonstrando um volumoso tumor em átrio esquerdo, móvel, não-obstrutivo, com pedículo proveniente da veia pulmonar superior direita. O paciente realizou cineangiocoronariografia com ventriculografia esquerda, evidenciando lesão obstrutiva grave em terço médio da artéria descendente anterior, moderada em terço proximal da artéria circunflexa, no local de saída do primeiro ramo marginal, e coronária direita com lesão não-obstrutiva em terço distal. Havia, ainda, disfunção ventricular esquerda moderada. O paciente foi então submetido a cirurgia para retirada do tumor e revascularização do miocárdio. O exame histopatológico mostrou tratar-se de um mixoma.We describe a case of a 67 year-old patient with obstructive coronary artery disease that, in the preoperative survey for inguinal herniorraphy surgery, discovered, by a two-dimensional echocardiogram, a tumor in left atrium, mobile, non-obstructive. The patient underwent a cineangiocoronariography showing severe stenosis in the left anterior descending artery, moderate stenosis in the left circumflex artery, near the origin of the first marginal branch, and a non-obstructive plaque in the right coronary artery. There was also moderate left ventricular dysfunction. After that, the patient has gone coronary artery bypass surgery and resection of the left atrial tumor. The histological exam revealed that the tumor was, in fact, a myxoma.

  2. Three years follow-up after cryoablation of a right atrial myxoma arising from the Koch's triangle.

    Science.gov (United States)

    Wauthy, P; Mircev, D; Marinakis, S

    2016-11-22

    We reported 3 years ago the use of cryoablation in the treatment of a right atrium myxoma arising from the Koch's triangle. The atrioventricular conduction was successfully preserved. Today, after 3 years follow-up, the patient remains with a conducted sinus rhythm and is free of recurrence. Even if extensive resection of the stack of the myxoma remains the first choice attitude, cryoablation could be considered as a serious second choice alternative.

  3. Radiological Characteristics and Management of Intramuscular Myxoma of the Temporal Muscle: Case Report

    Science.gov (United States)

    HIGASHIDA, Tetsuhiro

    2014-01-01

    The patient was a 51-year-old male with a 3-year history of a slow-growing, asymptomatic, subcutaneous mass in the left temporal region. Magnetic resonance imaging revealed a well-defined extracranial lesion with heterogeneous enhancement and without invasion of the skull. A variety of soft tissue tumors were included in the differential diagnosis. The patient underwent total resection of the tumor, and a diagnosis of intramuscular myxoma was confirmed histologically. There was no evidence of recurrence at 6-month follow-up. The present case is the first characterization of the radiological appearance of intramuscular myxoma in the temporal muscle. I emphasize that increased awareness of this rare lesion and a careful clinical and radiological preoperative assessment are crucial in determining an appropriate treatment strategy for patients with a soft tissue tumor of the head. PMID:24418787

  4. The Unusual Presentation of a Myxoma Within the Sphenoid Sinus: Case Report and Review of the Literature.

    Science.gov (United States)

    Clarke, Julian V; Mandpe, Aditi H; Weber, Peter B; Vogel, Hannes; Leng, Lewis Z

    2017-07-01

    We describe a rare case of a sphenoid sinus myxoma that was resected via an endoscopic endonasal skull base approach. We review the literature regarding these rare tumors of the paranasal sinuses. A 72-year-old woman was diagnosed with an incidental sphenoid sinus tumor and left sphenoid wing meningioma during a workup for left-sided proptosis and diplopia. Biopsies of the sphenoid wing and sphenoid sinus tumors were obtained. After undergoing surgical resection of the meningioma, the patient then underwent definitive resection of the sphenoid sinus myxoma via endoscopic endonasal skull base approach. Postoperative imaging demonstrated a gross total resection. The patient suffered postoperative thromboembolic complications due to underlying hypercoagulable state but made a complete recovery and returned to her neurologic baseline. There has been no evidence of recurrent myxoma in the sphenoid sinus 24 months after surgery. Myxomas are benign tumors derived from primitive mesenchyme. Myxomas very rarely present in the paranasal or skull base location. Complete surgical resection is the primary treatment for these tumors. The endoscopic endonasal approach is an effective technique for resecting various benign and more aggressive extradural skull base tumors. Myxomas of the sphenoid sinus are rare. The endoscopic endonasal skull base approach is an effective and minimal access technique for resection of this rare tumor of the sphenoid sinus. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Peripheral odontogenic myxoma

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    Sanober Tasnime

    2016-01-01

    Full Text Available Odontogenic myxomas are a rare benign odontogenic mesenchymal tumor found exclusively in the tooth-bearing area of the jaw and are usually located centrally in the mandible. Soft tissue localization is rarely seen and is classified as peripheral odontogenic myxoma (POM. POM is slow growing and less aggressive as compared to central myxoma. It has a low recurrence rate, comprises 3-6% of all odontogenic tumors. Only a few cases of POM on maxillary gingiva are reported in the literature. Here, we present an unusual case of primary POM occurring in the gingiva of anterior maxilla in a 14-year-old female patient.

  6. Peripheral odontogenic myxoma.

    Science.gov (United States)

    Tasnime, Sanober; Saxena, Chitrapriya; Bansal, Vishal; Wadhwan, Vijay

    2016-01-01

    Odontogenic myxomas are a rare benign odontogenic mesenchymal tumor found exclusively in the tooth-bearing area of the jaw and are usually located centrally in the mandible. Soft tissue localization is rarely seen and is classified as peripheral odontogenic myxoma (POM). POM is slow growing and less aggressive as compared to central myxoma. It has a low recurrence rate, comprises 3-6% of all odontogenic tumors. Only a few cases of POM on maxillary gingiva are reported in the literature. Here, we present an unusual case of primary POM occurring in the gingiva of anterior maxilla in a 14-year-old female patient.

  7. Cirurgia cardíaca de emergência para ressecção de mixoma atrial esquerdo Cardiac surgery of emergency for resection of left atrial myxoma

    Directory of Open Access Journals (Sweden)

    Antônio Augusto Ramalho Motta

    2008-06-01

    Full Text Available É descrito caso de paciente do sexo feminino que apresentava manifestações pulmonares e sistêmicas inespecíficas há vários meses, as quais resultaram em várias internações hospitalares com a hipótese diagnóstica de fibrose pulmonar. Estudo ecocardiográfico evidenciou a presença de grande mixoma pediculado no átrio esquerdo, que prolapsava, através da valva mitral, para o ventrículo esquerdo. Em condições clínicas bastante desfavoráveis, a paciente foi encaminhada ao nosso Serviço para tratamento cirúrgico, evoluindo durante o preparo pré-operatório com edema agudo pulmonar e instabilidade hemodinâmica, sendo submetida a cirurgia de emergência, com sucesso, para ressecção da tumoração. A paciente encontra-se assintomática.We report case of a female patient who during months presented pulmonary manifestation associated with nonspecific systemic symptoms resulting in several hospitalizations with the diagnostic hypothesis of pulmonary fibrosis. The echocardiographic study showed a great pedunculated left atrial myxoma prolapsing through the mitral valve for the left ventricle. In quite unfavorable clinical conditions the patient was sent to our Service for surgical treatment, evolving during the preparation for surgery with acute pulmonary edema and hemodinamic instability being submitted to a successfully surgery of emergency for resection of the tumor. The patient is asymptomatic.

  8. Intramuscular myxoma associated with an increased carbohydrate antigen 19.9 level in a woman: a case report

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    Toutouzas Kostas

    2011-05-01

    Full Text Available Abstract Introduction Intramuscular myxoma is a rare benign soft tissue tumor. The lack of specific symptoms and widely used laboratory tests makes the diagnosis quite difficult. We present a case of an Intramuscular myxoma associated with an increased carbohydrate antigen 19.9 level. To the best of our knowledge, there have not been any reported cases of an association of Intramuscular myxoma with tumor markers in the literature. Case presentation A 45-year-old Caucasian woman presented to our department for resection of a mass in her left groin area, discovered incidentally on a triplex ultrasonography of her lower extremities. The diagnosis of Intramuscular myxoma was confirmed on histopathology after the complete surgical excision of the tumor. On laboratory examination, the serum level of carbohydrate antigen 19.9 was found to be elevated, but it returned to normal six months after resection of the mass. Conclusion Carbohydrate antigen 19.9 is a tumor marker that increases in a variety of malignant and benign conditions. After the exclusion of all other possible reasons for carbohydrate antigen 19.9 elevation, we assumed a possible connection of carbohydrate antigen 19.9 elevation and Intramuscular myxoma, an issue that requires needs further investigation.

  9. Treatment of Odontogenic Myxoma: A Multidisciplinary Approach—6-Year Follow-Up Case

    Directory of Open Access Journals (Sweden)

    João Gustavo Oliveira de Souza

    2014-01-01

    Full Text Available The most aggressive diseases that affect the oral environment are considered tumors of the jaw. The surgical treatment is preferably done by surgical resection of the lesion, resulting in a great loss of tissue and esthetics. Multidisciplinary planning is required for the rehabilitation of these cases. Autogenous grafting techniques or vascularized flaps allow ridge reconstruction for implant placement, restoring function, and esthetics. This paper reports a 6-year follow-up case of an odontogenic myxoma treated with wide resection and mandibular bone reconstruction for posterior rehabilitation with dental implants.

  10. [Maxillary sinus myxoma].

    Science.gov (United States)

    Niedzielski, Artur; Partycka-Pietrzyk, Kornela; Brodzisz, Agnieszka; Walczyna, Beata; Mielnik-Niedzielska, Grażyna

    2016-07-29

    Myxoma is a slow growing, benign neoplasm, which pathogenesis still remains disputed. The lesion has well-defined borders but a true capsule is absent. Because of that myxoma can be locally invasive causing bone destruction. A change is mainly observed among persons between 20-30 years of age and is very uncommon in the pediatric population. Most myxomas are observed in myocardium, but rarely may also manifest in the head and neck region. In the paper we describe an unusual case of myxoma of maxillary sinus in a female infant. Diagnostic challenges, treatment, outcome, post-operative follow-up are discussed as well as a review of the literature in order to present many features of this rare pathology. © 2016 MEDPRESS.

  11. Maxillary bone myxoma.

    Science.gov (United States)

    Zainine, R; Mizouni, H; El Korbi, A; Beltaief, N; Sahtout, S; Besbes, G

    2014-09-01

    Maxillary bone myxoma is a rare benign mesenchymal tumor, slow-growing but locally aggressive. Pathogenesis remains disputed. To study the clinical, radiological and histological features and treatment of maxillary myxoma, based on a pediatric case report. An infant of two and a half months presented with endonasal tumor extending to ethmoid. Surgical excision was performed on an endonasal approach. Myxoma was diagnosed by histologic examination of the surgical specimen, whereas initial biopsy had suggested fibrous dysplasia. No recurrence was observed after two and a half years' surveillance. Positive diagnosis of maxillary myxoma is histological. Treatment is primarily surgical. Strict long-term surveillance is required because of the high risk of recurrence. Copyright © 2013. Published by Elsevier Masson SAS.

  12. Association between herpes simplex virus Types 1 and 2 with cardiac myxoma.

    Science.gov (United States)

    Anvari, Maryam Sotoudeh; Sabagh, Moud; Goodarzynejad, Hamidreza; Ziaei, Shayan; Boroumand, Mohammad Ali; Pourgholi, Leyla; Jenab, Yaser; Abbasi, Kyomars

    Most cases of atrial myxoma are sporadic, and the exact etiology is unknown. We examined if herpes simplex virus (HSV)-1 and HSV-2 antigens and/or DNA could be detected in a cohort of Iranian patients with cardiac myxomas. From July 2004 to June 2014, among a total of 36,703 patients undergoing open heart surgeries, consecutive patients with cardiac myxoma who were treated by surgical excision at our center included in this study. Of 73 patients studied, 56% were female with a mean age of 54 years (ranging from 23 to 77 years). Seventy-four myxomas were surgically removed from 73 patients, since one patient had two myxomas which were located on both the right atrium and right ventricle. The materials for this analysis were retrospectively gathered from extracted tumors that stored in a pathology bank of tissue paraffin blocks. The formalin fixed paraffin embedded tissue samples were investigated for HSV genomic DNA by both immunohistochemistry (IHC) and polymerase chain reaction (PCR) analysis. In all 74 cases there was no presence of HSV 1 and HSV 2 infection. This suggests that HSV may not play a role in sporadic cardiac myxomas; however, evidence for such association is currently lacking, and further studies are required to determine such a role. Copyright © 2016. Published by Elsevier Inc.

  13. Myxoma of the Left Ventricle

    Science.gov (United States)

    Novoa, José; Delgado, Antonio; Alonso, Ana

    2014-01-01

    This report concerns a 69-year-old woman who presented with an asymptomatic myxoma in the left ventricle. The tumor was successfully excised. We provide a very brief review of 72 other published cases of surgically treated left ventricular myxoma. PMID:25120392

  14. Odontogenic Myxoma of the Mandible

    Directory of Open Access Journals (Sweden)

    Rakesh Kumar Manne

    2012-01-01

    Full Text Available Odontogenic myxomas are benign but locally aggressive neoplasms found almost exclusively in the jaws and arise only occasionally in other bones. We present a rare case of odontogenic myxoma occurring in the mandible of a 19-year-old male patient with a brief review of clinical and radiological features, and diagnostic and operative dilemmas in managing the same.

  15. [Histopathological and immunohistochemical features of cardiac myxomas].

    Science.gov (United States)

    Hernández-Bringas, Omar; Ortiz-Hidalgo, Carlos

    2013-01-01

    Mixomas are the most common primary cardiac tumors with an estimate incidence of 0,5-1 per 10(6) individuals per year. These tumors have generated interest due to their unique location (left side of the atrial septum near the fossa ovalis), variable clinical presentation and undefined histogenesis. Most cardiac myxomas occur sporadically while approximately 10% of diagnosed cases develop as part of Carney complex. This neoplasm is of uncertain histogenesis, however, endothelial, neurogenic, fibroblastic, and cardiac and smooth muscle cells differentiation has been proposed, and rarely glandular differentiation has been observed. Recently, due to the expression of certain cardiomyocyte-specific factors, an origin of mesenchymal cardiomyocytes progenitor cells has been suggested. Histologically cardiac myxomas are mainly composed of stellated, fusiform and polygonal cells, immersed in an amorphous myxoid matrix. Immunohistochemically some endothelial markers, such as CD31, CD34, FVIIIAg, are present. Positive staining has also been reported for S-100 protein, calretinin, vimentin, desmin, smooth muscle myosin, CD56, α1 antitrypsin and α 1antichymotrypsin. Surgical resection is currently the only treatment of choice. We present in this article a histopathological and immunohistochemical review of cardiac myxomas. Copyright © 2012 Instituto Nacional de Cardiología Ignacio Chávez. Published by Masson Doyma México S.A. All rights reserved.

  16. Mixoma de átrio esquerdo associado a derrame pleural Left atrial myxoma associated with pleural effusion

    Directory of Open Access Journals (Sweden)

    Enoch Brandão de Souza MEIRA

    2000-09-01

    Full Text Available Homem de 65 anos apresentando emagrecimento, dispnéia e derrame pleural (DP recorrente. A avaliação cardiológica evidenciou ruflar diastólico (3/6 no foco mitral e hiperfonese da 1ª bulha. O ecocardiograma e o estudo hemodinâmico mostraram uma grande massa tumoral no átrio esquerdo (AE, sugerindo mixoma e hipertensão pulmonar. A biópsia pleural revelou pleurite crônica inespecífica. O paciente foi submetido à operação com circulação extracorpórea para exérese do tumor de AE e o estudo histopatológico confirmou o diagnóstico de mixoma. O DP tem sido manifestação muito rara do mixoma cardíaco (MC, que às vezes apresenta somente sinais e sintomas inespecíficos de doença inflamatória crônica.A 65-year-old man, presented with weight loss, dyspnea and recurrent pleural effusion. Cardiac evaluation showed a (3/6 diastolic rumble at the apex and accentuated 1st heart sound. Echocardiogram evaluation and hemodynamic study revealed a large mass within the left atrium (LA, suggesting a myxoma and pulmonary hypertension. Open heart surgery was performed and a large LA tumor excised, histopathology confirmed the diagnostic of myxoma. Pleural effusion has been a very rare manifestation of cardiac myxoma, that sometimes presents unspecific signs only and symptoms of chronic inflammatory disease.

  17. Cardiac Myxoma With Unusual Obstructive and Embolic Presentations

    Science.gov (United States)

    Chen, Robert Jeen-Chen; Chou, Hsin-Hua; Tsai, Kuei-Ton; Shen, Ta-Chung; Hu, Chin-Yuan

    2015-01-01

    Abstract We present a case of cardiac myxoma with atypical presentations of concurrent stroke and angiography-negative myocardial infarction. The case emphasizes the importance of basic echocardiography and timely surgery in the management of cardiac myxoma. An elderly woman presented to the emergency department in an unconscious state. Electrocardiogram and elevated cardiac enzymes suggested acute myocardial infarction; however, immediate coronary angiography proved patency. Basic echocardiography revealed an oscillating left atrial myxoma obstructing inflow through the mitral valve. After regaining consciousness while in the intensive care unit, the patient developed respiratory distress and shock, and emergent en bloc resection was performed. Ataxia was noted in her postoperative course and multiple small cerebellar infarcts were found on magnetic resonance imaging. After a 1-month period of rehabilitation, the patient recovered well and continues to be followed as an outpatient. Cardiac myxoma requires timely management and may be missed if not included in the differential diagnoses. Basic echocardiography, also called focused cardiac ultrasound, may aid in the diagnosing of perplexing cardiac cases. PMID:26402823

  18. Cerebral infarction due to cardiac myxoma developed with the loss of consciousness immediately after defecation-a case report.

    Science.gov (United States)

    Ikeda, Toshimasa; Oomura, Masahiro; Sato, Chikako; Anan, Chise; Yamada, Kentaro; Kamimoto, Kaoru

    2016-05-31

    A 74-year-old man lost consciousness immediately after defecation. The loss of consciousness lasted for several minutes, and he experienced difficulty in walking when he regained consciousness. He was transferred to our hospital via an ambulance. Upon neurological examination, nystagmus and ataxia in the left arm and leg were noted. An MRI of the brain revealed multiple acute infarcts mainly in the bilateral cerebellum. Intravenous thrombolytic therapy with alteplase was initiated 3 h and 20 min after the onset of symptoms, and an improvement in neurological symptoms was observed. Echocardiography displayed a mobile mass in the left atrium, suggesting myxoma. After 14 days from the onset of symptoms, the tumor was surgically resected, and a pathological diagnosis of myxoma was established. Because of the unique event surrounding the onset in this case, we considered that there was a potential detachment of myxoma and/or thrombi fragments triggered by an increase in intrathoracic pressure induced by the action of defecation. This present case suggests that clinicians should consider cardiac myxoma in patients with cerebral infarction if the stroke is preceded by a Valsalva maneuver-like action and accompanied by the loss of consciousness.

  19. Novel Association of Odontogenic Myxoma with Constitutional Chromosomal 1q21 Microduplication: Case Report and Review of the Literature.

    Science.gov (United States)

    Best-Rocha, Alejandro; Patel, Kalyani; Hicks, John; Edmonds, Joseph L; Paldino, Michael J; Wu, Hao

    2016-01-01

    Odontogenic myxoma (OM) is a rare, benign, and locally aggressive tumor. It tends to occur in the posterior maxilla and mandible and is often associated with root resorption and perforation of cortex. Histopathologically, there is a proliferation of spindle, bipolar, and stellate cells, with bland nuclei within a myxoid to infrequently fibromyxoid extracellular matrix. Long, thin residual bony trabeculae are often seen floating within the spindle cell proliferation because of the infiltrating nature of this tumor, and these trabeculae impart a "soap bubble" or "tennis-racket" radiologic appearance. No syndromic association of OM has been reported. Although similar histopathologic features are shared with cardiac myxoma and soft tissue myxoma, mutations in the GNAS gene have not been identified in OM to date, and only 2 of 17 OMs showed mutations in the PRKAR1A gene. In this report, we describe a case of OM in a patient with constitutional 1q21 microduplication, a locus that harbors genes encoding certain proteins in the cAMP-dependent protein kinase A (PKA) signaling pathway, including G-protein-coupled receptors and 1 phosphodiesterase interacting protein. Review of the literature describes the key clinical features and molecular pathogenesis of 1q21 microduplication, as well as highlighting the role of PKA signaling pathway in the pathogenesis of myxomas in general.

  20. Right atrial mass following transcatheter radiofrequency ablation for recurrent atrial fibrillation: thrombus, endocarditis or mixoma?

    Science.gov (United States)

    Ancona, Roberta; Comenale Pinto, Salvatore; Caso, Pio; Di Palma, Vito; Pisacane, Francesca; Martiniello, Alfonso Roberto; Quarto, Cesare; De Rosa, Nicla; Pisacane, Carlo; Calabrò, Raffaele

    2009-03-01

    We report a case of an asymptomatic patient in whom a right atrial mass was fortuitously documented by echocardiography few months after a transcatheter radiofrequency catheter ablation for recurrent AF. No masses were seen in the cardiac chambers before the ablative procedure, raising important diagnostic and decision-making issues. The patient was referred to the surgeon and a diagnosis of right atrial myxoma was made.

  1. Mixoma atrial esquerdo múltiplo: relato de caso Multiple left atrial myxoma: case report

    National Research Council Canada - National Science Library

    José Carlos Dorsa Vieira Pontes; Guilherme Viotto Rodrigues da Silva; Ricardo Adala Benfatti; João Jackson Duarte

    2011-01-01

    ...% dos casos. Os mixomas correspondem a aproximadamente 50% dessas neoplasias. Quanto à localização, 75 a 80% dos mixomas estão no átrio esquerdo, 18% no átrio direito, e mais raramente nos...

  2. Significance of 18 F-FDG PET and immunohistochemical GLUT-1 expression for cardiac myxoma.

    Science.gov (United States)

    Okazaki, Yukio; Yamada, Sohsuke; Kitada, Shohei; Matsunaga, Iwao; Nogami, Eijirou; Watanabe, Teruo; Sasaguri, Yasuyuki; Honma, Yutaka; Itou, Tsuyoshi

    2014-06-16

    Cardiac tumours are relatively rare and are difficult to diagnose merely with imaging techniques. We demonstrated an unusual case of left atrial myxoma, displaying the successful detection by positron emission tomography using 2-deoxy-2-[18 F] fluoro-D-glucose (18 F-FDG PET), correlated closely to more intense and enhanced immunoreactivity with glucose transporter-1 (GLUT-1) in a substantial number of cardiac myxoma cells. Further prospective studies are needed to validate the significance of 18 F-FDG PET findings for cardiac myxoma and the association with immunohistochemical GLUT-1 expression in its tumour cells, after collecting and investigating a larger number of surgical cases examined with both of them. The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/2991481941253449.

  3. Neuroimaging Findings in Cardiac Myxoma Patients: A Single-Center Case Series of 47 Patients.

    Science.gov (United States)

    Brinjikji, Waleed; Morris, Jonathan M; Brown, Robert D; Thielen, Kent R; Wald, John T; Giannini, Caterina; Cloft, Harry J; Wood, Christopher P

    2015-01-01

    Cardiac myxomas can present with a myriad of neurological complications including stroke, cerebral aneurysm formation and metastatic disease. Our study had two objectives: (1) to describe the neuroimaging findings of patients with cardiac myxomas and (2) to examine the relationship between a history of embolic complications secondary to myxoma and intracranial aneurysm formation, hemorrhage and metastatic disease. We hypothesized that patients who present with embolic complications related to myxoma would be more likely to have such complications. We searched our institutional database for all patients with pathologically proven cardiac myxomas from 1995 to 2014 who received neuroimaging. Neuroimaging findings were categorized as acute ischemic stroke, intracerebral hemorrhage, oncotic aneurysm, and cerebral metastasis. Cardiac myxoma patients were divided into those presenting with embolic complications (i.e. lower extremity emboli or cerebral emboli) and those presenting with non-embolic complications prior to surgical resection of the myxoma. The prevalence of intracranial hemorrhage, myxomatous aneurysm formation, and cerebral metastases was compared in myxoma patients presenting with and without embolic complications using a Chi-squared test. Forty-seven consecutive patients were included in this study. Sixteen patients (34.0%) had imaging evidence of acute ischemic stroke. Of these, 13 had acute ischemic strokes directly attributed to the cardiac myxoma (27.7%) and 3 had acute ischemic strokes secondary to causes other than myxoma (6.4%). Seven patients (14.9%) had aneurysms. Two patients (4.3%) had parenchymal metastatic disease on long-term imaging. Fourteen patients (29.8%) presented with ischemic symptoms that were attributed to cardiac myxoma (1 with lower extremity ischemia, 1 with lower extremity ischemia and ischemic stroke, and 12 with ischemic stroke). Patients presenting with embolic complications related to the myxoma (ischemic stroke or lower

  4. Odontogenic myxoma of maxilla: A review discussion with two case reports

    Directory of Open Access Journals (Sweden)

    Piyush Limdiwala

    2015-01-01

    Full Text Available Odontogenic myxoma (OM is a rare entity of slowly growing benign neoplasm of ectomesenchymal origin, comprising of 3-6% of all odontogenic tumors that histologically presenting spindle-shaped, stellate and round cells within loosely arranged myxomatous tissue stroma. OM originates from the dental papilla, follicle or periodontal ligament with an exclusive location in the tooth-bearing areas of the jaws, association with missing or unerupted teeth. Clinically and radiographically the reported incidence and demographic information of this tumor has wide variability. Most common clinical variant is associated with the impacted tooth and shows local invasion with destruction of adjacent structures and displacement of teeth. Radiographically, common manifestations are multilocular radiolucent areas with well-defined borders and typical soap bubble or tennis racket appearances. This paper presents two rare case reports of OM of maxilla along with review discussion.

  5. Odontogenic myxoma of maxilla: A review discussion with two case reports.

    Science.gov (United States)

    Limdiwala, Piyush; Shah, Jigna

    2015-01-01

    Odontogenic myxoma (OM) is a rare entity of slowly growing benign neoplasm of ectomesenchymal origin, comprising of 3-6% of all odontogenic tumors that histologically presenting spindle-shaped, stellate and round cells within loosely arranged myxomatous tissue stroma. OM originates from the dental papilla, follicle or periodontal ligament with an exclusive location in the tooth-bearing areas of the jaws, association with missing or unerupted teeth. Clinically and radiographically the reported incidence and demographic information of this tumor has wide variability. Most common clinical variant is associated with the impacted tooth and shows local invasion with destruction of adjacent structures and displacement of teeth. Radiographically, common manifestations are multilocular radiolucent areas with well-defined borders and typical soap bubble or tennis racket appearances. This paper presents two rare case reports of OM of maxilla along with review discussion.

  6. Possible left endoventricular myxoma in a patient with deep vein thrombosis of the lower limbs: a case report

    Directory of Open Access Journals (Sweden)

    Daniela Galimberti

    2013-03-01

    Full Text Available Introduction: We describe an unusual case of left ventricular myxoma associated with deep vein thrombosis (DVT. Materials and methods: A 79-year-old woman was admitted with bilateral proximal DVT that developed while she was on warfarin. The anticoagulant therapy had been started (after 2 weeks of low-molecular weight heparin 1 month earlier in a Cardiologic Unit, where the patient had been treated for ‘‘left ventricular thrombosis associated with acute pericarditis’’. After discharge, the patient continued to experience malaise, recurrent dizziness, dyspnea, flushing, and progressively severe leg swelling despite transthoracic echocardiography (TTE findings of normal left ventricular function. She was finally admitted to our Unit for ultrasound studies for possible DVT. On admission the INR was in the therapeutic range with increased C-reactive protein (CRP, thrombocytopenia, mild anemia, anti-PF4 antibodies, lupus anticoagulant (LAC, a positive direct Coombs test, and mildly increased anti-platelet and anticardiolipin antibody levels. Malignancy, SLE, and inherited thrombophilia were excluded by a broad-spectrum instrumental and laboratory investigation. Since heparin-induced-thrombocytopenia could not be excluded, the warfarin was replaced with fondaparinux (7.5 mg/day. Given the persistence on TTE of a ‘‘small floating mass’’ at the left ventricular apex, we suspected the previously diagnosed thrombosis was actually an unusually located myxoma, and this diagnosis was confirmed by CT and MRI. The patient also had markedly increased serum levels of interleukin 6 (IL-6, regarded by many as a marker of cardiac myxoma and the source of the constitutional symptoms and immunologic features (‘‘activity’’ of these lesions. The patient is now well except for recurrent flushing episodes. The IL-6 level is still high although the ESR, CRP, LAC have normalized. Since isolated IL-6 increases are associated with recurrence in PMR

  7. [Fever, asthenia, myalgia and murmur due to cardiac myxoma].

    Science.gov (United States)

    Giménez Roca, C; Felipe Villalobos, A; Cambra Lasaosa, F J; Prada Martínez, F; Caffarena Calvar, J M; Jou Muñoz, C

    2013-10-01

    Cardiac tumours are rare, especially in children, and most of them are benign. Myxomas are unusual in children, being more common among adults. They are usually located in the left atrium, with 25% appearing in the right. The clinical signs and symptoms depend mainly on where the tumour is located. A feature of these tumours is that they can be accompanied by constitutional symptoms and laboratory abnormalities. Echocardiography is the study of choice, and a prompt resection is required to prevent serious complications. We present a case of a 10 year-old girl diagnosed with right atrial myxoma who presented with a fever, myalgia, asthenia and laboratory abnormalities. Diagnosis was made by echocardiography, and the early surgical resection of the tumour ran smoothly and showed a good postoperative recovery. Copyright © 2012 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  8. Myxoma of the nasal bone.

    Science.gov (United States)

    Al-Qahtani, Khalid; Islam, Tahera; AlOulah, Mohammad; Bafaqeeh, Sameer; Faqeeh, Yasser

    2017-06-01

    Myxoma is a benign tumor that arises from mesenchymal tissue, and found in the soft tissue and less commonly in the bone. The majority of bony myxomas of the head and neck occur in the jaws and maxilla. We report an extremely rare case of nasal bone myxoma in a 52-year-old man. The diagnosis was confirmed by biopsy. Due to the aggressive nature of the lesion the nasal bone was eroded by the disease. The patient underwent resection of the mass with reconstruction of the defect by septal cartilage. The patient remains tumor free after 5 years. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  9. Cardiac myxoma: The influence of surgical technique on long-term prognosis

    Directory of Open Access Journals (Sweden)

    Mikić A.

    2012-01-01

    Full Text Available The aim of our study was to analyze the influence of different surgical techniques (left atriotomy, right atriotomy, biatrial approach and tumor basis solving on early and late outcomes of patients operated on for cardiac myxoma. We evaluated 74 patients operated on for cardiac myxoma from 1982 through 2011. Sixty-six patients (89.19% had left atrial myxoma and 8 (10.81% right atrial myxoma. Histopathologic examination confirmed the diagnosis of atrial myxoma in all patients. In analyzing different surgical techniques we found that they had no influence on the duration of extracorporeal circulation and aortic cross-clamp time. Mortality analysis revealed: no intraoperative mortality; early mortality in 2 patients; late mortality in 12 patients. Survival after 29 years was 81.08%. There were no myxoma recurrences. 83.78% of the patients had functional improvement. In our opinion the best approach for right atrial myxoma is through right atriotomy, for left atrial myxoma through left atriotomy, with a biatrial approach for large tumors of the left atrium or when exploration of all 4 chambers is necessary. Subendocardial excision or thermocauterization was used for small tumors with bases less than 5 mm. Myxoma with a wider basis, depending on the localization, were partially resected at the atrial septum in the whole thickness or subendocardial excision of the tumor basis.

  10. Periocular Myxoma in a Child

    Directory of Open Access Journals (Sweden)

    Dolores Ríos y Valles-Valles

    2012-01-01

    Full Text Available Myxomas are locally invasive, benign mesenchymal neoplasms with odontogenic, osteogenic, or soft tissue origin. Facial myxomas probably account for less than 0.5% of all paranasal sinus and nasal tumors. We report a case of a left painless periocular mass in a 11-month-old girl. The lesion was resected with a clinical diagnosis of lacrimal sac tumor. Histopathology and immunohistochemistry proved the tumor to be a myxoma. There has been no recurrence after 4 years of followup. Midfacial myxomas should be differentiated from other benign and malignant tumors such as dermoid, hamartoma, neurofibroma, nasolacrimal duct cyst, and sarcomas in particular embryonal rhabdomyosarcoma. Because of the infiltrative nature of these tumors, a wide surgery is required to achieve clear resection margins and avoid recurrence.

  11. Atrial Thrombus in a Neonate: A Diagnostic Challenge

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    Alicia Sheen

    2015-04-01

    Full Text Available Introduction - Left atrial thrombus is a rare finding in a neonate. In the previous literature, atrial thrombi have been associated with catheter placement or congenital heart disease in a preterm infant. Case - We report the case of a full-term neonate with no known risk factors found to have a left atrial thrombus. The neonate was born at 38 weeks' gestation to a 31-year-old female via cesarean section who was sent to the normal nursery. On postnatal day 5, the infant was noted to have low-to-medium level of oxygen saturations (∼90% and was transferred to the neonatal intensive care unit with an echocardiogram completed on postnatal day 6 demonstrating a mobile, pedunculated mass attached to the left atrial septum with an appearance concerning for atrial myxoma. The infant underwent surgical resection on postnatal day 8 and pathology revealed the mass to be a left atrial thrombus. Discussion - The rare finding of an atrial thrombus in a neonate has previously been associated with central venous catheter placement or congenital heart disease. This case is unusual in that the patient had neither condition. Although echocardiogram findings appeared more consistent with atrial myxoma, final pathology revealed a left atrial thrombus. Additionally, hypercoagulability work-up for this neonate was largely negative. This report underscores the importance of identification, search for etiology, and prompt therapy to prevent potential catastrophic outcomes.

  12. A STUDY ON CARDIAC MYXOMA OF POPULATION IN NORTH EAST INDIA

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    Jyoti Prasad Kalita

    2016-06-01

    Full Text Available BACKGROUND Cardiac myxomas are the most common primary cardiac tumors. A high degree of suspicion is required for diagnosing myxomas clinically and often leads to grave consequence if missed. Though surgical resection is the definitive treatment, but if not treated with the right surgical technique recurrence occurs. OBJECTIVES To describe clinical presentations, age and sex distribution, anatomical location and morbidity, mortality and recurrence rate following surgery of patients of North Eastern part of India who have presented in our Cardiothoracic Unit with cardiac myxomas. METHOD All consecutive patients over a period of 5 years who underwent surgical excision of cardiac myxoma at our Cardiothoracic Unit and histologically proven as cardiac myxoma were included in this study. Data were collected from the operation data base and the patient records. Echocardiography was the the diagnostic tool in all cases. The historical longitudinal study was performed. All patients underwent operation soon after the diagnosis of a myxoma was made. Complete tumour excision were done in all cases. All cases were followed up for a mean period of 32 months. RESULTS Of total 28 patients who underwent surgery for cardiac tumor over that period, 25(89.25% patients had histologically proven cardiac myxomas. Their age ranged from 15 to 55 years with a mean of 35 years. Majority patients were female (n-16, 64%. Most of the patients had clinical presentations similar to obstructive mitral valve. A small group of patients presented with embolic and constitutional symptoms. All patients underwent operation via right atrial approach. Left atrium (n-20, 80% is the commonest location followed by the right atrium (n-3, 12%. One patient had myxoma originating from tricuspid valve annulus, one from right ventricle and another one patient had mitral valve annulus origin. There was no death after surgery or recurrence was noted after mean 32 moths of follow-up. DISCUSSION

  13. [Large mitral annulus myxoma presenting with syncope: Report of one case].

    Science.gov (United States)

    Vega, Julián; Gabrielli, Luigi; Olivares, Gabriel; Córdova, Samuel; Méndez, Manuel; González, Rodrigo

    2016-12-01

    We report a 23-year-old woman, with three recent exertional syncopes. Transthoracic (TTE) and transesophageal (TEE) echocardiography found a large heterogeneous mass (38 x 35 mm) arising from the posterior mitral annulus, protruding in systole through the left ventricular outflow tract (LVOT). Heart MRI confirmed the echocardiography findings, suggesting a cardiac myxoma. Cardiac surgery accomplished the complete resection of the lesion, confirming a mass arising from the posterior mitral annulus and preserving mitral anatomy and function. Pathology was positive for a myxoma. Uneventful evolution allowed the discharge of the patient at the fifth postoperative day. Control TTE discarded any complication.

  14. [Case of acute ischemic stroke due to cardiac myxoma treated by intravenous thrombolysis and endovascular therapy].

    Science.gov (United States)

    Kamiya, Yuki; Ichikawa, Hiroo; Mizuma, Keita; Itaya, Kazuhiro; Shimizu, Yuki; Kawamura, Mitsuru

    2014-01-01

    A 48-year-old woman with no previous neurological diseases was transferred to our hospital because of sudden-onset unconsciousness. On arrival, she showed consciousness disturbance (E1V1M3 on the Glasgow Coma Scale), tetraplegia, right conjugate deviation and bilateral pathological reflexes. These symptoms resulted in a NIH stroke scale score of 32. Brain diffusion-weighted MR imaging (DWI) showed multiple hyper-intense lesions, and MR angiography revealed occlusions of the basilar artery (BA) and superior branch of the right middle cerebral artery (MCA). Transthoracic echocardiography disclosed a 51 × 24 mm myxoma in the left atrium. These findings led to diagnosis of acute ischemic stroke due to embolization from cardiac myxoma. Thrombolytic therapy with intravenous tissue plasminogen activator (IV tPA) was started 120 min after onset because there were no contraindications for this treatment. However, the symptoms did not resolve, and thus endovascular therapy was performed immediately after IV tPA. Angiography of the left vertebral artery initially showed BA occlusion, but a repeated angiogram resulted in spontaneous recanalization of the BA. However, the left posterior cerebral artery remained occluded by a residual embolus. Subsequently, occlusion found in the superior branch of the right MCA was treated by intra-arterial local thrombolysis using urokinase and thrombectomy with a foreign body retrieval device, but the MCA remained occluded. DWI after endovascular therapy showed new hyper-intense lesions in the bilateral medial thalamus and left occipital cortex. Clinically, neurological status did not improve, with a score of 5 on the modified Rankin Scale. IV tPA can be used for stroke due to cardiac myxoma, but development of brain aneurysms and metastases caused by myxoma is a concern. Given the difficulty of predicting an embolus composite from a thrombus or tumor particle, aspiration thrombectomy may be safer and more effective for stroke due to cardiac

  15. Diagnosis and results of treatment of heart myxoma

    Directory of Open Access Journals (Sweden)

    Rafajlovski Sašo

    2011-01-01

    Full Text Available Background/Aim. Myxoma is the most common benign primary cardiac neoplasm, and usually originates from the left atrial septum. Early diagnosis of cardiac myxomas depends on a high index of a clinical suspicion. Surgical management must be done as soon as possible after diagnosis. The aim of this retrospective study was to present diagnostics and treatment outcome data of 61 patients with cardiac myxoma treated in the Military Medical Academy, Belgrade during a 49-years period. Methods. Intrahospital diagnosis was established in all the patients by the cardiologist. Diagnostic methods were various, in dependence on the examination period and suspected diagnosis. Results. Within a 49-years period (1961-2009 heart myxoma was diagnozed and treated in 61 patients in the Military Medical Academy, Belgrade. Most of the operated patients were females (38 or 62.3%. The operated patients were 19-68 years old. Average age of all the patients was 47.9%. The great majority of them (98.4% had atrial, and only one operated patient had ventricular myxoma. In 13 (21.3% of the patients heart myxoma was found out accidentally due to no previous cardiologic symptomatology. In most patients (27.44% symptomatology was presented as thromboembolic disease. Because of the suspected ventricular myxoma in one patient, the patient was operated on, but Hodgkin's lymphoma was found out which, according to the subsequent course of the disease, could be justifiably recognized as primary heart lymphoma. This study presented brief descriptions of the course of the disease in 4 patients with myxomas in each of the cardiac cavities. Conclusion. The only diagnostic difficulty in cardiac myxoma is due to its asymptomatic and oligosymptomatic presence within the longer period of time, namely, its growth period. Echocardiography should be the standard method of cardiologic examination of these patients, which could considerably contribute to early diagnosis and treatment of heart

  16. Mixoma gigante em átrio esquerdo: relato de caso Giant myxoma in the left atrium: case report

    Directory of Open Access Journals (Sweden)

    Marcos de Paula Vale

    2008-06-01

    Full Text Available Paciente de 63 anos, sexo feminino, com história de dispnéia, palpitação e precordialgia foi submetida a avaliação cardiológica. Ao exame físico mostrava-se sem anormalidades. O ecocardiograma mostrou grande massa em átrio esquerdo, sugerindo mixoma; confirmado pela tomografia e cateterismo. A paciente foi submetida a tratamento cirúrgico, com boa evolução pós-operatória. O estudo anatomopatológico confirmou o diagnóstico de mixoma. Neste artigo é apresentada revisão bibliográfica, bem como comentários enfatizando-se a dificuldade diagnóstica baseada nos sinais e sintomas, assim como o desenvolvimento de derrame pleural bilateral no pós-operatório, possivelmente relacionado ao mixoma.In this study is reported the case of a 63-year-old-woman with history of dyspnea, palpitations, and precordial pain who underwent cardiologic evaluation. The physical examination did not reveal abnormalities. The echocardiogram showed great mass in the left atrium, suggesting myxoma which was confirmed by tomography and catheterization. The patient underwent surgical treatment with a good postoperative evolution. The diagnosis of myxoma was confirmed by histopathologic study. In this study is included a bibliographic review and a comment emphasizing the diagnostic difficulty based on signs and symptoms, as well as the details about the development of bilateral pleural effusion possibly related to the myxoma.

  17. Mixoma odontogênico maxilar: relato de caso clínico comprometendo seio maxilar Maxillary odontogenic myxoma involving the maxillary sinus: case report

    National Research Council Canada - National Science Library

    Allan Ulisses Carvalho de Melo; Sérgio Bartolomeu de Farias Martorelli; Paulo Henrique de Holanda Cavalcanti; Luiz Alcino Gueiros; Fernando de Oliveira Martorelli

    2008-01-01

    ... o número de patologias tumorais do sistema estomatognático com as quais pode ser feito o diagnóstico diferencial.The aim of this paper is to report a case of odontogenic myxoma that affected the right maxilla and maxillary sinus...

  18. Case report

    African Journals Online (AJOL)

    ebutamanya

    2015-06-05

    Jun 5, 2015 ... the right atrium and attached to the interatrial septum. Figure 4: explanted tumor, a lobulated mass. References. 1. Azevedo O et al. Massive right atrial myxoma presenting as syncope and exertional dyspnea: case report. Cardiovascular. Ultrasound. 2010; 8(1): 23. PubMed | Google Scholar ...

  19. Concomitant Left Atrial Myxoma and Patent Foramen Ovale: Is It an Evolutional Synergy for a Cerebrovascular Event?

    OpenAIRE

    Lasam, Glenmore; Ramirez, Roberto

    2017-01-01

    We report a case of a 48-year-old female who presented initially with an abrupt onset of left facial and hand numbness after her routine yoga with no associated syncope, palpitation, chest pain or dyspnea. She consulted her primary care physician and recommended hospital care for possible stroke. On the day of admission, she complained of left facial and hand hemiparesthesia. Cranial imaging and angiography were unremarkable but echocardiography and cardiac computed tomography revealed left a...

  20. [The clinical characteristics of stroke in young patients with cardiac myxoma].

    Science.gov (United States)

    Cao, G F; Bi, Q; Cao, L; Wang, C

    2017-04-01

    Objective: To investigate the clinical characteristics of stroke in young patients with cardiac myxoma. Methods: Medical records of young patients (aged between 18-44 years) diagnosed with cardiac myxoma in Beijing Anzhen Hospital affiliated to Capital Medical University from January 2005 to March 2016 were retrospective reviewed. Results: A total of 117 cases were included (85 female and 32 male)with the average age (36±7)years old. Most myxomas (83.8%) were located in the left atrium, 7.7% were in the right atrium, 3.5% were in the both atriums, 2.6% were in the left ventricle, and a few were in the left atrium plus left ventricle and in the right ventricle. Of all the patients, 24 (20.5%) (16 women and 8 men) were complicated with cerebral infarction. Among them, 3 patients were with lower extremity arterial embolisms. Two patients were with cerebral hemorrhage. The cerebral infarction mainly involved in the distribution area of the internal carotid artery. Infarctions involving 2 or more cerebral vessels were found in 4 cases. Most subjects (58.3%) manifested with hemiplegia, and some (18.2%) with syncope. The proportion of the left atrial myxoma in patients with cerebral infarction (100.0%) was significantly higher than those in patients without cerebral infarction (85.1%, P=0.044). Subjects with tumor diameter less than 3 cm were more frequently complicated with cerebral infarction (37.5% vs 13.8%, P= 0.009). A logistic analysis showed that the odds ratio of myxoma with tumor diameter less than 3 cm for cerebral infarction was 3.750(95%CI 1.343-10.470). Conclusions: Cardiac myxoma is more common in young women, and often complicated with cerebral infarction. The infarctions are mainly distributed in internal carotid artery system, and some are involved in multiple vascular systems. The incidence of stroke is associated with the position of the myxoma. Smail-size myxoma cannot be ignored for its risk of stroke.

  1. Prognostic prediction of troponins in cardiac myxoma: case study with literature review

    Directory of Open Access Journals (Sweden)

    Shi-Min Yuan

    2015-04-01

    Full Text Available AbstractObjective:It was supposed that troponins in cardiac myxoma patients might be in a same fashion as in the conditions without myocardial injury. In order to verify this hypothesis, troponins in cardiac myxoma patients were discussed by presenting a comprehensive retrieval of the literature with incorporating the information of a recent patient.Methods:Postoperative detections of troponin I, creatine kinase isoenzyme MB (CK-MB and N-terminal pro-B-type natriuretic peptide revealed elevated troponin I and CK-MB and normal N-terminal pro-B-type natriuretic peptide. Postoperative troponin I and CK-MB shared a same trend, reaching a peak value at postoperative hour 2, gradually decreased on postoperative day 1, and reached a plateau on postoperative days 7 and 13. A significant correlation could be noted between the postoperative values of the two indicators (Y=0.0714X + 0.6425, r2=0.9111, r=0.9545, P=0.0116. No significant linear correlation between troponin I and N-terminal pro-B-type natriuretic peptide were found. Literature review of troponins in cardiac myxoma patients revealed the uncomplicated patients had a normal or only slightly elevated troponin before open heart surgery. However, the complicated patients (with cerebral or cardiac events showed a normal preoperative troponin in 3 (23.1% and an elevated troponin in 10 (76.9% patients (χ2=7.54, P=0.0169, Fisher's exact test. The overall quantitative result of troponin I was 2.45±2.53 µg/L, and that of troponin T was 3.10±4.29 mg/L, respectively.Conclusion:Troponins are not necessarily elevated in patients with a cardiac myxoma without coronary syndrome. By contrast, patients with a cardiac myxoma with an elevated troponin may herald the presence of an associated coronary event. An old cerebral infarct does not necessarily cause an elevation of troponin or B-type natriuretic peptide, or new neurological events, but might lead to a delayed awakening.

  2. Prognostic prediction of troponins in cardiac myxoma: case study with literature review.

    Science.gov (United States)

    Yuan, Shi-Min

    2015-01-01

    It was supposed that troponins in cardiac myxoma patients might be in a same fashion as in the conditions without myocardial injury. In order to verify this hypothesis, troponins in cardiac myxoma patients were discussed by presenting a comprehensive retrieval of the literature with incorporating the information of a recent patient. Postoperative detections of troponin I, creatine kinase isoenzyme MB (CK-MB) and N-terminal pro-B-type natriuretic peptide revealed elevated troponin I and CK-MB and normal N-terminal pro-B-type natriuretic peptide. Postoperative troponin I and CK-MB shared a same trend, reaching a peak value at postoperative hour 2, gradually decreased on postoperative day 1, and reached a plateau on postoperative days 7 and 13. A significant correlation could be noted between the postoperative values of the two indicators (Y = 0.0714X + 0.6425, r2 = 0.9111, r=0.9545, P=0.0116). No significant linear correlation between troponin I and N-terminal pro-B-type natriuretic peptide were found. Literature review of troponins in cardiac myxoma patients revealed the uncomplicated patients had a normal or only slightly elevated troponin before open heart surgery. However, the complicated patients (with cerebral or cardiac events) showed a normal preoperative troponin in 3 (23.1%) and an elevated troponin in 10 (76.9%) patients (χ2 = 7.54, P = 0.0169, Fisher's exact test). The overall quantitative result of troponin I was 2.45 ± 2.53 µg/L, and that of troponin T was 3.10 ± 4.29 mg/L, respectively. Troponins are not necessarily elevated in patients with a cardiac myxoma without coronary syndrome. By contrast, patients with a cardiac myxoma with an elevated troponin may herald the presence of an associated coronary event. An old cerebral infarct does not necessarily cause an elevation of troponin or B-type natriuretic peptide, or new neurological events, but might lead to a delayed awakening.

  3. [MRI diagnosis of cardiac myxomas: sequence evaluation and differential diagnosis].

    Science.gov (United States)

    Sommer, T; Vahlhaus, C; Hofer, U; von Smekal, A; Wardelmann, E; Bierhoff, E; Pauleit, D; Wilhelm, K; Textor, J; Schild, H

    1999-02-01

    To evaluate native and contrast enhanced T1-weighted spin (T1-SE), cine gradient echo (Cine-GE), and T2-weighted turbo spin (T2-TSE) sequences in the diagnosis and differential diagnosis of cardiac myxomas. 15 patients with echocardiographically suspected cardiac atrial myxomas underwent 0.5 T-MR imaging of the heart with native T1-SE, contrast-enhanced T1-SE, Cine-GE, and T2-TSE sequences. MR images were evaluated for signal intensity (SI) and lesion's conspicuity. Results were confirmed histologically (14 x) or by follow-up (1 x). MRI revealed myxomas in 9 patients, sarcomas in three patients, and thrombi in three patients. Lesion conspicuity was better in Cine-GE and T2-TSE compared with native and contrast-enhanced T1-SE sequences. Myxomas were characterized by an intermediate SI similar to myocardium in T1-SE, high SI similar to water in T2-TSE, and low to moderately high enhancement (range 19-75%, mean 48%). Distinct SI characteristics together with anatomical-topographical features (attachment to the interatrial septum, no infiltration of myocardium and vessels) are diagnostic for cardiac myxomas. Cine-GE and T2-TSE sequences are the sequences of choice for detection of myxomas and other atrial masses. T2-TSE and contrast-enhanced T1-weighted sequences are most useful for mass characterisation and differentiation between myxomas, malignant tumors, and thrombi.

  4. Detection of myxoma viruses encoding a defective M135R gene from clinical cases of myxomatosis; possible implications for the role of the M135R protein as a virulence factor

    OpenAIRE

    Larsen Lars E; Breum Solvej Ø; Polacek Charlotta; Belsham Graham J; Bøtner Anette

    2010-01-01

    Abstract Background Myxoma virus is a member of the Poxviridae and causes disease in European rabbits. Laboratory confirmation of the clinical disease, which occurs in the autumn of most years in Denmark, has been achieved previously using antigen ELISA and electron microscopy. Results An unusually large number of clinically suspected cases of myxomatosis were observed in Denmark during 2007. Myxoma virus DNA was detected, using a new real time PCR assay which targets the M029L gene, in over ...

  5. Balloon atrial septostomy under echocardiographic guide: case series

    Directory of Open Access Journals (Sweden)

    SM Meraji

    2012-12-01

    Full Text Available Background: Balloon atrial septostomy is an emergent procedure in pediatric cardiology. Nowadays, most patients in need of the procedure have acceptable outcomes after surgical repair. Thus, it is important to perform this procedure as safe as possible. By performing early arterial switch operation and prostaglandin infusion, the rate of balloon atrial septostomy has markedly decreased. However, not all centers performing early arterial switch repairs have abandoned atrial septostomy, even in patients who respond favorably to prostaglandin infusion.Case presentation: In total, eight 1- to 15-day old term neonates admitted in Shahid Rajaee Heart Center in Tehran, Iran from October 2009 to February 2011, with congenital heart diseases were scheduled for balloon atrial septostomy. In six cases the procedure was done exclusively under echocardiographic guidance and in two cases with the help of fluoroscopy. Success was defined as the creation of an atrial septal defect with a diameter equal to or more than 5 mm and ample mobility of its margins.Results: Male sex was predominant (87% and the mean age of the neonates was six days. The diagnosis in all cases was simple transposition of great arteries. The procedure was successful in all patients with any cardiovascular complication.Conclusion: Balloon atrial septostomy is an emergent procedure that can be done safely and effectively under echocardiographic guidance. According to the feasibility of this technique it could be performed fast, safe and effective at bedside, avoiding patient transportation to hemodynamic laboratory or referral center.

  6. Cardiac Mixoma a Cause of Sudden Death in Childhood a Case Report

    Directory of Open Access Journals (Sweden)

    Arzu Akçay Turan

    2009-04-01

    Full Text Available The primary tumors of the heart are quite rare and, it’s frequency in the autopsy series is reported between 0,0017-0,28 %. Among the entire age groups, myxomas are seen to form half percent of these tumors. Despite the cardiac myxomas are histologically benign, they are classified among the fatal tumors, causing tendency to cardiac obstruction and embolism. In this study, by examining the history and autopsy findings of a 9 year old sudden death case of which left atrial myxoma is detected in the autopsy; it is aimed to point to cardiac myxomas which can be seen as the cause of sudden death especially in the early ages in the legal autopsies Keywords: Cardiac myxoma, sudden cardiac death, autopsy

  7. Association Between Left Atrial Compression And Atrial Fibrillation: A Case Presentation And A Short Review Of Literature.

    Science.gov (United States)

    Ahmed, Niloy; Carlos, Morales-Mangual; Moshe, Gunsburg; Yitzhak, Rosen

    2016-01-01

    This case report describes a patient who developed palpitations and chest pain and was found to be in atrial fibrillation, which was likely due to the presence of an extra-cardiac mass. This was compressing the left atrium. The mass was related to small cell carcinoma, which decreased significantly in size after chemotherapy. Resolution of the atrial fibrillation correlated temporally with reduction in the size of the mass and alleviation of the left atrial compression.

  8. Stroke of a cardiac myxoma origin.

    Science.gov (United States)

    Yuan, Shi-Min; Humuruola, Gulimila

    2015-01-01

    The clinical features of cardiac myxoma stroke have not been sufficiently described. Debates remain concerning the options and timing of treatment and the clinical outcomes are unknown. This article aims to highlight the pertinent aspects of this rare condition. Data source of the present study came from a comprehensive literature collection of cardiac myxoma stroke in PubMed, Google search engine and Highwire Press for the year range 2000-2014. Young adults, female predominance, single cerebral vessel (mostly the middle cerebral artery), multiple territory involvements and solitary left atrial myxoma constituted the outstanding characteristics of this patient setting. The most common affected cerebral vessel (the middle cerebral artery) and areas (the basal ganglion, cerebellum and parietal and temporal regions) corresponded well to the common manifestations of this patient setting, such as conscious alteration, ataxia, hemiparesis and hemiplegia, aphasia and dysarthria. Initial computed tomography scan carried a higher false negative rate for the diagnosis of cerebral infarction than magnetic resonance imaging did. A delayed surgical resection of cardiac myxoma was associated with an increased risk of potential consequences in particular otherwise arterial embolism. The mortality rate of this patient population was 15.3%. Cardiac myxoma stroke is rare. Often does it affect young females. For an improved diagnostic accuracy, magnetic resonance imaging of the brain and echocardiography are imperative for young stroke patients in identifying the cerebral infarct and determining the stroke of a cardiac origin. Immediate thrombolytic therapy may completely resolve the cerebral stroke and improve the neurologic function of the patients. An early surgical resection of cardiac myxoma is recommended in patients with not large territory cerebral infarct.

  9. Stroke of a cardiac myxoma origin

    Directory of Open Access Journals (Sweden)

    Shi-Min Yuan

    2015-04-01

    Full Text Available AbstractObjective:The clinical features of cardiac myxoma stroke have not been sufficiently described. Debates remain concerning the options and timing of treatment and the clinical outcomes are unknown. This article aims to highlight the pertinent aspects of this rare condition.Methods:Data source of the present study came from a comprehensive literature collection of cardiac myxoma stroke in PubMed, Google search engine and Highwire Press for the year range 2000-2014.Results:Young adults, female predominance, single cerebral vessel (mostly the middle cerebral artery, multiple territory involvements and solitary left atrial myxoma constituted the outstanding characteristics of this patient setting. The most common affected cerebral vessel (the middle cerebral artery and areas (the basal ganglion, cerebellum and parietal and temporal regions corresponded well to the common manifestations of this patient setting, such as conscious alteration, ataxia, hemiparesis and hemiplegia, aphasia and dysarthria. Initial computed tomography scan carried a higher false negative rate for the diagnosis of cerebral infarction than magnetic resonance imaging did. A delayed surgical resection of cardiac myxoma was associated with an increased risk of potential consequences in particular otherwise arterial embolism. The mortality rate of this patient population was 15.3%.Conclusion:Cardiac myxoma stroke is rare. Often does it affect young females. For an improved diagnostic accuracy, magnetic resonance imaging of the brain and echocardiography are imperative for young stroke patients in identifying the cerebral infarct and determining the stroke of a cardiac origin. Immediate thrombolytic therapy may completely resolve the cerebral stroke and improve the neurologic function of the patients. An early surgical resection of cardiac myxoma is recommended in patients with not large territory cerebral infarct.

  10. Left Ventricular Myxoma Occluding the Suprarenal Abdominal Aorta in an Infant.

    Science.gov (United States)

    Kawabata, Takuya; Kasahara, Shingo; Ohtsuki, Shin-ichi; Kuroko, Yosuke; Kotani, Yasuhiro; Fujii, Yasuhiro; Yoshizumi, Ko; Arai, Sadahiko; Sano, Shunji

    2015-07-01

    Myxoma is the most common primary cardiac tumor in adults; however, it is extremely rare in infants. Acute occlusion of the abdominal aorta by a cardiac myxoma is also rare. We report the case of an infant with acute occlusion of the suprarenal abdominal aorta by a left ventricular myxoma. The patient underwent successful catheter embolectomy of the abdominal aorta and surgical resection of the cardiac myxoma. This is a very rare case report of the combination of infantile left ventricular myxoma and acute occlusion of the abdominal aorta. Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  11. Left ventricular cardiac myxoma and sudden death in a dog

    NARCIS (Netherlands)

    de Nijs, Maria Irene; Vink, Aryan; Bergmann, Wilhelmina; Szatmári, Viktor

    2016-01-01

    BACKGROUND: Myxoma is a very rare benign cardiac tumor in dogs. This is the first description of a cardiac myxoma originating from the left ventricular outflow tract, presumably causing sudden death. CASE PRESENTATION: A previously healthy 12-year-old male West Highland white terrier was found dead

  12. Left ventricular cardiac myxoma and sudden death in a dog

    NARCIS (Netherlands)

    de Nijs, M.I.; Vink, Aryan; Bergmann, W.; Szatmári, V.

    2016-01-01

    Background: Myxoma is a very rare benign cardiac tumor in dogs. This is the first description of a cardiac myxoma originating from the left ventricular outflow tract, presumably causing sudden death. Case presentation: A previously healthy 12-year-old male West Highland white terrier was found dead

  13. Prominent crista terminalis mimicking a right atrial mass: case report

    Directory of Open Access Journals (Sweden)

    Lange Peter

    2010-10-01

    Full Text Available Abstract The crista terminalis is a normal anatomical structure within the right atrium that is not normally visualised in the standard views obtained while performing a transthoracic echocardiogram. In this case report, transthoracic echocardiography suggested the presence of a right atrial mass in a patient with end stage renal disease. However, subsequent transesophageal echocardiography revealed that the right atrial mass was actually a thick muscular bridge in the right atrium consistent with a prominent crista terminalis. An understanding of the anatomy and the echocardiographic appearance of a prominent crista terminalis will minimize the misdiagnosis of this structure avoiding unnecessary expensive additional tests.

  14. Left atrial thrombus following bilobectomy: a case report

    Directory of Open Access Journals (Sweden)

    Kaya Ugur

    2010-02-01

    Full Text Available Abstract Introduction Left atrial free floating ball thrombus is a relatively rare event, especially without mitral valve disease. Case presentation A 61-year-old Turkish man was admitted to our hospital with a thrombus mass in his left atrium. Five months earlier, he had undergone right bilobectomy and superior bronchoplasty due to squamous cell carcinoma in the lung. The patient had no evidence of cardiac disease except atrial fibrillation and there were no defined embolizations. The thrombus mass was surgically removed. The patient was discharged from hospital on the sixth postoperative day. Conclusion Surgery with cardiopulmonary bypass is a safe method for treatment. The patient should be medicated with warfarin, especially in the presence of atrial fibrillation.

  15. Odontogenic myxoma of maxilla

    Directory of Open Access Journals (Sweden)

    Sivakumar G

    2008-01-01

    Full Text Available Odontogenic myxoma (OM is a rare and locally invasive benign neoplasm found exclusively in the jaws. OM commonly occurs in the second and third decade, and the mandible is involved more commonly than the maxilla. The lesion often grows without symptoms and presents as a painless swelling. The radiographic features are variable, and the diagnosis is therefore not easy. A case of OM of the maxilla with unusual radiographic and histologic features is described in a 30-year-old male. A panoramic radiograph revealed a well-demarcated, multilocular radiolucent lesion with ′tennis racket′ appearance involving maxillary antrum. The histopathology showed loosely arranged spindle-shaped stellate cells and few areas of inactive odontogenic epithelium in a mucoid intercellular substance.

  16. A giant myxoma originating from the aortic valve causing severe left ventricular tract obstruction: a case report and literature review.

    Science.gov (United States)

    Prifti, Edvin; Ademaj, Fadil; Kajo, Efrosina; Baboci, Arben

    2015-04-16

    The left ventricular localization of a myxoma is very rare, usually arising from the interventricular septum close to the left ventricular outflow tract, the mitral valve, the ventricular wall and extremely rarely the aortic valve. A 13-year-old male was admitted due to dyspnea and angina. Transesophageal echocardiography revealed left ventricular outflow tract obstruction with a mean gradient of 58 mmHg, and a mobile mass measuring 65×25 mm originating from the ventricular surface of the aortic valve was identified. The patient underwent urgent surgical excision and aortic valve replacement. Histopathological examination of the mass confirmed the diagnosis of a myxoma. In conclusion, a myxoma originating from the aortic valve remains a very rare localization. Total resection associated with aortic valve replacement seems to offer an excellent outcome.

  17. Neurological manifestations of cardiac myxoma: experience in a referral hospital.

    Science.gov (United States)

    Pérez Andreu, J; Parrilla, G; Arribas, J M; García-Villalba, B; Lucas, J J; Garcia Navarro, M; Marín, F; Gutierrez, F; Moreno, A

    2013-01-01

    Cardiac myxoma is an important but uncommon cause of stroke in younger patients. Few published case series analyse the frequency and clinical presentation of neurological complications in patients with myxoma. To list all neurological complications from cardiac myxoma recorded in our hospital in the past 28 years. We retrospectively reviewed the neurological manifestations of cardiac myxoma in patients treated in our hospital between December 1983 and March 2012. Of the 36 patients with cardiac myxoma, 8 (22%) presented neurological manifestations. Half were women and mean age of patients was 52.4 ± 11.6 years. Sudden-onset hemiparesis was the most frequent neurological symptom (63%). Established ischaemic stroke was the most common clinical manifestation (75%), followed by transient ischemic attack. The most commonly affected territory corresponded to the middle cerebral artery. Myxoma was diagnosed by echocardiography in all cases. Mean myxoma size was 4.1cm and most of the tumours (63%) had a polypoid surface. All tumours were successfully removed by surgery. There were no in-hospital deaths. Cardiac myxomas frequently present with neurological symptoms, especially ischaemic events (established stroke or transient ischaemic attack), in younger patients with no cardiovascular risk factors. The anterior circulation is more frequently affected, especially the middle cerebral artery. Echocardiography can facilitate prompt diagnosis and early treatment of the lesion. Copyright © 2012 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.

  18. Renal Myxoma, an Incidental Finding

    Directory of Open Access Journals (Sweden)

    Parth Thakker

    2017-07-01

    Full Text Available Myxomas are mesenchymal tumors commonly found in the heart and skin. Renal myxomas are rare, having only been documented 14 times. Our case is a 55-year-old woman who presented to our clinic after a right renal mass was incidentally found on CT. Evaluation with MRI showed a mass that appeared to arise from the supero-medial cortex of the right kidney. As the imaging was concerning for renal cell carcinoma, the patient underwent a partial nephrectomy. Microscopic examination showed a well-circumscribed mass with polygonal to spindle-shaped cells in a granular eosinophilic cytoplasm. Immunohistochemical staining for CD-10, Desmin, HMB-45, and Pankeratin were negative.

  19. Expression of MMP-2 and MMP-9 in odontogenic myxoma in a child: report of a clinical case.

    Science.gov (United States)

    Mauro, Annamaria; Lipari, Luana; Tortorici, Silvia; Leone, Angelo; Gerbino, Aldo; Buscemi, Maria

    2013-07-01

    Odontogenic myxoma (OM) is a benign, locally invasive, non-metastasizing neoplasm of the jaw bones. Despite the benign nature of these lesions, there is a high rate of recurrence and the current recommended therapy, depending on the size and behaviour of the lesion, can vary from curettage with peripheral ostectomy, segmental resection up to radical resections for more aggressive lesions. OM is a rare tumour which occurs predominantly in the third decade of life and it is rare in children. Matrix metalloproteinases (MMPs) are a family of extracellular endopeptidases responsible for the degradation and remodelling of extracellular matrix, they are known to be involved in the progression and invasiveness of many types of tumour. MMPs have been studied in OM because of their well-known role in extracellular matrix degradation, tumour invasion and recurrence. We report a case of OM in a 6-year-old boy. A conservative excision was accomplished. The mass was excised without affecting the mandibular bone and the inferior alveolar nerve. Curettage and removal of the first right inferior molar were performed. After 6-month follow-up, no evidence of recurrence was found. We investigated the expression of MMP-2 and MMP-9 in this case of OM in a child. RT-PCR showed the expression of both MMP-2 and MMP-9 mRNAs. Immunohistochemistry showed a weak MMP-2 protein expression while MMP-9 protein was not detected. In this case of OM in a child, we report lack of recurrence after excision associated with low MMP-2 protein expression and absence of MMP-9. We believe it is worthy to deeply investigate the relationship between MMPs expression and OM behaviour with the aim to use MMPs as prognostic and/or therapeutic markers in OM.

  20. Atrial flutter complicating severe leptospirosis: a case report

    Directory of Open Access Journals (Sweden)

    Francisco Theogenes Macêdo Silva

    2013-04-01

    Full Text Available Cardiac disturbances are relatively common and electrocardiographic abnormalities may be found in more than 70% of patients with leptospirosis. We report the case of a 68 year-old male with severe leptospirosis who developed atrial flutter. Effective treatment was done with amiodarone. The patient became clinical stable, with complete recovery. Rigorous clinical observation and continuous electrocardiogram (ECG monitoring may facilitate the identification of rhythm disorders, and thus prevent a probable fatal outcome, in severe cases of leptospirosis.

  1. Detection of myxoma viruses encoding a defective M135R gene from clinical cases of myxomatosis; possible implications for the role of the M135R protein as a virulence factor

    Science.gov (United States)

    2010-01-01

    Background Myxoma virus is a member of the Poxviridae and causes disease in European rabbits. Laboratory confirmation of the clinical disease, which occurs in the autumn of most years in Denmark, has been achieved previously using antigen ELISA and electron microscopy. Results An unusually large number of clinically suspected cases of myxomatosis were observed in Denmark during 2007. Myxoma virus DNA was detected, using a new real time PCR assay which targets the M029L gene, in over 70% of the clinical samples submitted for laboratory confirmation. Unexpectedly, further analysis revealed that a high proportion of these viral DNA preparations contained a frame-shift mutation within the M135R gene that has previously been identified as a virulence factor. This frame-shift mutation results in expression of a greatly truncated product. The same frame-shift mutation has also been found recently within an avirulent strain of myxoma virus (6918). However, three other frame-shift mutations found in this strain (in the genes M009L, M036L and M148R) were not shared with the Danish viruses but a single nucleotide deletion in the M138R/M139R intergenic region was a common feature. Conclusions It appears that expression of the full-length myxoma virus M135R protein is not required for virulence in rabbits. Hence, the frame-shift mutation in the M135R gene in the nonpathogenic 6918 virus strain is not sufficient to explain the attenuation of this myxoma virus but one/some of the other frame-shift mutations alone or in conjunction with one/some of the thirty two amino acid substitutions must also contribute. The real time PCR assay for myxoma virus is a useful diagnostic tool for laboratory confirmation of suspected cases of myxomatosis. PMID:20078890

  2. Detection of myxoma viruses encoding a defective M135R gene from clinical cases of myxomatosis; possible implications for the role of the M135R protein as a virulence factor

    Directory of Open Access Journals (Sweden)

    Larsen Lars E

    2010-01-01

    Full Text Available Abstract Background Myxoma virus is a member of the Poxviridae and causes disease in European rabbits. Laboratory confirmation of the clinical disease, which occurs in the autumn of most years in Denmark, has been achieved previously using antigen ELISA and electron microscopy. Results An unusually large number of clinically suspected cases of myxomatosis were observed in Denmark during 2007. Myxoma virus DNA was detected, using a new real time PCR assay which targets the M029L gene, in over 70% of the clinical samples submitted for laboratory confirmation. Unexpectedly, further analysis revealed that a high proportion of these viral DNA preparations contained a frame-shift mutation within the M135R gene that has previously been identified as a virulence factor. This frame-shift mutation results in expression of a greatly truncated product. The same frame-shift mutation has also been found recently within an avirulent strain of myxoma virus (6918. However, three other frame-shift mutations found in this strain (in the genes M009L, M036L and M148R were not shared with the Danish viruses but a single nucleotide deletion in the M138R/M139R intergenic region was a common feature. Conclusions It appears that expression of the full-length myxoma virus M135R protein is not required for virulence in rabbits. Hence, the frame-shift mutation in the M135R gene in the nonpathogenic 6918 virus strain is not sufficient to explain the attenuation of this myxoma virus but one/some of the other frame-shift mutations alone or in conjunction with one/some of the thirty two amino acid substitutions must also contribute. The real time PCR assay for myxoma virus is a useful diagnostic tool for laboratory confirmation of suspected cases of myxomatosis.

  3. Detection of myxoma viruses encoding a defective M135R gene from clinical cases of myxomatosis; possible implications for the role of the M135R protein as a virulence factor.

    Science.gov (United States)

    Belsham, Graham J; Polacek, Charlotta; Breum, Solvej Ø; Larsen, Lars E; Bøtner, Anette

    2010-01-16

    Myxoma virus is a member of the Poxviridae and causes disease in European rabbits. Laboratory confirmation of the clinical disease, which occurs in the autumn of most years in Denmark, has been achieved previously using antigen ELISA and electron microscopy. An unusually large number of clinically suspected cases of myxomatosis were observed in Denmark during 2007. Myxoma virus DNA was detected, using a new real time PCR assay which targets the M029L gene, in over 70% of the clinical samples submitted for laboratory confirmation. Unexpectedly, further analysis revealed that a high proportion of these viral DNA preparations contained a frame-shift mutation within the M135R gene that has previously been identified as a virulence factor. This frame-shift mutation results in expression of a greatly truncated product. The same frame-shift mutation has also been found recently within an avirulent strain of myxoma virus (6918). However, three other frame-shift mutations found in this strain (in the genes M009L, M036L and M148R) were not shared with the Danish viruses but a single nucleotide deletion in the M138R/M139R intergenic region was a common feature. It appears that expression of the full-length myxoma virus M135R protein is not required for virulence in rabbits. Hence, the frame-shift mutation in the M135R gene in the nonpathogenic 6918 virus strain is not sufficient to explain the attenuation of this myxoma virus but one/some of the other frame-shift mutations alone or in conjunction with one/some of the thirty two amino acid substitutions must also contribute. The real time PCR assay for myxoma virus is a useful diagnostic tool for laboratory confirmation of suspected cases of myxomatosis.

  4. Large B-cell lymphoma arising in cardiac myxoma or intracardiac fibrinous mass: a localized lymphoma usually associated with Epstein-Barr virus?

    Science.gov (United States)

    Aguilar, Cristian; Beltran, Brady; Quiñones, Pilar; Carbajal, Tomas; Vilcapaza, Jorge; Yabar, Alejandro; Segura, Pedro; Quintanilla-Martinez, Leticia; Miranda, Roberto N; Castillo, Jorge J

    2015-01-01

    Primary cardiac neoplasms are rare. However, among them, cardiac myxoma is the most common tumor. In contrast, primary cardiac lymphoma within a cardiac myxoma is extremely rare and might be difficult to diagnose because of non-specific clinical manifestations. We report the case of a previously healthy 52-year-old man who presented with acute onset of transient dysarthria and left hemiplegia. A transthoracic echocardiography showed a 6×2.5-cm solid mass in the left atrium, which was subsequently resected. Histological, immunohistochemical, and molecular analyses revealed an EBV-associated CD30-positive large B-cell lymphoma with anaplastic morphology within a cardiac myxoma and fibrinous material. Staging studies showed no evidence of lymphoma elsewhere. The patient achieved complete remission and is alive 42 months after diagnosis, and did not receive chemotherapy. We discuss the clinical and pathologic features of lymphoma arising in cardiac myxoma or in intra-atrial fibrinoid mass and the potential role of IL-6 in its pathogenesis. Copyright © 2014 Elsevier Inc. All rights reserved.

  5. Right atrial tumor embolism from thoracic chondrosarcoma: A case report

    OpenAIRE

    LV, LIYUAN; WANG, XUEQIAN; ZHANG, YING

    2015-01-01

    Chondrosarcoma accounts for ~15% of all primary malignant bone tumors. Chondrosarcoma of the spine is rare, while intra-atrial tumor embolisms as a result of chondrosarcoma are extremely rare. In the present study, the case of a 70-year-old male with thoracic chondrosarcoma, who presented with a fever and exertional dyspnea, is reported. Following anti-infection treatment with cefoperazone sodium and sulbactam sodium, the patient developed shock and a mass was identified in the right atrium b...

  6. Clinicopathological Characteristics of Odontogenic Myxoma in ...

    African Journals Online (AJOL)

    Odontogenic epithelium was rare and observed in 5 (9.5%) cases while calcific material was present in sixteen (25.4%) cases. Late presentation was a common feature and surgical excision was the treatment of choice. Conclusion: Odontogenic myxoma is un-common among Nigerians when compared with ameloblastoma ...

  7. An ectopic tooth concealing an odontogenic myxoma.

    Science.gov (United States)

    Singh, Parmjit; Davies, Huw Teifion

    2013-01-01

    This case report presents a 13-year-old girl who attended an orthodontic clinic for an ectopic UR5. After investigation, a diagnosis of an odontogenic myxoma was made and the tumour was excised. A panoramic radiograph taken almost two years earlier for another dental problem was found to show an ectopic UR5 associated with a subtle radiolucency. Odontogenic myxomas may be of higher frequency than once thought in the paediatric population and therefore should always be considered in the differential diagnosis of any intraosseous radiolucency. Any radiolucent area associated with an unerupted tooth should be investigated further or closely followed up. The odontogenic myxoma is a rare but potentially serious benign tumour of the jaws.

  8. [Traumatic left ventricle-right atrial communication. A case report].

    Science.gov (United States)

    Benyass, A; Belmadani, K; Lakhal, Z; Moustaghfir, A; Hda, A; Boukili, M A; Ohayon, V; Maazouzi, W; Archane, M I

    1999-11-01

    The authors report the case of an acquired left ventricle-right atrial communication after open chest trauma. The initial clinical presentation was a haemothorax and haemopericardium responding well to emergency surgical drainage. Secondarily, a systolic murmur suggesting a ventricular septal defect and signs of right heart failure were observed. Colour Doppler echocardiography led to the diagnosis of a left ventricle-right atrial communication associated with tricuspid regurgitation with dilatation of the right heart chambers and pulmonary hypertension. At surgery, a defect in the membranous interventricular septum was confirmed with rupture of the septal tricuspid leaflet causing tricuspid regurgitation. The surgeon closed the defect with a patch and performed a De Vega tricuspid valvuloplasty. The postoperative outcome was uneventful.

  9. [Intramuscular myxoma].

    Science.gov (United States)

    Parmeggiani, A; Gentile, R; Castellaneta, A

    1996-02-01

    Intramuscolar mixoma is a rare benign neoplasm of mesenchymal origin consisting of stellate shaped cells in an abundant loose, mucopolysaccharide rich matrix. We report two cases of intramuscolar mixoma with review of the literature. Our objectives are to delineate the clinico pathologic characteristic, the nature of constituent cells and the features differing from others benign and malignant neoplasms.

  10. [Cardiac myxoma in the elderly. Clinical study].

    Science.gov (United States)

    Pentimone, F; Del Corso, L; Siuti, E; Verunelli, F; Bortolotti, U; Salvatore, L

    1997-01-01

    Cardiac mixoma in the elderly. A clinical study. The clinical features of 13 cardiac myxomas surgically resected are presented. The mean age at presentation was 68 years. Ten were in the left atrium, 5 near the fossa ovalis, 3 at the base of the atrial septum, 1 at the inferior wall and 1 on the anterior leaflet of mitral valve, 3 were in the right atrium, 1 of these was accompanied with a myxoma at the apex of left ventricle. The ECG and the chest X-ray were normal in 9 and in 8 patients, respectively. In 3 patients, the diagnosis was occasionally made by routine 2-dimensional echocardiography. 5 patients presented with fever of unknown origin, arthralgias, weakness, weight loss. None had intracardiac or extracardiac recurrence in the 73 months follow-up. The presentation with constitutional symptoms only like fever of UO, may mimic collagen and neoplastic diseases, vasculitis, lymphomas: the 2-dimensional echocardiography is mandatory to esclude a cardiac myxoma in the elderly.

  11. Mixoma odontogênico maxilar: relato de caso clínico comprometendo seio maxilar Maxillary odontogenic myxoma involving the maxillary sinus: case report

    Directory of Open Access Journals (Sweden)

    Allan Ulisses Carvalho de Melo

    2008-06-01

    Full Text Available O objetivo deste artigo é relatar um caso de mixoma odontogênico no lado direito da maxila com envolvimento do seio maxilar e fazer uma revisão de literatura envolvendo aspectos clínicos, radiográficos, histológicos e de tratamento desta patologia. O mixoma odontogênico dos maxilares é uma lesão benigna, sem preferência por sexo, raça ou localização, com características clínicas e radiográficas extremamente variadas, o que amplia demasiadamente o número de patologias tumorais do sistema estomatognático com as quais pode ser feito o diagnóstico diferencial.The aim of this paper is to report a case of odontogenic myxoma that affected the right maxilla and maxillary sinus. We have also reviewed the literature in regards of the clinical, radiographic, histological and treatment aspects of this pathology. Odontogenic myxomas of the maxillofacial region are benign lesions, without preference for gender, race or location, with extremely varied clinical and radiographic characteristics, thus increasing the number oral and maxillofacial region tumors with which we can make the differential diagnosis.

  12. [Myxoma of the mitral valve with embolization of the posterior circulation. A case report and review of the literature].

    Science.gov (United States)

    Remes Troche, J M; Zuñiga, J; Rebollar, V; Hernández, P; Narváez, R; Téllez Zenteno, J F; García Ramos, G

    Although cardiac tumours are infrequent, over half are myxomas. Most are situated in the cavities of the heart and exceptionally on the valves. Embolism towards the arteries of the anterior circulation of the central nervous system is the commonest neurological finding, but rarely involves the posterior circulation. A 79 year old woman who one year before admission had had a right hemiparesia of the face and body, from which she had made a complete recovery. Three months later she had a sudden onset of unsteady gait which was deviated towards the right and vertigo. She attended our institution where magnetic resonance (MR) studies showed that there were infarcts in the territory of the right anterior and posterior inferior cerebellar arteries. Four months later she had a further episode of unsteady gait, vertigo and right hemiparesia of face and body for which she was admitted to hospital. On physical examination there was dysmetry, dysdiadokokinesia and involvement of the third cranial nerve. Further MR studies showed the previous lesions and also a new ischaemic lesion of the mesencephalum. A transoesophagic echocardiogram showed a tumour of approximately 18 x 20 mm, implanted in the mitral valve. Study of the resected tumour showed it to be a myxoma. Six months later the patient was asymptomatic and had not relapsed. Although the association of vascular events of the posterior circulation with myxomas of the mitral valve is rare, its clinical importance cannot be overlooked.

  13. Cutaneous myxoma in a pintagol (Sporagra magellanica X Serinus canaria

    Directory of Open Access Journals (Sweden)

    Guilherme Reis Blume

    2015-09-01

    Full Text Available Myxomas are benign mesenchymal tumors rarely described in birds. This report describes the clinical and pathological findings in a case of myxoma in a pintagol (Sporagra magellanicaX Serinus canaria. The animal had a nodule on the dorsal region of the third digit on the left hindlimb. Grossly, it was a 0.9×0.5×0.4cm, soft, white nodule, with black and yellow areas on the cut surface. Microscopically, a well-differentiated monomorphic population of spindle cells arranged in an abundant Alcian blue-positive myxoid matrix was observed. The diagnosis of myxoma was based on the microscopic findings

  14. [Right ventricular myxoma in a child: an uncommon presentation].

    Science.gov (United States)

    Tarmiz, Amine; Mgarrech, Imene; Slim, Mehdi; Kortas, Chokri; Jerbi, Sofiane

    2016-01-01

    The right ventricle is an uncommon location for cardiac myxoma. Its most common complications are pulmonary embolism and obstruction due to pulmonary valve tumor. We report the case of a 11-year old child with repetitive syncopes admitted to Cardiology ward. Echocardiography showed a right ventricular myxoma of 2cm obstructing the pulmonary orifice. Emergency surgical excision was performed under cardiopulmonary bypasss with favorable postoperative course. Anatomo-pathological examination of the surgical specimen confirmed the diagnosis of myxoma. At 18 months follow-up, there was no evidence of tumor recurrence.

  15. Computed tomography of odontogenic myxoma

    Energy Technology Data Exchange (ETDEWEB)

    MacDonald-Jankowski, D.S. E-mail: d.macdon@interchange.ubc.ca; Yeung, R.W.K.; Li, T.; Lee, K.M

    2004-03-01

    AIM: The aim of this study was to determine the computed tomography (CT) presentation of odontogenic myxoma (OM) in a Chinese population and to compare them with those observed on the accompanying conventional radiographs (CR). MATERIALS AND METHODS: The files of the Department of Oral and Maxillofacial Surgery of the University of Hong Kong between 1989 and 2000 were reviewed for myxoma cases. RESULTS: Ten cases of OM were found of which eight had been investigated by CT. The formatted hard copy was found in seven cases, four in the maxilla and three in the mandible. Most of the OMs had a round shape but one was fusiform. CT was more likely to display a cortex and its perforation. All OMs had perforated cortices on CT with soft tissue appearing outside the bony contour in two cases. Contrast enhancement was apparent in six cases. Both CR and CT displayed septae, but the latter method revealed that most septae were situated at the periphery, presenting as 'sunray' type spicules in one case. Tooth displacement and root resorption were more reliably observed on CR. CONCLUSION: The likelihood of perforation and pattern of septa of OM is better displayed by CT. CR should also allow a better assessment of the degree of definition of the lesion's margins with adjacent normal bone. Therefore, both CT and CR should be used in an investigation of an OM.

  16. Left ventricular mass: Myxoma or thrombus?

    Directory of Open Access Journals (Sweden)

    Monish S Raut

    2015-01-01

    Full Text Available Patient with embolic episode should always be evaluated for cardiac mass. Mass in left ventricular can be a myxoma or thrombus even in a normal functioning heart . In either case, mobile mass with embolic potential should be surgically resected.

  17. Cardiac myxoma in pregnancy: a comprehensive review

    Directory of Open Access Journals (Sweden)

    Shi-Min Yuan

    2015-09-01

    Full Text Available AbstractObjective:Cardiac myxoma in pregnancy is rare and the clinical characteristics of this entity have been insufficiently elucidated. This article aims to describe the treatment options and the risk factors responsible for the maternal and feto-neonatal prognoses.Methods:A comprehensive search of the literature of cardiac myxoma in pregnancy was conducted and 44 articles with 51 patients were included in the present review.Results:Transthoracic echocardiography was the most common diagnostic tool for the diagnosis of cardiac myxoma during pregnancy. Cardiac myxoma resection was performed in 95.9% (47/49; while no surgical resection was performed in 4.1% (2/49 patients (P=0.000. More patients had an isolated cardiac myxoma resection in comparison to those with a concurrent or staged additional cardiac operation [87.2% (41/47 vs. 12.8% (6/47, P=0.000]. A voluntary termination of the pregnancy was done in 7 (13.7% cases. In the remaining 31 (60.8% pregnant patients, cesarean section was the most common delivery mode representing 61.3% and vaginal delivery was more common accounting for 19.4%. Cardiac surgery was performed in the first, second and third trimester in 5 (13.9%, 14 (38.9% and 17 (47.2% patients, respectively. No patients died. In the delivery group, 20 (76.9% neonates were event-free survivals, 4 (15.4% were complicated and 2 (7.7% died. Neonatal prognoses did not differ between the delivery modes, treatment options, timing of cardiac surgery and sequence of cardiac myxoma resection in relation to delivery.Conclusion:The diagnosis of cardiac myxoma in pregnancy is important. Surgical treatment of cardiac myxoma in the pregnant patients has brought about favorable maternal and feto-neonatal outcomes in the delivery group, which might be attributable to the shorter operation duration and non-emergency nature of the surgical intervention. Proper timing of cardiac surgery and improved cardiopulmonary bypass conditions may result in

  18. Cardiac myxoma in pregnancy: a comprehensive review.

    Science.gov (United States)

    Yuan, Shi-Min

    2015-01-01

    Cardiac myxoma in pregnancy is rare and the clinical characteristics of this entity have been insufficiently elucidated. This article aims to describe the treatment options and the risk factors responsible for the maternal and feto-neonatal prognoses. A comprehensive search of the literature of cardiac myxoma in pregnancy was conducted and 44 articles with 51 patients were included in the present review. Transthoracic echocardiography was the most common diagnostic tool for the diagnosis of cardiac myxoma during pregnancy. Cardiac myxoma resection was performed in 95.9% (47/49); while no surgical resection was performed in 4.1% (2/49) patients (P=0.000). More patients had an isolated cardiac myxoma resection in comparison to those with a concurrent or staged additional cardiac operation [87.2% (41/47) vs. 12.8% (6/47), P=0.000]. A voluntary termination of the pregnancy was done in 7 (13.7%) cases. In the remaining 31 (60.8%) pregnant patients, cesarean section was the most common delivery mode representing 61.3% and vaginal delivery was more common accounting for 19.4%. Cardiac surgery was performed in the first, second and third trimester in 5 (13.9%), 14 (38.9%) and 17 (47.2%) patients, respectively. No patients died. In the delivery group, 20 (76.9%) neonates were event-free survivals, 4 (15.4%) were complicated and 2 (7.7%) died. Neonatal prognoses did not differ between the delivery modes, treatment options, timing of cardiac surgery and sequence of cardiac myxoma resection in relation to delivery. The diagnosis of cardiac myxoma in pregnancy is important. Surgical treatment of cardiac myxoma in the pregnant patients has brought about favorable maternal and feto-neonatal outcomes in the delivery group, which might be attributable to the shorter operation duration and non-emergency nature of the surgical intervention. Proper timing of cardiac surgery and improved cardiopulmonary bypass conditions may result in even better maternal and feto-neonatal survivals.

  19. Paradoxical undersensing of atrial electrograms during atrial fibrillation due to repeated activation of the quiet timer blanking interval: Case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Itsuro Morishima, MD, PhD

    2014-10-01

    Full Text Available This report describes a case of paradoxical atrial undersensing by a dual-chamber pacemaker during paroxysmal atrial fibrillation. Undersensing of 5.6 mV atrial signals at a programmed sensitivity of 0.5 mV returned to normal sensing by decreasing atrial sensitivity to 1.0 mV. This uncommon phenomenon can be explained by a repeated activation of the quiet timer blanking interval. Knowledge of this phenomenon is important in the current pacemaker management to improve the accuracy of the diagnostic feature for atrial tachyarrhythmia burden and to avoid unnecessary lead revisions.

  20. Isolated tear in left atrial appendage due to blunt trauma chest: A rare case report

    OpenAIRE

    Salooja, Manpreet S.; Singla, Manender; Srivastava, Anupam; Mukherjee, Kishore C.

    2013-01-01

    Blunt traumatic cardiac rupture is associated with a high mortality rate. Motor vehicle accidents account for most cardiac ruptures, but crush injury is relatively rare. We describe a case of a 72-year-old man who had the left atrial appendage ruptured through blunt trauma due to a fall from scooter. Simple suture repair of the atrial appendage was achieved after clamping the base of the left atrium to control the bleeding. He recovered without complication. Traumatic injury to left atrial ap...

  1. Pediatric giant right atrial aneurysm: a case series and review of the literature.

    Science.gov (United States)

    Harder, Erika E; Ohye, Richard G; Knepp, Marc D; Owens, Sonal T

    2014-01-01

    Giant right atrial aneurysm is a rare form of congenital heart disease with a wide spectrum of clinical presentation varying from asymptomatic patients to those with refractory atrial arrhythmias or severe airway obstruction. Diagnosis is often confused with other causes of right atrial dilation such as Ebstein disease. Because of its rare occurrence and variable clinical presentation, inconsistencies in medical and surgical management strategies exist between centers. We present five cases of giant right atrial aneurysm managed at our institution and discuss the clinical presentation, diagnostic challenges, and medical and surgical management. © 2013 Wiley Periodicals, Inc.

  2. Atrial Fibrillation after Robotic Cardiac Surgery

    OpenAIRE

    LEONARDO CANALE; STEPHANIE MICK; RAVI NAIR; TOMISLAV MIHALJEVIC; JOHANNES BONATTI

    2014-01-01

    Atrial fibrillation is a common arrhythmia after conventional open heart surgery. A minimally invasive robotic approach has the potential to lower its occurrence. We sought to review the literature on the incidence of post operative atrial fibrillation in robotic heart surgery and compare it to the incidence in conventional cardiac surgery. The types of operation investigated were: coronary artery bypass surgery, mitral valve repair, atrial septal defect closure and myxoma excision. Operation...

  3. Electrophysiological Features of Atrial Flutter in Cardiac Sarcoidosis: A Report of Two Cases

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    Narayanan Namboodiri, MD

    2012-11-01

    Full Text Available We report two cases of systemic sarcoidosis with atrial flutter as the clinical manifestation. In one patient, who had symptoms of shorter duration, the arrhythmia was no longer inducible after a course of glucocorticoid therapy. Electroanatomical mapping in the other case revealed patchy fibrosis of the left atrial myocardium and multiple macro-reentrant circuits. Sinus rhythm could be restored with ablation of these reentrant circuits. To our knowledge, this is the first report on the demonstration of atrial scarring in a patient with sarcoidosis using 3-D electroanatomical mapping. These two cases illustrate that the inflammation of atrial myocardium is the primary mechanism of atrial arrhythmias in patients with cardiac sarcoidosis.

  4. Detection of myxoma viruses encoding a defective M135R gene from clinical cases of myxomatosis; possible implications for the role of the M135R protein as a virulence factor

    DEFF Research Database (Denmark)

    Belsham, Graham; Polacek, Charlotta; Breum, Solvej Østergaard

    2010-01-01

    number of clinically suspected cases of myxomatosis were observed in Denmark during 2007. Myxoma virus DNA was detected, using a new real time PCR assay which targets the M029L gene, in over 70% of the clinical samples submitted for laboratory confirmation. Unexpectedly, further analysis revealed...... that a high proportion of these viral DNA preparations contained a frame-shift mutation within the M135R gene that has previously been identified as a virulence factor. This frame-shift mutation results in expression of a greatly truncated product. The same frame-shift mutation has also been found recently......-shift mutations alone or in conjunction with one/some of the thirty two amino acid substitutions must also contribute. The real time PCR assay for myxoma virus is a useful diagnostic tool for laboratory confirmation of suspected cases of myxomatosis....

  5. What to do when facing with atrial thrombus: Surgical treatment of five cases

    OpenAIRE

    Deser, Serkan Burc; Demirag, Mustafa Kemal

    2018-01-01

    Although atrial thrombuses are not very common, may represent as tumors. Urgentsurgery is indicated in patients to prevent pulmonary embolism, acute valveobstruction or heart failure. We review here the clinical features, epidemiology,diagnosis and treatment of five interesting cases with atrial thrombuses. 

  6. Peripheral odontogenic myxoma in a 12-year-old girl: a rare entity.

    Science.gov (United States)

    Kanitkar, Sampada; Kamat, Mamata; Tamagond, Sridevi; Varekar, Aniruddha; Datar, Uma

    2017-06-01

    Peripheral odontogenic myxoma is a rare odontogenic tumor representing an extra osseous counterpart of central odontogenic myxoma. It is commonly seen in gingiva between the 3rd and 4th decades of life and appears predominantly in females. Compared to central odontogenic myxoma, it is a less aggressive, slow-growing lesion with a low recurrence rate. However, close postoperative follow-up is required because of the unlimited growth potential of incompletely removed lesions. It shares many features with other soft tissue myxoid proliferations occurring in the oral cavity and hence needs to be differentiated from them. Very few cases of peripheral odontogenic myxomas have been reported and, to the best of our knowledge, no case has been reported in a pediatric patient. We present an unusual case of peripheral odontogenic myxoma occurring in a 12-year-old girl located in the anterior mandibular gingiva, with an emphasis on differential diagnosis.

  7. Surgical resection of cardiac myxoma-a 30-year single institutional experience.

    Science.gov (United States)

    Lee, Kyo Seon; Kim, Gwan Sic; Jung, Yochun; Jeong, In Seok; Na, Kook Joo; Oh, Bong Suk; Ahn, Byung Hee; Oh, Sang Gi

    2017-03-27

    Primary cardiac tumors are rare and myxoma constitutes the majority. The present study summarizes our 30-year clinical outcomes of surgical myxoma resection. Between January 1986 and December 2015, 93 patients (30 men, 63 women; mean age, 54.7 ± 16.6 years) underwent surgical myxoma resection. The most common origin site was the left atrium. Surgery was performed via a biatrial approach in 74.2%, atrial septotomy through right atriotomy in 17.2%, and left atriotomy only in 8.6%. Mean myxoma size based on longest length was 4.73 ± 1.92 cm (range, 1.2-11.0 cm). The mean follow-up duration was 9.9 ± 7.8 years (range, 0-29 years). In-hospital mortality was 3.2%. The most common postoperative complication was atrial fibrillation (4.3%). The 5-, 10-, and 30-year survival rates were 92.9%, 87.2%, and 75.5%, respectively. Recurrence occurred in two patients (2.1%), which were detected at 20 and 79 months after the first surgery, respectively. Long-term survival after myxoma resection was excellent and recurrence was rare. Based on our experience, surgical method did not affect the outcome.

  8. Ancient cardiac myxomas – another point of view in the light of tetraspanins

    Directory of Open Access Journals (Sweden)

    Piotr Lewitowicz

    2016-05-01

    Full Text Available Myxomas are the most common non-invasive but life-threatening cardiac neoplasms due to obstruction of heart chambers and risk of embolism in a manner resembling thromboembolism as well. They can occasionally disseminate via their detached fragments into the bloodstream to seed and grow as secondary still benign tumors. In this study we evaluated morphological and clinical aspects of 14 ancient, degenerated left or right-sided cardiac atrial myxomas with expression of CD9 and CD63, which are found to contribute to platelet activation, aggregation and, as a result, intratumoral thrombosis or fragmentation. The appearance of tumors varied from sessile to polypoid revealing that a higher rate of endocardial thrombosis was associated with sessile compared to polypoid myxomas and left-sided tumors compared to right-sided ones in our study. In the general aspect of ancient calcifications, amorphous calcification with intra-tumor thrombosis was noted more frequently in sessile tumors, while well-formed osseous metaplasia was usually a feature of polypoid tumors. In our material osseous metaplasia did not coexist with massive thrombosis and was found in polypoid, pedunculated myxomas. Most importantly, CD9 overexpression was recorded in every studied myxoma and CD63 gave a weak reaction in myxoma cells.

  9. Stroke caused by a myxoma stenosing the common carotid artery.

    Science.gov (United States)

    Cortés-Vicente, Elena; Delgado-Mederos, Raquel; Bellmunt, Sergi; Borras, Xavier F; Gómez-Ansón, Beatriz; Bagué, Silvia; Camps-Renom, Pol; Martí-Fàbregas, Joan

    2015-04-01

    We report a case of stroke due to stenosis caused by a myxoma in the common carotid artery with no evidence of a cardiac origin. Only 1 such case has been reported previously in the literature. A previously healthy 37-year-old woman presented with repeated episodes of acute focal deficits together with motor, sensory, and language symptoms typical of left internal carotid territory involvement. Brain magnetic resonance imaging showed acute and subacute ischemic lesions in the territory of the left middle cerebral artery and border zone infarcts (middle cerebral artery with anterior and posterior cerebral arteries). Magnetic resonance angiography showed a filling defect in the distal portion of the left common carotid artery causing stenosis over 70%. Transesophageal echocardiography showed no embolic sources. Blood tests ruled out a prothrombotic state. The image was initially interpreted as a possible subacute thrombus and anticoagulation was started. No changes were observed in the follow-up carotid ultrasound examination after 12 days of treatment. A gelatinous mass was removed during carotid surgery. No subjacent lesion was observed in the vessel wall. Pathology examination showed a spindle cell fibromyxoid tissue with fibrinoid material typical of myxoma. We hypothesize that the myxoma originated in the vessel, or alternatively, that a cardiac myxoma embolized without leaving a residual cardiac tumor. Although exceptional, myxoma should be added to the list of unusual causes of carotid artery stenosis causing stroke. Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  10. Intense 18F-FDG uptake in an organizing right atrial thrombus mimicking malignancy

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    Krishna G. Chaudhuri, MD

    2017-09-01

    Full Text Available We present a case of an intensely hypermetabolic intracavitary cardiac mass, standardized uptake values max 44.4, that was pathologically proved to be organizing and organized thrombus, negative for tumor. Our patient had previous right atrial mass resection 2 years prior that was pathologically described as either thrombus or infarcted atrial myxoma. She had since been on lifelong controlled anticoagulation; and on routine follow-up imaging, she had recurrent slow growth of a new right atrial mass. During a later hospital admission for chest pain, the mass was evaluated on both transthoracic and transesophageal echo cardiogram, which could not differentiate thrombus vs neoplasm. Cardiac magnetic resonance imaging was equivocal for mass enhancement. The patient underwent fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT evaluation, which revealed intensely hypermetabolic activity within the mass concerning for malignancy, potentially an aggressive tumor. Subsequently, the mass was surgically excised for pathological diagnosis.

  11. 1C-INDUCED ATRIAL FLUTTER IN A PATIENT WITH WPW SYNDROME: CASE REPORT AND REVIEW

    Directory of Open Access Journals (Sweden)

    R. R. Mamatkazina

    2012-01-01

    Full Text Available The clinical case of a rare proarrhythmic effect of antiarrhythmic drugs with a poor prognosis (medication-induced atrial flutter in a patient with "malignant" Kent’s bundle is presented. Radiofrequency ablation (RFA is the most justified treatment method in patients with WPW-syndrome and "malignant" Kent’s bundle. RFA in descripted case has been postponed due to technical reasons. While waiting for RFA and after consideration of the potential risks and benefits the decision to use antiarrhythmic drugs to block the additional bundle was made. Paroxysm of broad-complex tachycardia developed on the third day of the treatment. It was regarded as a paroxysm of atrial fibrillation/flutter in the patient with WPW syndrome induced by taking antiarrhythmic drugs class 1C (allapinine. Review of the literature on the atrial fibrillation induced by antiarrhythmic of 1C class, and association of atrial fibrillation with WPW-syndrome is presented.

  12. 1C-INDUCED ATRIAL FLUTTER IN A PATIENT WITH WPW SYNDROME: CASE REPORT AND REVIEW

    Directory of Open Access Journals (Sweden)

    R. R. Mamatkazina

    2015-12-01

    Full Text Available The clinical case of a rare proarrhythmic effect of antiarrhythmic drugs with a poor prognosis (medication-induced atrial flutter in a patient with "malignant" Kent’s bundle is presented. Radiofrequency ablation (RFA is the most justified treatment method in patients with WPW-syndrome and "malignant" Kent’s bundle. RFA in descripted case has been postponed due to technical reasons. While waiting for RFA and after consideration of the potential risks and benefits the decision to use antiarrhythmic drugs to block the additional bundle was made. Paroxysm of broad-complex tachycardia developed on the third day of the treatment. It was regarded as a paroxysm of atrial fibrillation/flutter in the patient with WPW syndrome induced by taking antiarrhythmic drugs class 1C (allapinine. Review of the literature on the atrial fibrillation induced by antiarrhythmic of 1C class, and association of atrial fibrillation with WPW-syndrome is presented.

  13. Fibrilação atrial em cão associada ao quimiodectoma infiltrativo atrial: relato de caso Atrial fibrillation in dog associated with an infiltrative chemodectoma in the atrial myocardium: a case report

    Directory of Open Access Journals (Sweden)

    G.A.O. Cavalcanti

    2006-12-01

    Full Text Available Relata-se o caso de um cão, sem raça definida, levado ao veterinário por apresentar cansaço fácil e episódios de síncope. Foram identificadas fibrilação atrial e extra-sístoles ventriculares isoladas ao exame eletrocardiográfico. O tratamento antiarrítmico não foi eficaz, e o animal morreu devido a um episódio de síncope. À necropsia, observou-se massa em região de base cardíaca, invadindo a luz do átrio esquerdo. Histologicamente, constatou-se a presença de quimiodectoma. A infiltração miocárdica atrial causou lesões nos miócitos, produzindo circuitos reentrantes e/ou focos ectópicos de despolarização atrial.This case reports a mongrel dog referred to a veterinarian due to tiredness and syncope episodes. Atrial fibrillation and ventricular premature complex were observed during electrocardiographic exam. The anti-arrhythmic treatment was not effective and the dog died from syncope. At necropsy, a mass invading the internal area of the left atrium was evidenced in the base of the heart. The occurrence of chemodectoma was histologically exhibited. Infiltrations in the atrial myocardium caused alterations in the miocites and produced reentrant circuits and/or atrial depolarization ectopic points.

  14. Intracranial and visceral arterial embolization of a cardiac myxoma that was treated with endovascular stent-retriever therapy.

    Science.gov (United States)

    McGowan, Archie R; Thibodeau, Cheryl; McGowan, Amelia

    2016-10-01

    We report a case of a ruptured left atrial myxoma with multiple synchronous sites of embolization, including the intracranial cerebral (left middle cerebral artery (MCA) and basilar), visceral (renal, superior mesenteric artery (SMA)) and peripheral circulatory beds (aorta and lower extremities). This synchronous embolization resulted in a catastrophic neurologic and systemic event. An intracranial stent retriever was used to restore cerebral circulation in the symptomatic left MCA distribution, which resulted in resolution of the acute neurologic deficits. Endovascular and open surgical interventions were later performed to address the residual cardiac mass and other embolic sites. The patient survived the event with the loss of her right leg below the knee and a transient dialysis requirement. The purpose of this case report is to document the successful utilization of a stent-retriever device in removing an embolized myxoma from the cerebral circulation, to review the unique pathology of this source of embolic stroke and to reiterate the importance of considering embolic and non-thrombotic etiologies of acute ischemic stroke, especially in atypical patient populations and patient presentations. © The Author(s) 2016.

  15. Persistent wandering atrial pacemaker after epinephrine overdosing – a case report

    Directory of Open Access Journals (Sweden)

    Aburawi Elhadi H

    2013-01-01

    Full Text Available Abstract Background Long-term complications of sympathomimetic drug overdosing have not been adequately investigated in infants and young children. Despite reports discouraging their use in children, these formulations are frequently administered for “cold-like symptoms”. Their frequent adverse events are different forms of arrhythmias, including multifocal atrial tachycardia. Case presentation A 3-year-old toddler developed multifocal atrial tachycardia following an iatrogenic overdose of epinephrine accidentally administered intravenously. His ECG showed wandering atrial pacemaker (p-waves with different origins and configurations that persisted for at least one year. This event demonstrated the sensitivity of young children to the sympathomimetic drugs, especially overdosing. Conclusions Health care providers and parents should be warned of toxicities associated with sympathomimetic drug overdosing. Future studies are needed to determine whether wandering atrial pacemaker is a potential long-term complication of high-dose sympathomimetics.

  16. The pathogenesis of ovarian myxoma: a neoplasm sometimes arising from other ovarian stromal tumors.

    Science.gov (United States)

    Roth, Lawrence M; Gaba, Arthur R; Cheng, Liang

    2013-07-01

    Ovarian myxoma is a rare distinctive benign ovarian stromal neoplasm that occurs predominantly in young women and is hormonally inactive. Although typically classified as an ovarian stromal tumor, its exact pathogenesis remains uncertain. We report 4 cases of ovarian myxoma, 3 of which were associated with another type or other types of ovarian stromal tumor and 1 occurred as a pure myxoma. In 2 cases, the myxoma arose from a sclerosing stromal tumor, and the third, most likely arose from a luteinized theca cell tumor (LTCT). Myxoid transformation of the connective tissue of the parent neoplasm appears to be a precursor of ovarian myxoma in some instances. We believe that the occurrence of trisomy 12 or other genetic abnormalities may play a role in this transformation. Whether or not associated with another type of ovarian stromal tumor, ovarian myxoma can be suspected macroscopically by its cystic gelatinous appearance and sharp circumscription. The most important differential diagnosis is a low-grade sarcoma with myxomatous features. We believe that myxomas arising from different anatomic sites likely are genetically, histologically, and biologically distinct. For purposes of classification, they should be considered as separate tumor types.

  17. No association between herpes simplex virus 1 and cardiac myxoma.

    Science.gov (United States)

    Schurr, Ulrich P; Berdajs, Denis A; Bode, Beate; Dzemali, Omer; Emmert, Maximilian Y; Genoni, Michele

    2011-08-26

    Cardiac myxoma is the most commonly diagnosed cardiac tumour. Infection of herpes simplex virus 1 (HSV1) has been postulated to be a factor for this pathologic entity. The aim of the current study was to evaluate the association between HSV 1 and myxoma occurrence. Between 1965 and 2005, 70 patients (36 female, mean age: 52.6 years) underwent a resection of myxoma. Selected variables such as hospital mortality and morbidity were studied. A follow-up (FU; mean FU time: 138 ± 83 months) was obtained (76% complete). Immunohistological studies with monoclonal antibodies against HSV type 1 were performed on tumour biopsies of 40 patients. The mean age was 53 ± 16 years (range 23 to 84 years, 51% female). Of the investigated population, 31 (44%) were in New York Heart Association (NYHA) class III-IV. Mitral valve stenosis was identified in 14 patients (20%), and in 25 (36%) patients mitral valve was insufficient. During hospitalisation 3 patients suffered from a transient neurological disorder, and in addition to myxoma resection 18 (25.7%) patients had to undergo an additional intervention. The overall survival rate was 91% at 40 years. There was no early postoperative mortality in follow-up, although 4 patients died and 2 patients had been re-operated on for recurrent myxomas after 2 and 9 years. Immunohistology revealed no positive signals for HSV-1 antigens among the 40 analysed cases. Complete surgical resection, septum included, was the treatment of choice and mandatory to prevent relapse. Peri-operative morbidity and mortality over 40 years remained low, and no association between HSV infection and occurrence of cardiac myxoma was found.

  18. [Radiofrequency ablation of long standing persistent atrial fibrillation and post-incisional macroreentrant right atrial tachycardia in patient with advanced biventricular heart failure--case raport].

    Science.gov (United States)

    Zakrzewska, Joanna; Derejko, Paweł; Szufladowicz, Ewa; Bodalski, Robert; Orczykowski, Michał; Przybylski, Andrzej; Szumowski, Lukasz; Michałek, Piotr; Walczak, Franciszek

    2008-11-01

    We present a case of a 54 year old male with a long-standing atrial fibrillation (AF) who was scheduled for cardiac transplantation due to the progression of heart failure. Previous treatment included pacemaker implantation, mitral valvuloplasty, a-v node modification using RF ablation, and pharmacological therapy. This time the patient underwent complex AF ablation which consisted of pulmonary vein isolation, mitral and left atrial roof line creation, cavo-tricuspid isthmus ablation and ablation of complex fractionated atrial electrograms, which resulted in restoration of sinus rhythm. Because of the right atrial post-incisional tachycardia the patient underwent second ablation session. This complex invasive approach occurred successful. The patient remains in sinus rhythm with improved left ventricular function and better NYHA class over a 12-month follow-up.

  19. Giant cardiac myxoma with malignant transformed glandular structures

    Energy Technology Data Exchange (ETDEWEB)

    Eckhardt, Boris P.; Stuckmann, Gerd; Zollikofer, Christoph L. [Institute of Radiology, Cantonal Hospital, Brauerstrasse 15, 8401 Winterthur (Switzerland); Dommann-Scherrer, Corina C. [Insitute of Pathology, Cantonal Hospital, Brauerstrasse 15, 8401 Winterthur (Switzerland); Wentz, Klaus U. [Institute of Radiology, Cantonal Hospital, Brauerstrasse 15, 8401 Winterthur (Switzerland); Medical Faculty, University of Witten/Herdecke, Alfred-Herrhausen-Strasse 50, 58448 Witten (Germany)

    2003-09-01

    A case of a right-sided giant cardiac myxoma with malignant transformation of glandular structures causing systemic metastases is described. Plain chest radiography and computed tomography localized the tumor within the heart. Exact depiction of the origin of the tumor using subtracted 2D-projection MR angiography is documented. Radiologic findings and differential diagnosis of this unique tumor are discussed. (orig.)

  20. Polyostotic fibrous dysplasia associated with intramuscular myxomas: Mazabraud`s syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Lassance Cabral, C.E.; Guedes, P.; Celso Cruz, L. Jr.; Smith, J. [Inst. Nacional de Cancer, Rio de Janeiro (Brazil). Dept. of Radiol.; Fonseca, T. [Department of Surgical Pathology, Instituto Nacional de Cancer (INCA), Rio de Janeiro (Brazil); Rezende, J.F. [Department of Surgery, Instituto Nacional de Cancer (INCA), Rio de Janeiro (Brazil)

    1998-05-01

    Mazabraud`s syndrome, though uncommon, is reported increasingly frequently. It represents an entity readily recognisable radiologically on MR imaging. Awareness of the syndrome, particularly when the myxoma is solitary, can prevent misdiagnosis of intramuscular myxomas (especially when large) as malignant mesenchymal tumors containing myxoid tissue. We review the 34 cases previously reported in the literature and include a recent case from our center. (orig.) With 3 figs., 1 tab., 21 refs.

  1. Effective mechanical thrombectomy in a patient with hyperacute ischemic stroke associated with cardiac myxoma.

    Science.gov (United States)

    Baek, Seol-Hee; Park, Soonchan; Lee, Nam Joon; Kang, Youngjin; Cho, Kyung-Hee

    2014-10-01

    Ischemic stroke is the most common neurologic manifestation of cardiac myxoma. However, there has been no current guideline on the treatment of hyperacute ischemic stroke due to cardiac myxoma. We describe a patient with hyperacute stroke caused by cardiac myxoma who had a good outcome with rapid recanalization through mechanical thrombectomy. A 46-year-old man was admitted with acute symptoms of right side hemiplegia and global aphasia. Brain computed tomography (CT) angiography showed a T occlusion of the left internal carotid artery. Intravenous recombinant tissue plasminogen activator was administered. However, his clinical symptoms did not improve. Thus, we performed endovascular treatment and had a successful outcome. A pathologic examination of the retrieved clot revealed a tumor emboli from a cardiac myxoma. Transthoracic echocardiogram revealed a left atrial myxoma in which a large mass was attached to the posterior wall of the aorta. The patient's neurologic deficits recovered with the exception of left eye blindness. Reperfusion therapy with mechanical thrombectomy might be safe and effective for the rapid revascularization of large vessel occlusions in hyperacute ischemic stroke, from which the tumor thrombi can be retrieved. Copyright © 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  2. [Giant congenital intrapericardial left atrial appendage aneurysm: about a case and review of the literature].

    Science.gov (United States)

    Zhari, Bouchra; Bellamlih, Habib; Boumdine, Hassan; Amil, Touriya; Bamous, Mehdi; En-Nouali, Hassan

    2016-01-01

    Left atrial appendage aneurysm is a very rare heart anomaly. It may be congenital or acquired, secondary to inflammatory or degenerative processes. Most cases are asymptomatic. The prevalence of these lesions in pediatric age has been very rarely reported. As it can cause potentially fatal arrhythmias or thrombus, surgery is required immediately after diagnosis. This study reports the case of a 14-year-old boy with rapidly progressive dyspnea, palpitations, sensation of repetitive dizziness and fainting, in whom congenital left atrial appendage aneurysm was detected. Diagnosis was based on coronary CTA data. The patient was successfully treated with surgical resection of the aneurysm.

  3. Conjunctival myxoma: a synopsis of a rare ocular tumor.

    Science.gov (United States)

    Xiong, Meng-Jun; Dim, Daniel C

    2015-05-01

    Conjunctival myxoma is an exceptionally rare, slow-growing, benign neoplasm of primitive mesenchyme origin. Forty-one cases of conjunctival myxoma from a literature review, including the authors' case, are listed. The usual clinical history is a painless mass appearing during months to years. Grossly, the tumor is a well-circumscribed, cystlike, gelatinous, yellow-to-pink, translucent-to-solid mass. Microscopically, the hypocellular tumor contains stellate- and spindle-shaped cells in a mucoid stroma with abundant hyaluronic acid mucopolysaccharides. Vimentin and α-smooth muscle actin highlight the spindle and stellate cells. S100 protein and desmin are negative for the tumor cells. Treatment is complete surgical excision, with no recurrence reported in the follow-up period. Notably, conjunctival myxoma may be associated with Carney complex, an autosomal-dominant disorder associated with skin pigmentation, endocrine abnormalities, and myxoma of the heart and eye. Physicians should appreciate this unique ocular tumor because of its potential association with Carney complex.

  4. Robotic-assisted endoscopic atrial septal defect closure: analysis of 115 cases in a single center.

    Science.gov (United States)

    Yang, Ming; Gao, Changqing; Xiao, Cangsong

    2012-06-01

    To summarize the experience with the application of robotic technique in totally endoscopic atrial septal defect closure in a single center. Between January 2007 and September 2011, 115 patients with the diagnosis of secundum type atrial septal defects underwent robotic atrial septal defect repair with the assistance of da Vinci surgical system. The patients had a median age of 35 years and a median defect diameter of 28 mm. Cardiopulmonary bypass was established via peripheral cannulation. Via three 8-mm ports and one 15-mm port in the right chest, the surgeon manipulated the microinstruments to complete the defect closure with or without tricuspid valve plasty. Echocardiography was performed intraoperatively, before discharge and at 30 days after the operation. Atrial septal defect closure was completed on arrested heart in 44 patients and on beating heart in 61 patients. No deaths or conversions to alternate techniques occurred in these cases. No residual shunt was detected by intraoperative or postoperative echocardiography. The mean operating time and cardiopulmonary bypass time on bearing heart group were significantly shorter than those on arrested heart group. The median ventilation time, intensive care unit stay, drainage volume, or length of hospital stay showed no significant differences between the two groups. Secundum type atrial septal defect closure can be successfully performed with the assistance of the robotic system with good surgical results.

  5. Atrial flutter ablation in a case of diuretic resistant constrictive pericarditis

    Directory of Open Access Journals (Sweden)

    James F. Pittaway

    2015-07-01

    This is the first reported case of symptomatic improvement in a patient with constrictive pericarditis and persistent atrial flutter with targeted treatment of the dysrhythmia. This offers a possible short-term palliation option in a group of patients where definitive surgical management carries too high a risk.

  6. Synchronous occurrence of odontogenic myxoma with multiple keratocystic odontogenic tumors in nevoid basal cell carcinoma syndrome.

    Science.gov (United States)

    Shao, Zhe; Liu, Bing; Zhang, WenFeng; Chen, XinMing

    2013-01-01

    The keratocystic odontogenic tumor (KCOT) is a benign developmental tumor with many distinguishing clinical and histologic features. Usually, multiple KCOTs occur as a component of nevoid basal cell carcinoma syndrome. The odontogenic myxoma is a rare benign tumor that represents about 3% of all odontogenic tumors. This article reports the case of mandible odontogenic myxoma with synchronous occurrence of multiple KCOTs, partial expression of nevoid basal cell carcinoma syndrome. A review of the international literature is also presented.

  7. Neonatal aortic arch obstruction due to pedunculated left ventricular foetal myxoma.

    Science.gov (United States)

    Kaulitz, Renate; Haen, Susanne; Sieverding, Ludger

    2015-10-01

    Myxoma in neonatal life are extremely rare. We report a case of a neonate with a pedunculated cardiac tumour arising from the anterolateral left ventricular wall protruding across the left ventricular outflow tract and continuously extending into the distal aortic arch. Surgical removal at 14 days of age via combined transaortic approach and apical ventriculotomy was indicated because of the risk of further compromise of aortic valve function and aortic arch obstruction. Histopathologic examination was consistent with a myxoma.

  8. Emergency bypass post percutaneous atrial ablation: a case report.

    LENUS (Irish Health Repository)

    Hargrove, M

    2010-11-01

    A 34-year-old male undergoing percutaneous atrial ablation procedure for paroxysmal fibrillation required emergency sternotomy for cardiac tamponade. The patient had been anticoagulated and had received plavix and aspirin prior to and during the ablation procedure. Seven units of red cell concentrate had been transfused in the cardiac catherisation laboratory. On arrival in theatre, the patient was hypotensive, but was awake on induction of anaesthesia. No recordable blood pressure with non-invasive monitoring was observed. A sternotomy was immediately performed and, on evacuation of the pericardium, a bleeding site was not visible. The patient was commenced on cardiopulmonary bypass. Bleeding site was identified and the defect closed. The patient was weaned from cardiopulmonary bypass with minimal inotropic support and made an uneventful recovery. Bypass time was 38 minutes. A literature review showed a 1% incidence of post-ablation bleeding(1). The incidence of reverting to bypass for such an event has not been reported previously. During these procedures, it might be wise to have the cardiothoracic team notified while atrial ablation procedures are being performed in the cardiac catheterization laboratory.

  9. Aortic valve myxoma at the extreme age: a review of literature

    Science.gov (United States)

    Javed, Arshad; Zalawadiya, Sandip; Kovach, Julie; Afonso, Luis

    2014-01-01

    Primary cardiac tumours are a rare finding, with cardiac myxoma and fibroelastoma representing the majority of these tumours. Cardiac myxomas are most commonly found in the left atrium but are rarely found with attachment to the cardiac valves. The authors describe a case of aortic myxoma found in an 81-year-old man presented with peripheral arterial disease. CT angiogram of the thorax was performed to find the source of emboli and it showed a mass attached to the aortic valve and protruding into the aorta. Details of the location and texture were studied on transoesophageal echocardiography. Preoperative coronary angiography showed coronary artery disease and the patient underwent successful coronary artery bypass grafting and simultaneous resection of the mass. Histopathology revealed the mass as a myxoma. PMID:24642215

  10. Left atrial spindle cell sarcoma – Case report

    Directory of Open Access Journals (Sweden)

    Nihar Mehta

    2012-07-01

    Full Text Available Primary spindle cell sarcoma of the left atrium is an extremely rare tumour. Surgical excision is the mainstay of treatment since it responds poorly to chemotherapy or radiotherapy. In spite of all the treatment, the prognosis remains poor due to inadvertent delay in diagnosis, few therapeutic options and propensity to metastasize. We present a 47-year-old male who underwent a surgical excision of a left atrial mass in February 2010. It was proved to be a high-grade spindle cell sarcoma on histopathology. He presented again in October 2010 with recurrence of the tumour for which he was re-operated. However, the tumour recurred again within one month, to which the patient succumbed.

  11. Computed tomography of intramuscular myxoma

    Energy Technology Data Exchange (ETDEWEB)

    Ekelund, L.; Herrlin, K.; Rydholm, A.

    1982-11-01

    Computed tomography (CT) was performed in seven patients with intramuscular myxoma. All lesions were well demarcated, of homogeneous appearance and attenuation values ranging from 10 to 60 (HU). The tumor size, as estimated at CT, correlated well with the size of the surgical specimen, which is in contrast to the findings in some high grade malignant sarcomas.

  12. Minimally invasive atrial fibrillation ablation combined with a new technique for thoracoscopic stapling of the left atrial appendage: case report.

    Science.gov (United States)

    Balkhy, Husam H; Chapman, Peter D; Arnsdorf, Susan E

    2004-01-01

    Surgical therapy for atrial fibrillation (AF) is becoming increasingly popular in the concomitant setting. Minimally invasive techniques are being developed for management of the patient with stand-alone AF. We report on our first case of a patient undergoing thoracoscopic microwave epicardial AF ablation combined with the incorporation of a new device for left atrial appendage (LAA) exclusion. The patient is a 62-year-old man with a 10-year history of drug-resistant paroxysmal AF. He had failed multiple electrical cardioversions, as well as a percutaneous attempt at left and right superior pulmonary vein (PV) isolation. On October 8, 2003, he was admitted to undergo an off-pump thoracoscopic epicardial microwave ablation. While the patient was under general anesthesia, 3 thoracoscopic access ports were created in the right chest. The pericardium was widely opened. Red rubber catheters were positioned in the transverse and oblique sinuses. The 2 catheters were retrieved on the left side and tied together, forming a guide to the Flex 10 microwave ablation probe (Guidant Corporation, Fremont, CA, USA). The Flex 10 sheath was positioned to encircle all 4 pulmonary veins. The position of the ablation catheter was confirmed visually to be behind the LAA. Sequential ablation was then performed in the segments of the Flex 10 to create a continuous ablation line around the PVs. A connecting lesion to the base of the LAA was then performed. The LAA was then stapled using the SurgASSIST computer-mediated thoracoscopic stapling system (Power Medical Intervention, New Hope, PA, USA). The procedure was uneventful and lasted for a total of 2.5 hours. The patient was discharged home on postoperative day 2 in rate-controlled AF. He was successfully electrically cardioverted to normal sinus rhythm (NSR). At latest follow-up he remained in NSR and continued to take dofetilide (Tikosyn). Thoracoscopic epicardial microwave ablation of AF is a technically feasible procedure with

  13. Nickel hypersensitivity following closure of atrial septal defect: A case report and review of the literature.

    Science.gov (United States)

    Dickison, Philippa; Harris, Victoria; Smith, Saxon D

    2018-01-29

    We present an unusual case where symptoms of headache and chest pain persisted for 3 years following the implantation of a septal occluder device for an atrial septal defect despite endothelialisation of the device. The patient was found to have nickel hypersensitivity on patch testing. Following the removal of the device the patient had complete resolution of headaches and chest pain up to 10 months post-explantation. © 2018 The Australasian College of Dermatologists.

  14. Atrial Ectopics Precipitating Atrial Fibrillation

    Directory of Open Access Journals (Sweden)

    Johnson Francis

    2015-04-01

    Full Text Available Holter monitor tracing showing blocked atrial ectopics and atrial ectopic precipitating atrial fibrillation is being demonstrated. Initially it was coarse atrial fibrillation, which rapidly degenerated into fine atrial fibrillation.

  15. Atrial tumors in cardiac MRI; Vorhoftumoren in der kardialen MRT

    Energy Technology Data Exchange (ETDEWEB)

    Kraemer, Nils; Schoth, F.; Guenther, R.W.; Krombach, G. [Klinik fuer Radiologische Diagnostik, Universitaetsklinikum RWTH Aachen (Germany); Balzer, J.C.; Neizel, M.; Kuehl, H. [Klinik fuer Kardiologie, Pneumologie und Angiologie, Universitaetsklinikum RWTH Aachen (Germany)

    2009-11-15

    Cardiac magnetic resonance imaging (MRI) is an important tool for the diagnosis of cardiac masses. Various cardiac tumors are predisposed to occurring in atrial structures. The aim of this review article is the description of atrial tumors and their morphological features in MRI. In general, cardiac tumors are rare: approximately 0.001-0.03% in autopsy studies. About 75% of them are benign. The most common cardiac tumor is the myxoma. They are predisposed to occur in the atria and show a characteristically strong hyperintense signal on T2-wieghted images in MRI. In other sequences a heterogeneous pattern reflects its variable histological appearance. Lipomas exhibit a signal behavior identical to fatty tissue with a typical passive movement in cine imaging. Fibroelastomas are the most common tumors of the cardiac valves. Consisting of avascular fibrous tissue, they often present with hypointense signal intensities. Thrombi attached to their surface can cause severe emboli even in small tumors. Amongst primary cardiac malignancies, sarcomas are most common and favor the atria. Secondary malignancies of the heart are far more common than primary ones (20-40 times). In case of known malignancies, approximately 10% of patients develop cardiac metastasis at the end of their disease. Lymphogenic metastases favor the pericardium, while hematogenic spread prefers the myocardium. Since they are not real atrial tumors, thrombi and anatomical structures of the atria have to be differentiated from other pathologies. (orig.)

  16. Microinsertions in PRKACA cause activation of the protein kinase A pathway in cardiac myxoma.

    Science.gov (United States)

    Tseng, I-Ching; Huang, Wei-Ju; Jhuang, Yu-Ling; Chang, Ya-Yun; Hsu, Hung-Pin; Jeng, Yung-Ming

    2017-06-01

    Cardiac myxoma is the most common cardiac tumour. Most lesions occur sporadically, but occasional lesions develop in patients with Carney complex, a syndrome characterized by cardiac myxoma, spotty pigmentation, and endocrine overactivity. Two-thirds of patients with Carney complex harbour germline mutations in PRKAR1A, which encodes the type I regulatory subunit of protein kinase A (PKA). Most studies have not found a mutation in PRKAR1A in sporadic cardiac myxoma cases. Recent studies identified frequent mutations in PRKACA, which encodes the catalytic subunit of PKA, in cortisol-secreting adrenocortical adenoma cases. To determine whether the PRKACA mutation is involved in the tumourigenesis of cardiac myxoma, we performed Sanger sequencing of 41 specimens of sporadic cardiac myxoma to test for the presence of mutations in the coding regions and intron-exon boundaries of PRKACA. Mutations were identified in four cases (9.7%). In contrast to the point mutations identified in adrenocortical adenoma, all mutations were in-frame microinsertions of 18-33 bp clustered in exons 7 and 8. The mutated PRKACA proteins lost their ability to bind to PRKAR1A, and thereby lead to constitutive activation of the PKA pathway. Together with previous reports of PRKAR1A mutations in syndromic cardiac myxoma, our study demonstrates the importance of the PKA pathway in the tumourigenesis of cardiac myxoma. Copyright © 2017 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd. Copyright © 2017 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.

  17. Blunt cardiac injury: case report of salvaged traumatic right atrial rupture.

    Science.gov (United States)

    Al Ayyan, Muna; Aziz, Tanim; El Sherif, Amgad; Bekdache, Omar

    2015-12-01

    The incidence of cardiac rupture following blunt trauma is rare, occurring in 0.3%-0.5% of all blunt trauma patients. It can be fatal at the trauma scene, and is frequently missed in the emergency room setting. The severity of a cardiac trauma is based on the mechanism and degree of the force applied. The objective of this study was to report the case of a 32-year-old male patient who was involved in a motor vehicle collision and presented to the emergency room with signs of hypovolemic shock. The patient was found to have severe chest trauma associated with massive hemothorax requiring immediate intervention. The patient had an emergent thoracotomy revealing a right atrial injury. Repair of the atrial injury reversed the state of shock. The patient was discharged after 35 days of hospitalization in good condition.

  18. Dextrocardia with asymptomatic right atrial appendage aneurysm: a case report

    National Research Council Canada - National Science Library

    Sate, Hossein; Reshadati, Najmeh; Aliakbarzadeh, Parvaneh; Molazadeh, Negin

    2017-01-01

    .... We report a case of asymptomatic RAAA in a patient with dextrocardia and anomalous origin of RCA from left coronary sinus which was treated successfully by CABG and the aneurysm was completely excised...

  19. Biatrial Approach Provides Better Outcomes in the Surgical Treatment of Cardiac Myxomas

    Directory of Open Access Journals (Sweden)

    Ahmet Yüksel

    Full Text Available Abstract Objective: We aimed to present clinical features, surgical approaches, importance of surgical technique and long-term outcomes of our patients with cardiac myxoma who underwent surgery. Methods: We retrospectively collected data of patients with cardiac myxoma who underwent surgical resection between February 1990 and November 2014. Biatrial approach is the preferred surgical method in a large proportion of patients that are operated due to left atrial myxoma because it provides wider exposure than the uniatrial approach. To prevent recurrence during surgical resection, a large excision is made so as to include at least 5 mm of normal area from clean tissue around the tumor. Moreover, special attention is paid to the excision that is made as a whole, without digesting the fragment of tumor with gentle dissections. Results: Forty-three patients (20 males, mean age of 51.7±8.8 years were included. Most common symptom was dyspnea (48.8%. Tumor was located in the left atrium in 37 (86% patients. Resections were achieved via biatrial approach in 34 patients, uniatrial approach in 8 patients, and right atriotomy with right ventriculotomy in 1 patient. One patient died due to low cardiac output syndrome in the early postoperative period. Mean follow-up time was 102.3±66.5 months. Actuarial survival rates were 95%, 92% and 78% at five, 10 and 15 years, respectively. Recurrence was observed in none of the patients during follow-up. Conclusion: Although myxomas are benign tumors, due to embolic complications and obstructive signs, they should be treated surgically as soon as possible after diagnosis. To prevent recurrence, especially in cardiac myxomas which are located in left atrium, preferred biatrial approach is suggested for wide resection of the tumor and to avoid residual tumor.

  20. Odontogenic myxoma involving the orbit in a 3-year-old boy

    DEFF Research Database (Denmark)

    Schjals Hansen, Teis; Danielsson, Lina Isabella; Fast, Søren

    2016-01-01

    We present a rare case of a 3-year-old boy with an odontogenic myxoma (OM) involving the orbita. Including our case, only nine cases of OM have been reported to involve the eye in children.There is no gold standard for treatment of OM in children with orbital involvement. The recurrence rate of O...

  1. Stroke in a Young Man Secondary to Paroxysmal Atrial Fibrillation and Thyrotoxicosis: A Case Report

    Directory of Open Access Journals (Sweden)

    Rodrigo Bazan

    2017-10-01

    Full Text Available We report a case of a male patient with stroke caused by atrial fibrillation (AF due to thyrotoxicosis. At hospital admission, he presented hypertension and AF. Magnetic resonance imaging confirmed a right-side ischemic area. The thyrotoxicosis was confirmed by thyroid function and thyroid scintigraphy that showed goiter with diffuse hypercaptation. The patient was treated with tapazole and total thyroidectomy, and pathological findings suggested Graves’ disease. Hyperthyroidism is associated with increased supraventricular ectopic activity in patients with a normal heart, and may be an important causal link between hyperthyroidism and AF. The patient experienced significant clinical improvement, but presented long-term neuropsychiatric disorders.

  2. Atrial fibrillation in healthy adolescents after highly caffeinated beverage consumption: two case reports

    Directory of Open Access Journals (Sweden)

    Heyden Marybeth

    2011-01-01

    Full Text Available Abstract Introduction Energy drinks and highly caffeinated drinks comprise some of the fastest growing products of the beverage industry, often targeting teenagers and young adults. Cardiac arrhythmias in children related to high caffeine consumption have not been well described in the literature. This case series describes the possible association between the consumption of highly caffeinated drinks and the subsequent development of atrial fibrillation in the adolescent population. Case presentations We report the cases of two Caucasian adolescent boys of 14 and 16 years of age at the time of presentation, each without a significant cardiac history, who presented with palpitations or vague chest discomfort or both after a recent history of excessive caffeine consumption. Both were found to have atrial fibrillation on electrocardiogram; one patient required digoxin to restore a normal sinus rhythm, and the other self-converted after intravenous fluid administration. Conclusion With the increasing popularity of energy drinks in the pediatric and adolescent population, physicians should be aware of the arrhythmogenic potential associated with highly caffeinated beverage consumption. It is important for pediatricians to understand the lack of regulation in the caffeine content and other ingredients of these high-energy beverages and their complications so that parents and children can be educated about the risk of cardiac arrhythmias with excessive energy drink consumption.

  3. Successful Removal of a Conjunctival Myxoma

    Science.gov (United States)

    Al-Ghadeer, Huda; Al-Assiri, Abdullah; Al-Odhaib, Sami; Alkatan, Hind

    2012-01-01

    A 45-year-old woman presented with conjunctival myxoma in the right eye. A mixture of healon and trypan blue solution 0.06 mg was injected through a 27-gauge needle into the conjunctiva to delineate the lesion to achieve complete removal. This technique is effective in delineating the myxoma while preserving its integrity during removal. It may also help in lowering recurrence. PMID:22837636

  4. A Large Left Ventricle Myxoma: Presenting with Epigastric Pain and Weight Loss

    Directory of Open Access Journals (Sweden)

    Solmaz Fakhari

    2016-01-01

    Full Text Available Cardiac myxomas are the most common benign tumors found in the heart. They usually appear in the left atrium. Those originating from the left ventricle (LV are rare. Although clinical presentation may vary, dyspnea and embolism are the most commonly reported symptoms. In the present case study, a 27-year-old woman with a large myxoma originating from the left ventricular free wall is studied. She had atypical complaints, mainly epigastric discomfort, nausea, vomiting, and anorexia. She was hospitalized for acute abdomen, but subsequent investigations revealed a large myxoma that fully filled the LV and severely compromised the flow of the aortic and mitral valves. After successful emergency tumor resection, all symptoms disappeared. The uncommon presentation caused by these tumors is discussed in this study.

  5. [Unexpected atrial fibrillation when monitoring in operating room. Case of the trimester].

    Science.gov (United States)

    2014-05-01

    A real case reported to the SENSAR database of incidents is presented. In a patient scheduled for nose fracture repair surgery an unexpected atrial fibrillation was found when monitored in the operating room. The operation was not delayed. After induction of general anaesthesia heart rate suddenly increased and hemodinamic situation was impaired. Cardioversion was required. Two electric countershocks were given but sinus rhythm was not restored. Heart rate was controlled with amiodarone infusion. Optimal defibrillation characteristics are described in these cases. Increased risk of thromboembolism (1-2%) following cardioversion is present even if atrial thrombi are ruled out. The mainstay therapies of are rhythm and rate control and prevention of thromboembolic complications. We describe recommendations on the management of these critical situations with emphasis in learning through the creation of protocols and training practice in simulation. Copyright © 2013 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Published by Elsevier España. All rights reserved.

  6. Infected Cardiac Myxoma: an Updated Review

    Directory of Open Access Journals (Sweden)

    Shi-Min Yuan

    2015-10-01

    Full Text Available ABSTRACT OBJECTIVE: This study aims to present an updated clinical picture of the infected cardiac myxoma. Revankar & Clark made a systematic review of infected cardiac myxoma based on the literature before 1998. Since then, there has not been any updated information describing its recent changing trends. METHODS: A comprehensive literature search of infected cardiac myxoma was conducted on MEDLINE, Highwire Press and Google between 1998 and 2014. RESULTS: In comparison with Revankar & Clark's series, the present series disclosed a significantly decreased overall mortality. It is believed that refinement of the prompt diagnosis and timely management (use of sensitive antibiotics and surgical resection of the infected myxoma have resulted in better outcomes of such patients. CONCLUSION: The present series of infected cardiac myxoma illustrated some aggravated clinical manifestations (relative more occasions of high-grade fever, multiple embolic events and the presence of refractory microorganisms, which should draw enough attention to careful diagnosis and treatment. In general, the prognosis of infected cardiac myxoma is relatively benign and the long-term survival is always promising.

  7. Infected Cardiac Myxoma: an Updated Review.

    Science.gov (United States)

    Yuan, Shi-Min

    2015-01-01

    This study aims to present an updated clinical picture of the infected cardiac myxoma. Revankar & Clark made a systematic review of infected cardiac myxoma based on the literature before 1998. Since then, there has not been any updated information describing its recent changing trends. A comprehensive literature search of infected cardiac myxoma was conducted on MEDLINE, Highwire Press and Google between 1998 and 2014. In comparison with Revankar & Clark's series, the present series disclosed a significantly decreased overall mortality. It is believed that refinement of the prompt diagnosis and timely management (use of sensitive antibiotics and surgical resection of the infected myxoma) have resulted in better outcomes of such patients. The present series of infected cardiac myxoma illustrated some aggravated clinical manifestations (relative more occasions of high-grade fever, multiple embolic events and the presence of refractory microorganisms), which should draw enough attention to careful diagnosis and treatment. In general, the prognosis of infected cardiac myxoma is relatively benign and the long-term survival is always promising.

  8. Development and validation of a Myxoma virus real-time polymerase chain reaction assay.

    Science.gov (United States)

    Albini, Sarah; Sigrist, Brigitte; Güttinger, Regula; Schelling, Claude; Hoop, Richard K; Vögtlin, Andrea

    2012-01-01

    To aid in the rapid diagnosis of myxomatosis in rabbits, a real-time polymerase chain reaction (PCR) for the specific detection of Myxoma virus is described. Primers and probe were designed to amplify a 147-bp fragment within the Serp2 gene. The assay was able to detect 23 copies of a synthesized oligo indicating a reliable sensitivity. In addition, the real-time PCR did not detect the Rabbit fibroma virus used in myxomatosis vaccines. The novel PCR was shown to be able to detect Myxoma virus in fresh and paraffin-embedded rabbit tissues originating from myxomatosis cases from various regions in Switzerland.

  9. Odontogenic myxoma of the face: mimicry of cherubism.

    Science.gov (United States)

    Kleiber, Grant M; Skapek, Stephen X; Lingen, Mark; Reid, Russell R

    2014-11-01

    The present study is a case report of a 3-year-old girl who was referred to our clinic with the clinical features of cherubism. A locally aggressive tumor was diffusely infiltrating the maxilla and mandible. At 4 years after resection, our patient has not demonstrated any signs of recurrence, which might point to a role for adjunctive chemotherapy, in this case imatinib (Gleevec), for odontogenic myxoma. Copyright © 2014 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  10. Tulip deformity with Cera atrial septal defect devices: a report of 3 cases.

    Science.gov (United States)

    Kohli, Vikas

    2015-02-01

    Device closure of secundum atrial septal defect (ASD) is the treatment of choice when anatomy is favourable. Amplatzer device has remained the gold standard for closure of ASD. Cobra deformity is a well-reported problem with devices. Recently, Tulip deformity has been reported in a single case. We report a series of cases where we noted Tulip deformity along with inability to retract the device in the sheath in Cera Lifetech devices. This resulted in prolongation of procedure, excessive fluoroscopic exposure and additional interventional procedures not usually anticipated in ASD device closure. We believe that the problem is due to the stiffness of the device resulting in its inability to be retracted into the sheath. We also report a unique way of retrieving the device.

  11. The role of cell signaling in poxvirus tropism: the case of the M-T5 host range protein of myxoma virus.

    Science.gov (United States)

    Werden, Steven J; McFadden, Grant

    2008-01-01

    Poxviruses demonstrate strict species specificity in vivo that range from narrow to broad, however the fundamental factors that mediate the basis of poxvirus tropism remain poorly understood. It is generally believed that most, if not all, poxviruses can efficiently bind and enter a wide range of mammalian cells and all of the known host anti-viral pathways that block viral replication in nonpremissive cells operate downstream of virus entry. A productive poxvirus infection is heavily dependent upon the production of a vast array of host modulatory products that specifically target and manipulate both extracellular immune response pathways of the host, as well as intracellular signal transduction pathways of the individually infected cells. The unique pathogenesis and host tropism of specific poxviruses can be attributed to the broad diversity of host modulatory proteins they express. Myxoma virus (MV) is a rabbit-specific poxviruses that encodes multiple host range factors, including an ankyrin-repeat protein M-T5, which functions to regulate tropism of MV for rabbit lymphocytes and some human cancer cells. At the molecular level, M-T5 binds and alters at least two distinct cellular proteins: Akt and cullin-1. The direct interaction between M-T5 and Akt was shown to be a key restriction determinant for MV tropism in a spectrum of human cancer cells making MV an excellent oncolytic candidate. Thus, the intricate relationship between viral encoded proteins and components of the host cell signaling networks can have profound impact on poxvirus tropism. The lessons we continue to learn from poxvirus host range factors like M-T5 will provide further insights into the factors that regulate poxvirus tropism and the mechanisms by which poxviruses micromanipulate the signaling pathways of the infected cell.

  12. The Right Ventricular Myxoma Which Attached to the Tricuspid Valve: Sliding Tricuspid Valvuloplasty

    Directory of Open Access Journals (Sweden)

    Seong Ho Cho

    2015-06-01

    Full Text Available We report a rare case of an extremely large right ventricular myxoma involving the ventricular side of the tricuspid valve. The tumor was excised along with the entire posterior leaflet and part of the anterior leaflet. The tricuspid valve was repaired by sliding valvuloplasty combined with ring annuloplasty.

  13. CARDIAC ARRHYTHMIAS IN MEDICAL PRACTICE: CLINICAL CASE OF AMIODARONE-INDUCED THYROTOXICOSIS TYPE 2 AS A CAUSE OF RECURRENT ATRIAL FIBRILLATION

    Directory of Open Access Journals (Sweden)

    O. V. Gaisenok

    2010-01-01

    Full Text Available Atrial fibrillation is a common cardiac arrhythmia. Amiodarone is an effective drug used for atrial fibrillation treatment. Various side effects of this drug including amiodarone-induced thyrotoxicosis are discussed. A clinical case is presented to provide data for the differential diagnosis between types 1 and 2 of amiodarone-induced thyrotoxicosis and to define approaches to the treatment.

  14. The business case for quality improvement: oral anticoagulation for atrial fibrillation.

    Science.gov (United States)

    Rose, Adam J; Berlowitz, Dan R; Ash, Arlene S; Ozonoff, Al; Hylek, Elaine M; Goldhaber-Fiebert, Jeremy D

    2011-07-01

    The potential to save money within a short time frame provides a more compelling "business case" for quality improvement than merely demonstrating cost-effectiveness. Our objective was to demonstrate the potential for cost savings from improved control in patients anticoagulated for atrial fibrillation. Our population consisted of 67 077 Veterans Health Administration patients anticoagulated for atrial fibrillation between October 1, 2006, and September 30, 2008. We simulated the number of adverse events and their associated costs and utilities, both before and after various degrees of improvement in percent time in therapeutic range (TTR). The simulation had a 2-year time horizon, and costs were calculated from the perspective of the payer. In the base-case analysis, improving TTR by 5% prevented 1114 adverse events, including 662 deaths; it gained 863 quality-adjusted life-years and saved $15.9 million compared with the status quo, not accounting for the cost of the quality improvement program. Improving TTR by 10% prevented 2087 events, gained 1606 quality-adjusted life-years, and saved $29.7 million. In sensitivity analyses, costs were most sensitive to the estimated risk of stroke and the expected stroke reduction from improved TTR. Utilities were most sensitive to the estimated risk of death and the expected mortality benefit from improved TTR. A quality improvement program to improve anticoagulation control probably would be cost-saving for the payer, even if it were only modestly effective in improving control and even without considering the value of improved health. This study demonstrates how to make a business case for a quality improvement initiative.

  15. Myxoma virus induces apoptosis in cultured feline carcinoma cells.

    Science.gov (United States)

    MacNeill, A L; Moldenhauer, T; Doty, R; Mann, T

    2012-10-01

    There is growing interest in utilizing replicating oncolytic viruses as cancer therapeutics agents. The effectiveness of myxoma virus-induced oncolysis was evaluated in two feline cancer cell cultures. Although myxoma virus is a rabbit-specific pathogen, protein expression driven by myxoma virus and production of infectious viral particles were detected. Cell death occurred in primary feline cancer cells within 48 h of inoculation with myxoma virus. Future studies to determine if other feline neoplasms are susceptible to myxoma virus infection are warranted. Copyright © 2011 Elsevier Ltd. All rights reserved.

  16. [Intraoperative treatment for atrial fibrillation using bi-polar radiofrequency ablation system: a clinical report of 91 cases].

    Science.gov (United States)

    Cui, Yong-qiang; Meng, Xu; Li, Yan; Wang, Jian-gang; Zeng, Wen; Gao, Feng; Xu, Chun-lei

    2009-04-01

    To observe the short and mid-term therapeutic effects of Bi-polar ablation systems for intraoperative treatment of atrial fibrillation (AF). From March 2005 to January 2007, 91 patients received intraoperative treatment of atrial fibrillation with Bi-polar ablation systems, including 5 cases of paroxysmal atrial fibrillation and 86 persistent/permanent cases. The main concomitant heart diseases were rheumatic mitral valve diseases. Atricure Dry Ablation System was used for 37 cases and Cardioblate Irrigated Ablation System for 54 cases. The ablation lesion patterns included Cox-maze III, Modified Cox Mini-maze and Left-sided Maze. Mean ablation time was (14.1+/-6.7) min. No ablation-related complications occurred. Three patients died perioperatively. Two patients had permanent pacemaker implantation 3 months after operation. One case suffered from stroke and lower limb thrombosis 2.5 years after operation. Follow-up lasted for 6 to 29 months. The none-AF rhythm were 62.5%, 85.2%, 79.0% and 74.5% at discharge, 3 months, 6 months, and>or=12 months respectively. Compared to Uni-polar Ablation therapy group, the restoration of sinus rhythm in Bi-polar group were significantly higher at 6 months and>or=12 months postoperatively. The latest follow-up results indicated that 100% of preoperative paroxysmal atrial fibrillation patients restored sinus rhythm and 75.3% of persistent/permanent patients were free from atrial fibrillation. The none-AF rhythm of Atricure group (81.1%) showed no difference from the Cardioblate (77.5%). Meanwhile there were no significant differences among the three ablation lesion groups. Intraoperative radiofrequency ablation with Bi-polar systems is a feasible, safe and highly effective surgical option compared to the Uni-polar ablation technique.

  17. Atrial fibrillation as an unexpected complication after peroral endoscopic myotomy (POEM): a case report.

    Science.gov (United States)

    Saleem, Abdulaziz M; Hennessey, Hooman; von Renteln, Daniel; Vassiliou, Melina C

    2014-10-01

    Peroral endoscopic myotomy (POEM) is an entirely endoscopic approach for the treatment of achalasia. This new procedure has been shown to be safe, effective, and associated with only minor complications in the postoperative period. This case report describes the development of atrial fibrillation after POEM secondary to direct compression from a hematoma in the submucosal tunnel. To our knowledge, this is the first report of a delayed hematoma after POEM. This procedure is still novel, and it is important to continue to share information about potential complications and long-term results. This report also includes several interesting radiographic images to illustrate what occurred. Finally, we provide a brief review of the literature on complications that have been described after POEM.

  18. The Carney syndrome associated fibroelastoma and myxoma

    Directory of Open Access Journals (Sweden)

    Ali Kemal Gür

    2012-09-01

    Full Text Available Myxoma is the most common benign primary tumor of theheart. Carney syndrome is an autosomal dominant disordercharacterized by myxomas (heart, skin, breast tissue,skin pigmentation, myxoid fibroadenomas of the breast,endocrine neoplasia. The most frequent signs of endocrineorgan involvement are adrenocorticotropic hormone(ACTH production-dependent Cushing’s syndrome, acromegalyand thyroid and testicular tumors. Surgery isthe only treatment modality of the cardiac myxomas. Theother tumoral formations in the syndrome require differenttreatment modalities according to the localization,size and clinical status of the secreted hormones. A thirtyeight years old female patient was presented to generalsurgery outpatient clinic with complaints of fatigue, palpitations,weight gain, chest pigmentation and on her physicalexamination left breast mass was detected. The massbiopsy was reported as fibroelastoma. The patient wasconsulted to the cardiology clinic due to palpitation complaintand echocardiography revealed a mobile 40 x50mm sized mass inside the left atrium. Tumor resectionwas performed with cardiopulmonary bypass. Patient wasdischarged at the postoperative 5th day. The histopathologicalexamination of the mass was reported as myxoma.Key words: Carney Syndrome, fibroelastoma, myxoma

  19. Atrial septal aneurysm associated with additional cardiovascular comorbidities in two middle age female patients with ECG signs of right bundle branch block: two case reports.

    Science.gov (United States)

    Bakalli, Aurora; Kamberi, Lulzim; Pllana, Ejup; Gashi, Afrim

    2008-07-19

    Atrial septal aneurysm (ASA) is often associated with other atrial septal abnormalities, particularly with atrial septal defect type ostium secundum or patent foramen ovale. ECG signs of incomplete or complete right bundle branch block are known to be associated with atrial septal defects, however such correlation with other atrial septal abnormalities is not documented. We report here two cases of middle age female patients that presented with dyspnea on physical effort, right bundle branch block (RBBB) on ECG and ASA combined with other cardiac disorders. Transesophageal echocardiography revealed additional information to the ones obtained by surface echocardiography, in both cases. ASA associated with RBBB on ECG may serve as a hint for the presence of additional cardiac abnormalities, thus rousing the demand for a detailed cardiac investigation.

  20. Intramuscular myxoma and fibrous dysplasia of bone - Mazabraud`s syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Court-Payen, M. [Copenhagen Univ. (Denmark). Dept. of Ultrasound; Ingemann Jensen, L. [Copenhagen Univ. (Denmark). Dept. of Radiology; Bjerregaard, B. [Copenhagen Univ. (Denmark). Dept. of Pathology; Schwarz Lausten, G. [Copenhagen Univ. (Denmark). Dept. of Orthopedics; Skjoldbye, B. [Copenhagen Univ. (Denmark). Dept. of Ultrasound

    1997-05-01

    We present a case of Mazabroud`s syndrome, a rare benign disease, with multiple intramuscular myxomas of the thoracic wall associated with fibrous dysplasia of bone. CT, MR imaging and ultrasonography (US) of the thorax showed 2 well circumscribed homogeneous intramuscular tumors. A US-guided needle biopsy with a large-core needle (2.0 mm) and a fine needle (0.8 mm) showed that the tumors were intramuscular myxomas with no sign of malignancy. {sup 99m}Tc bone scintigraphy showed a markedly increased uptake in the right lower skull, and multiple smaller foci. CT of the skull revealed a right-sided unilateral bone thickening of the orbit and the ethomoidal cells, and right-sided exophthalmia. This case history suggests that patients with multiple intramuscular myxomas should be preoperatively examined for osseous lesions. A postoperative follow-up should also be performed to detect other soft-tissue myxomas not as yet clinically detectable, or rare osseous complications. (orig.).

  1. Simultaneous occurrence of an Odontogenic Myxoma and a Squamous Cell Carcinoma of the Mandible

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Bong Su; Lee, Sang Rae; Hwang, Eui Hwan; Lee, Byung Do [Dept. of Oral and Maxillofacial Radiology, College of Dentistry, Kyunghee University, Seoul (Korea, Republic of)

    1999-02-15

    Squamous cell carcinoma is the most common type of oral cancer and odontogenic myxoma is relatively uncommon benign tumor of mesenchymal origin. There are, to our knowledge, no prior reports of simultaneously occurring squamous cell carcinoma and odontogenic myxoma of the jaw bones. In this case, at first, the plain films and computed tomograms revealed a large expansible multilocular radiolucent lesion on left mandible and marked expansion of cortical plate. In addition this radiograms revealed also infiltrative bony destruction of anterior and medial border of ascending ramus of left mandible and alveolar bone of left maxilla, floating teeth on left lower molar area and metastatic enlargement of left submandibular, jugular digastric and spinal accessory lymph nodes. Magnetic resonance imaging of this patient revealed infiltrative growth of tumor on alveolar bone of left maxilla, left retromolar fat pad, left masseter and left medial pterygoid muscle. Intraoral presurgical biopsy presented typical features of squamous cell carcinoma. After chemotherapy with radiation therapy during 6 months, this central lesion was diagnosed as odontogenic myxoma by the postsurgical biopsy. After 3 months, this patient presented multiple metastatic signs at lumbar spines, rib and liver. Consequently, our case is simultaneous occurrence of squamous cell carcinoma and odontogenic myxoma.

  2. Deglutition induced atrial tachycardia and atrial fibrillation.

    Science.gov (United States)

    Kanjwal, Yousuf; Imran, Naser; Grubb, Blair

    2007-12-01

    Deglutition induced supraventricular tachycardia is an uncommon condition postulated to be a vagally mediated phenomenon due to mechanical stimulation. Patients usually present with mild symptoms or may have severe debilitating symptoms. Treatment with Class I agents, beta blockers, calcium channel blockers, amiodarone and radiofrquency catheter ablation has shown to be successful in the majority of reported cases. We report the case of a 46-year-old healthy woman presenting with palpitations on swallowing that was documented to be transient atrial tachycardia with aberrant ventricular conduction as well as transient atrial fibrillation. She was successfully treated with propafenone with no induction of swallowing-induced tachycardia after treatment. This is also the first case to show swallowing-induced atrial tachycardia and atrial fibrillation in the same patient.

  3. Diaphragmatic Stimulation: A case of Atrial Lead Dislodgement and Right Atrium perforation

    Directory of Open Access Journals (Sweden)

    Namazi MH

    2008-04-01

    Full Text Available We report a 48 year old male who presented with diaphragmatic stimulation. The biventricular implantable cardioverter and defibrillator (CRT-D was implanted two weeks before admission and active fixation lead caused perforation of the right atrial wall. Echocardiography did not demonstrate pericardial effusion but Chest X-ray and computed tomography (CT visualized the atrial screw helix outside the right atrial wall, penetrating through the right lung middle lobe. There was no atrial capture. After changing the pace mode DDDR to VVIR, diaphragmatic stimulation was disappeared. The atrial lead was repositioned and fixed again. During the hospital admission and after that the patient was well and free of any symptoms.

  4. Oral bisphosphonates and risk of atrial fibrillation and flutter in women: a self-controlled case-series safety analysis.

    Directory of Open Access Journals (Sweden)

    Anthony Grosso

    Full Text Available A recent trial unexpectedly reported that atrial fibrillation, when defined as serious, occurred more often in participants randomized to an annual infusion of the relatively new parenteral bisphosphonate, zoledronic acid, than among those given placebo, but had limited power. Two subsequent population-based case-control studies of patients receiving a more established oral bisphosphonate, alendronic acid, reported conflicting results, possibly due to uncontrolled confounding factors.We used the United Kingdom General Practice Research Database to assess the risk of atrial fibrillation and flutter in women exposed to the oral bisphosphonates, alendronic acid and risedronate sodium. The self-controlled case-series method was used to minimise the potential for confounding. The age-adjusted incidence rate ratio for atrial fibrillation or flutter in individuals during their exposure to these oral bisphosphonates (n = 2195 was 1.07 (95% CI 0.94-1.21. The age-adjusted incidence rate ratio for alendronic acid (n = 1489 and risedronate sodium (n = 649 exposed individuals were 1.09 (95% CI 0.93-1.26 and 0.99 (95% CI 0.78-1.26 respectively. In post-hoc analyses, an increased risk of incident atrial fibrillation or flutter was detected for patients during their first few months of alendronic acid therapy.We found no robust evidence of an overall long-term increased risk of atrial fibrillation or flutter associated with continued exposure to the oral bisphosphonates, alendronic acid and risedronate sodium. A possible signal for an increase in risk during the first few months of therapy with alendronic acid needs to be re-assessed in additional studies.

  5. Biatrial myxoma and multiple organ infarctions combined with Leriche syndrome in a female patient.

    Science.gov (United States)

    Min, Seung Yeon; Lim, Young-Hyo; Lee, Hyung Tak; Shin, Jinho; Kim, Kyung-Soo; Kim, Hyuck

    2014-12-05

    Multiple organ infarctions combined with Leriche syndrome due to embolic particles of myxoma are very rare. There is no definite guideline for immediate medical treatment. A 36-year-old married female was referred to the emergency department (ED) with severe pain of both lower extremities and gradual decreased mental status. Brain magnetic resonance imaging (MRI) and computed tomography angiography (CTA) revealed acute multiple organ infarctions including the brain, spleen, and bilateral kidneys combined with Leriche syndrome. To evaluate the embolic source, echocardiography was performed and it revealed biatrial myxoma. Because of the risk of progression in systemic embolic events, surgical excision and embolectomy were performed urgently. After the operation, renal function was recovered, and the pain of both limbs was relieved. However, the visual field defect due to the brain infarction remained. She was discharged uneventfully on the fourteenth postoperative day. This was an extremely rare case of multiple organ infarctions combined with Leriche syndrome as the initial presentation of biatrial myxoma. The treatment of choice for myxoma is surgical excision, but the optimal timing of operations is still controversial in patients who have had recent neurological insults. Echocardiography was useful to clarify the diagnosis and decide on the proper treatment modality: surgical treatment or thrombolysis.

  6. Acute Chest Pain and Broad Complex Tachycardia. A Non-typical Case of Pre-excited Atrial Fibrillation

    OpenAIRE

    Arias, Ramon Suarez; Villanueva, Nuria Perez; Cubero, Gustavo Iglesias; Lopez, Jose Rubin

    2011-01-01

    Wolff-Parkinson-White syndrome is a common condition in the emergency department. A case is presented of a 76-year-old patient with acute chest pain and broad complex tachycardia. Despite the fact that previous and post cardioversion ECG tracings in sinus rhythm showed no signs of pre-excitation, the characteristic pattern of pre-excited atrial fibrillation (AF) is recognized and after successful DC cardioversion the patient is referred for catheter ablation of the accessory pathway. This cas...

  7. Extraskeletal multiple myeloma presenting with an atrial mass: a case report and a review of the literature

    OpenAIRE

    Vigo, Federica; Ciammella, Patrizia; Valli, Riccardo; Cagni, Elisabetta; Iotti, Cinzia

    2012-01-01

    Abstract Introduction Extraskeletal presentation at diagnosis or during the course of multiple myeloma is a rare event. The prognosis is usually very poor. At the moment there is no agreed gold standard for the treatment of this presentation. Case presentation A 79-year-old Caucasian woman was treated at our hospital for right atrial myeloma localization. Our patient showed the following signs and symptoms of congestive heart failure: dyspnea, hypotension, cyanosis and facial edema. Surgery w...

  8. Demographic presentation of odontogenic myxoma among patients ...

    African Journals Online (AJOL)

    They accounted for 10.6% of all odontogenic tumours, thus ranked the 2nd most attended odontogenic tumour in twelve year period. the 1st one being Ameloblastoma (72.2%). In this study odontogenic myxoma was found to occur in children below ten years old. There was female preponderance, but a lack of mandible ...

  9. The immunomodulatory gene products of myxoma virus

    Indian Academy of Sciences (India)

    Unknown

    vity regulates innate immunity. Moreover, TNF-α is in- volved in the regulation of cell differentiation, prolifera- tion and apoptosis. Rabbit RL-5 T lymphocyte cells in- fected with an M-T2 knock-out myxoma virus undergo apoptosis, resulting in an aborted infection (Macen et al. 1996). These results suggest that the binding of ...

  10. Intramuscular myxoma: value of MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Fontana, M. [Div. Ist. Ortopedico Rizzoli, Bologna (Italy); Capanna, R. [Div. Ist. Ortopedico Rizzoli (Italy); Gigli, F. [Servizio di Radiologia, Ospedale Maggiore, Bologna (Italy)

    1993-06-01

    A 58-year-old woman with a large intramuscular myxoma of the left thigh was studied with standard X-rays, ultrasonography, CT, MRI and incisional biopsy. MRI provided the most complete information, giving sufficient data for a correct therapeutic approach. (orig.)

  11. Clot in Lung, Clot in Heart: A Case Report of Tumor-Like Thrombus in Right Atrium

    Directory of Open Access Journals (Sweden)

    Roshanak Habibi

    2017-04-01

    Full Text Available Tumor-like formation of thrombus in the right atrial cavity is rare. It may be mistaken for a myxoma. The exact pathophysiology of an isolated thrombus in the heart is still unclear. Management to prevent complications such as pulmonary thromboembolism depends on the clinical judgment of a cardiologist. This report describes a 76-year-old woman with right atrial thrombus causing subsequent pulmonary thromboembolism in right lung. She initially presented to us with pulmonary embolism, and later, an incidental finding of a mass in her right atrium revealed an association of thrombus in heart with thrombus in lung. The challenging management was to resect this thrombus which was fixed to atrial septum, and a trial of anticoagulation did not resolve it. Exact management of such incidental findings in right heart cavities is not well established. Some cases may benefit from resection of such formed fixed thrombus.

  12. Lift the quilt in case of atrial fibrillation and disc prolapse

    Directory of Open Access Journals (Sweden)

    Bastovansky A

    2012-06-01

    Full Text Available Adam Bastovansky,1 Kathrin Ziegler,2 Claudia Stöllberger,2 Josef Finsterer31Department of Radiology, 2Medical Department, Krankenanstalt Rudolfstiftung, Vienna, Austria; 3Danube University Krems, Krems, AustriaBackground: Peripheral embolism to the lower extremities may mimic disc prolapse with severe consequences.Case report:  A 71-year-old male with a history of chronic alcoholism developed low back pain radiating to both lower extremities in a nonradicular distribution and bilateral dysesthesias of the distal lower legs after lifting a heavy weight. Given that magnetic resonance imaging (MRI of the lumbar spine showed disc herniation in L3/4 and L4/5, he was scheduled for laminectomy but was unable to undergo surgery due to thrombocytopenia. After transfer to another hospital, persistence of symptoms and signs, absent pulses on the distal lower legs, and rhabdomyolysis with temporary renal insufficiency, peripheral embolism with compartment syndrome was suspected. Magnetic resonance angiography revealed occlusion of the right superficial femoral artery and long high-grade stenosis of the left superficial and profound femoral arteries and distal arteries. He successfully underwent embolectomy and fasciotomy.Conclusions: If lumbar pain is not radicular, peripheral pulses are minimally palpable, and distal limbs are cold and show livid decolorization, peripheral embolism is much more likely than disc herniation, particularly if the patient's history is positive for atrial fibrillation. MRI of the lumbar spine must be interpreted in conjunction with clinical presentation.Keywords: embolism, compartment syndrome, neurosurgery, embolectomy, fasciotomy, rhabdomyolysis

  13. Exercise-induced vasospastic angina after left atrial catheter ablation: a case report.

    Science.gov (United States)

    Blessberger, Hermann; Kammler, Jürgen; Wichert-Schmitt, Barbara; Steinwender, Clemens

    2013-01-01

    Left atrial catheter ablation (LACA) is routinely used in the management of recurrent atrial fibrillation. We report a patient suffering from vasospastic angina 2 months after a LACA procedure. Typical clinical symptoms, ST-segment changes during exercise test and successful treatment with nicorandil led to the diagnosis. According to our hypothesis, destruction of autonomic ganglia in the left atrium and resulting autonomic nerve tone imbalance might be the main determinants that have caused this phenomenon. Coronary spasms even weeks after LACA should draw attention to a possible association with the procedure. © 2013.

  14. Infant with nasolacrimal sinonasal myxoma: Difusion MRI features

    Directory of Open Access Journals (Sweden)

    Teresa Gross Kelly, MD

    2015-01-01

    Full Text Available We report the imaging features of a rare sinonasal myxoma situated over the right nasolacrimal duct in a 5-month-old male. We emphasize the importance of including sinonasal myxomas in the list of differential diagnostic possibilities when encountering a nasolacrimal gland mass in an infant, and describe the CT and MRI characteristics of this rare entity.

  15. Genetic Variability of Myxoma Virus Genomes

    OpenAIRE

    Braun, Christoph; Thürmer, Andrea; Daniel, Rolf; Schultz, Anne-Kathrin; Bulla, Ingo; Schirrmeier, Horst; Mayer, Dietmar; Neubert, Andreas; Czerny, Claus-Peter

    2017-01-01

    Myxomatosis is a recurrent problem on rabbit farms throughout Europe despite the success of vaccines. To identify gene variations of field and vaccine strains that may be responsible for changes in virulence, immunomodulation, and immunoprotection, the genomes of 6 myxoma virus (MYXV) strains were sequenced: German field isolates Munich-1, FLI-H, 2604, and 3207; vaccine strain MAV; and challenge strain ZA. The analyzed genomes ranged from 147.6 kb (strain MAV) to 161.8 kb (strain 3207). All s...

  16. Myxoma Virus: Propagation, Purification, Quantification, and Storage

    OpenAIRE

    Smallwood, Sherin E.; Rahman, Masmudur M.; Smith, Dorothy W.; McFadden, Grant

    2010-01-01

    Myxoma virus (MYXV) is a member of the Poxviridae family and prototype for the genus Leporipoxvirus. It is pathogenic only for European rabbits (Oryctolagus cuniculus), in which it causes a lethal disease called myxomatosis, and for two North American species, Sylvilagus audubonni and Sylvilagus nuttalli, in which it causes a less severe disease. MYXV replicates exclusively in the cytoplasm of the host cell, and its genome encodes 171 open reading frames. A number of these genes encode protei...

  17. Intramuscular myxoma of the face: an unusual localization. A clinicopathological study.

    Science.gov (United States)

    Orlandi, A; Bianchi, L; Marino, B; Spagnoli, L G; Nini, G

    1995-03-01

    Intramuscular myxoma is a rare benign mesenchymal lesion. Only very rare cases of cutaneous localization of this tumor have been described, in particular related to the somatic soft tissues of the face. This unusual localization may clinically mimic nodular or cystic facial lesions having different origins. The aim of our work was to well characterize the phenotype of the spindle cells characteristic of intramuscular mixoma. Tissue samples were processed for morphological and ultrastructural studies. Moreover, immunohistochemical stainings were performed to characterize the expression of different nonmuscular and muscular cytoskeletal proteins. The tumor was composed of sparse spindle cells embedded in a prominent mucoid matrix. Besides the predominance of a fibroblast-like appearance, some neoplastic cells displayed immunohistochemical and ultrastructural features resembling either myofibroblasts or primitive mesenchymal cells, with a modulation of cell actin expression. The presence of multiple phenotypes of nonmuscular, mesenchymal pathway of differentiation can be considered a peculiar feature of intramuscular myxoma.

  18. Mixoma odontogénico Odontogenic myxoma

    Directory of Open Access Journals (Sweden)

    Julio Valcárcel Llerandi

    2009-09-01

    Full Text Available El mixoma odontogénico se considera una neoplasia benigna, poco frecuente, de consistencia firme y gelatinosa, de crecimiento lento con potencial infiltrativo que produce expansión de la cortical con extensa destrucción ósea y alto índice de recidiva. De origen ectomesenquimático, probablemente derivado del órgano dentario. No existe una predilección particular por sexo, y si una ligera preferencia por presentarse en mandíbula, generalmente asintomático. Se presenta una paciente femenina de dieciséis años de edad, color de la piel blanca, con antecedentes de salud, que acude a consulta de cirugía máxilo facial por aumento de volumen de hemicara derecha, sin otra sintomatología acompañante. Al examen físico se observa aumento de volumen en región maxilar derecha. Al realizar tomografía axial computarizada se observó lesión hiperdensa que ocupaba todo el seno maxilar derecho, con áreas de mayor densidad, que respetaba el hueso que conforma el piso de la órbita. Bajo anestesia general naso traqueal se le realizó hemimaxilectomia, retirada de tumor y colocación de prótesis inmediata obturadora. Después de un año de evolución clínica y radiográfica se colocó la prótesis definitiva, sin presencia de recidiva tumoral.An odontogenic myxoma is a uncommon benign neoplasm of a gelatinous and solid consistency, of lengthy growing with a infiltration potential producing an cortex expansion of with and extend bone destruction and a high rate of relapse. Its origin is ectomesenchymal, probably derived from dental organ. There is not a particular sexual preference, but a slight one by be present in mandible and generally asymptomatic. This is the case of a female white patient aged 16, with health backgrounds referred to Maxillofacial consultation due to an of right hemifacial increase without another accompanying symptomatology. At physical examination there is an increase in volume of right maxillary region. In computerized

  19. Cell cycle and apoptosis regulatory proteins, proliferative markers, cell signaling molecules, CD209, and decorin immunoreactivity in low-grade myxofibrosarcoma and myxoma.

    Science.gov (United States)

    Cates, Justin M M; Memoli, Vincent A; Gonzalez, Raul S

    2015-08-01

    The histologic differential diagnosis between intramuscular myxoma and low-grade myxofibrosarcoma can be quite difficult in some cases. To identify a diagnostic immunohistochemical marker, we compared the staining profiles of 19 different antigens, including cell cycle proteins, apoptosis proteins, and proliferative markers, and selected other signaling and structural proteins in these two tumors. Ten cases each of intramuscular myxoma and low-grade myxofibrosarcoma were stained with antibodies directed against apoptosis regulatory proteins (Bcl2, activated caspase-3, phospho-H2A.X, and cleaved PARP), cell cycle regulatory proteins (Rb1, Cyclin-A, CDKN1B, and Cdt1), proliferative markers (KI67, MCM2, phospho-histone H3, and geminin), cell signalling molecules (c-Myc, EGF, EGFR, PLA2G4A, and HSP90), a dendritic cell marker (CD209), and the extracellular matrix proteoglycan decorin. Staining patterns of myxoma and myxofibrosarcoma were compared using Fisher's exact test and the Mann-Whitney test. For each potential diagnostic marker studied, the proportions of cases scored as positive on both dichotomous or ordinal scales were not significantly different between myxoma and myxofibrosarcoma. Myxoma and myxofibrosarcoma share a common immunophenotype for each of the markers studied. Distinction between these tumors is still predominantly based on morphologic criteria.

  20. Unilateral atrial fibrillation - how common is atrial divorce?

    Science.gov (United States)

    Ker, J

    2017-06-01

    Atrial fibrillation is the most common pathologic supraventricular tachycardia. It has many causes, is an expensive disease, impairs quality of life and leads to an increased risk of death. Atrial dissociation is characterised by the presence of two independent sets of P-waves. This peculiar abnormality may give rise to the scenario where one atrium is in atrial fibrillation while the other is in sinus rhythm. This is the first published case of atrial dissociation where the phenomenon is demonstrated by transmitral and transtricuspid pulsed wave Doppler.

  1. [A case of subpulmonary membranous stenosis associated with atrial septal defect].

    Science.gov (United States)

    Ono, Y; Momokawa, T; Shuto, K; Munakata, M; Suzuki, S; Koie, H

    1993-09-01

    The patient was a 5 years old male who had had the cyanosis and congestive heart failure from his neonatal period. Dopamine, digitalis and diuretics disappeared his symptoms and he had been followed up as the out-patient. Preoperative cardiac catheterization revealed atrial septal defect and moderately pulmonary stenosis with two-staged systolic pressure gradient in a right ventricular cavity. Right ventriculogram showed subpulmonary crescent-shaped, linear filling defect. Ventricular septal defect was not detected. He was underwent open heart surgery and subpulmonary membranous stenosis was found out. Pressure gradient across the right ventricular outflow tract was diminished by the resection of the membranous structure. Atrial septal defect without lower margin was closed directly. Postoperative course was uneventful. Right ventricular apical systolic pressure was decreased to the degree of 27 mmHg postoperatively.

  2. [An adult case of left ventricular-right atrial communication with a false aneurysm of membranous septum].

    Science.gov (United States)

    Ashida, Y; Okada, M; Taniguchi, I; Yamaga, T

    1993-12-01

    A case of left ventricular-right atrial (LV-RA) communication associated with a false aneurysm of membranous septum is presented. The patient was a 51-year-old woman. Using a left ventriculography this case was diagnosed preoperatively as LV-RA communication. We found that the right atrium was directly communicated with the left ventricle through a fibrous membranous aneurysm adhering to the septal leaflet of the tricuspid valve. It was suggested that a false aneurysm, made by jet lesion from the left ventricle, perforated to the right atrium. So the current case was considered an acquired infravaluvular type LV-RA communication formed in the course of the natural closure of the membranous ventricular septal defect.

  3. Risk factors for embolism in cardiac myxoma: a retrospective analysis.

    Science.gov (United States)

    He, Deng-Ke; Zhang, Yu-Feng; Liang, Yin; Ye, Shi-Xing; Wang, Chong; Kang, Bo; Wang, Zhi-Nong

    2015-04-22

    Myxomas are the most common primary heart tumors and are closely associated with embolic events. Cardiac myxomas typically arise from the interatrial septum at the border of the fossa ovalis in the left atrium. Any other location is considered atypical. Embolism, one of the complications of myxoma, is associated with high morbidity and mortality. The aim of this study was to investigate the risk factors for embolism in patients with cardiac myxoma. In this retrospective study, a cohort of 162 patients with cardiac myxomas was surgically treated between January 1998 and June 2014 at 3 cardiac centers in China. Preoperative data, including platelet count, sex, age, and the tumor (size, location, surface, and attachment), were compared between embolic and non-embolic groups of patients. No significant differences in vascular risk factors were seen between the 2 groups. However, the percentage of higher platelet count (>300 × 10(9)/L) and mean platelet volume in the embolic group were significantly higher than in the non-embolic group (P=0.0356, and 0.0113, respectively). Irregular surface and atypical location of the myxomas were also independently associated with increased risk of embolic complications. Tumor location, macroscopic appearance, mean platelet volume, and high platelet count are strong risk factors for embolic events in patients with cardiac myxomas.

  4. Pseudo myxoma peritonei - report of three cases: computed tomography and magnetic resonance imaging findings; Pseudomixoma peritoneal: aspectos tomograficos e na ressonancia magnetica - relato de tres casos

    Energy Technology Data Exchange (ETDEWEB)

    Moreira, Luiza Beatriz Melo; Crespo, Sheila Jandhyra Vianna; Marchiori, Edson [Universidade Federal Fluminense, Niteroi, RJ (Brazil). Dept. de Radiologia; Melo, Alessandro Severo Alves de; Pinheiro, Ricardo Andrade [Hospital Barra D' Or, Rio de Janeiro, RJ (Brazil). Servico de Radiologia]. E-mail: edmarchiori@zipmail.com.br

    2001-06-01

    Pseudomyxoma peritonei is rare tumor that presents insidious evolution and is characterized by mucinous ascites or implants in the peritoneal cavity. The origin of this tumor is frequently the appendix or the ovaries. Diagnosis can be established by fine needle aspiration cytology, ultrasonography, computed tomography or magnetic resonance imaging . The authors report three cases of patients with pseudomyxoma peritonei arising from the ovary that were submitted to computed tomography and magnetic resonance imaging examinations of the abdomen. This paper emphasizes the importance of these imaging methods that permit greater spatial resolution, multiplanar images and different types of sequences (magnetic resonance imaging), and allow better evaluation of these lesions. Computed tomography examinations showed lobulated low-density masses with well defined limits causing 'scalloping' of the hepatic and splenic borders due to extrinsic compression by adjacent peritoneal implants. Invasion of the liver and spleen was not observed. Magnetic resonance imaging examinations revealed expansive peritoneal lesions with low-intensity signal on T 1-weighted images and high-intensity signal on T 2-weighted images, adjacent to the hepatic and splenic borders. (author)

  5. No association between herpes simplex virus 1 and cardiac myxoma

    OpenAIRE

    Schurr, U.; Berdajs, D A; Bode, B.; Dzemali, O.; Emmert, M. Y.; Genoni, M

    2011-01-01

    PRINCIPLES: Cardiac myxoma is the most commonly diagnosed cardiac tumour. Infection of herpes simplex virus 1 (HSV1) has been postulated to be a factor for this pathologic entity. The aim of the current study was to evaluate the association between HSV 1 and myxoma occurrence.METHODS: Between 1965 and 2005, 70 patients (36 female, mean age: 52.6 years) underwent a resection of myxoma. Selected variables such as hospital mortality and morbidity were studied. A follow-up (FU; mean FU time: 138 ...

  6. Atrial fibrillation

    African Journals Online (AJOL)

    ABEOLUGBENGAS

    Objective: Atrial fibrillation is the commonest chronic arrhythmia and the etiology is widely varied. The aim of this study was to determine the etiology, clinical characteristics and treatment offered to adult patients with atrial fibrillation managed in a referral hospital in Port Harcourt, southern Nigeria. Methods:A retrospective ...

  7. Acute Chest Pain and Broad Complex Tachycardia. A Non-typical Case of Pre-excited Atrial Fibrillation

    Science.gov (United States)

    Arias, Ramon Suarez; Villanueva, Nuria Perez; Cubero, Gustavo Iglesias; Lopez, Jose Rubin

    2011-01-01

    Wolff-Parkinson-White syndrome is a common condition in the emergency department. A case is presented of a 76-year-old patient with acute chest pain and broad complex tachycardia. Despite the fact that previous and post cardioversion ECG tracings in sinus rhythm showed no signs of pre-excitation, the characteristic pattern of pre-excited atrial fibrillation (AF) is recognized and after successful DC cardioversion the patient is referred for catheter ablation of the accessory pathway. This case illustrates a non-typical presentation of the WPW syndrome, with an older patient than usual with slight signs of pre-excitation. We highlight the need for high grades of suspicion for the early recognition of pre-excited AF when attending patients with tachycardia and the obligation to know the distinctive aspects of its management for this potentially life-threatening arrhythmia. PMID:28352389

  8. Intrathecal Fentanyl for Labour Analgesia in a Patient with Severe Mitral Stenosis and Atrial Fibrillation in Advanced Stage of Labour-Case Report

    OpenAIRE

    Vaijayanti Nitin Gadre

    2013-01-01

    Labour is an intensely painful experience and puts considerable physiological stress on the circulation. A case of rheumatic valvular heart disease with severe mitral stenosis in atrial fibrillation is discussed here in which analgesia with intrathecal fentanyl proved beneficial given during the advanced first stage of labour.

  9. Intrathecal Fentanyl for Labour Analgesia in a Patient with Severe Mitral Stenosis and Atrial Fibrillation in Advanced Stage of Labour-Case Report

    Directory of Open Access Journals (Sweden)

    Vaijayanti Nitin Gadre

    2013-12-01

    Full Text Available Labour is an intensely painful experience and puts considerable physiological stress on the circulation. A case of rheumatic valvular heart disease with severe mitral stenosis in atrial fibrillation is discussed here in which analgesia with intrathecal fentanyl proved beneficial given during the advanced first stage of labour.

  10. TOGETHER WiTH ATRiAL SEPTAL DEFECT, BiCUSPiD AORTA, PECTUS EXCAVATUM AND MENTAL RETARDATiON : A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Mustafa Necati Dagli

    2015-03-01

    Full Text Available In this case, patient with mental retardation accepted in our clinic complain with shortness of breath. Then physical examination inspection evident in the pectus excavatum and made Echocardiography Atrial septal defect (ASD and bicuspid aortic consistent with the view were identified.Congenital abnormalities in patients with the aim of further evaluation of transesophageal echocardiography (TEE planned. In TEE, 26 mm secundum atrial septal defect, bicuspid aortic valve was detected. Percutaneous transcatheter atrial septal defect closure with septal occluder device. Pectus excavatum, such as mental retardation or even cardiac abnormalities do not complain about aspects of the research must be done. Cardiac abnormalities regardless of the direction of the association needs to be done to show that we have a rigorous screening. [J Contemp Med 2015; 5(1.000: 48-50

  11. Evolutionary history and attenuation of myxoma virus on two continents

    National Research Council Canada - National Science Library

    Kerr, Peter J; Ghedin, Elodie; DePasse, Jay V; Fitch, Adam; Cattadori, Isabella M; Hudson, Peter J; Tscharke, David C; Read, Andrew F; Holmes, Edward C

    2012-01-01

    The attenuation of myxoma virus (MYXV) following its introduction as a biological control into the European rabbit populations of Australia and Europe is the canonical study of the evolution of virulence...

  12. Importance of Close Follow-Up in the Fetus with Premature Atrial Contractions Accompanied by Atrial Septal Aneurysm: A Case Report

    Directory of Open Access Journals (Sweden)

    Yilmaz Yozgat

    2013-01-01

    Full Text Available Rhythms that derive from parts of atria other than the sinus node are called premature atrial contractions (PACs. Vast majority of fetal PACs are idiopathic. Fetal PACs usually have a good prognosis and disappear spontaneously during pregnancy or after delivery. Development of fetal tachycardia or fetal bradycardia is rarely reported during follow-up of fetuses diagnosed with PACs. To the best of our knowledge, coexistence of tachycardia and bradycardia leading to hemodynamic impairment has not yet been reported. We present a fetus diagnosed with PACs and atrial septal aneurysm (ASA on the 23rd week of gestation proceeding to fetal bradycardia and fetal tachycardia and consequently hemodynamic impairment. We suggest closer follow-up of fetuses with PACs accompanied by ASA.

  13. Left atrial appendage occlusion

    Directory of Open Access Journals (Sweden)

    Ahmad Mirdamadi

    2013-01-01

    Full Text Available Left atrial appendage (LAA occlusion is a treatment strategy to prevent blood clot formation in atrial appendage. Although, LAA occlusion usually was done by catheter-based techniques, especially percutaneous trans-luminal mitral commissurotomy (PTMC, it can be done during closed and open mitral valve commissurotomy (CMVC, OMVC and mitral valve replacement (MVR too. Nowadays, PTMC is performed as an optimal management of severe mitral stenosis (MS and many patients currently are treated by PTMC instead of previous surgical methods. One of the most important contraindications of PTMC is presence of clot in LAA. So, each patient who suffers of severe MS is evaluated by Trans-Esophageal Echocardiogram to rule out thrombus in LAA before PTMC. At open heart surgery, replacement of the mitral valve was performed for 49-year-old woman. Also, left atrial appendage occlusion was done during surgery. Immediately after surgery, echocardiography demonstrates an echo imitated the presence of a thrombus in left atrial appendage area, although there was not any evidence of thrombus in pre-pump TEE. We can conclude from this case report that when we suspect of thrombus of left atrial, we should obtain exact history of previous surgery of mitral valve to avoid misdiagnosis clotted LAA, instead of obliterated LAA. Consequently, it can prevent additional evaluations and treatments such as oral anticoagulation and exclusion or postponing surgeries including PTMC.

  14. MRT diagnosis of cardiac myxomas: sequence evaluation and differential diagnosis; MRT-Diagnostik kardialer Myxome: Sequenzevaluierung und Differentialdiagnose

    Energy Technology Data Exchange (ETDEWEB)

    Sommer, T.; Hofer, U.; Pauleit, D.; Wilhelm, K.; Textor, J.; Schild, H. [Bonn Univ. (Germany). Radiologische Klinik; Vahlhaus, C. [Bonn Univ. (Germany). Medizinische Poliklinik; Smekal, A. v. [UniversitaetsSpital Zuerich, Zurich (Switzerland). Inst. fuer Diagnostische Radiologie; Wardelmann, E.; Bierhoff, E. [Bonn Univ. (Germany). Pathologisches Inst.

    1999-02-01

    Purpose: To evaluate native and contrast enhanced T{sub 1}-weighted spin (T{sub 1}-SE), cine gradient echo (Cine-GE), and T{sub 2}-weighted turbo spin (T{sub 2}-TSE) sequences in the diagnosis and differential diagnosis of cardiac myxomas. Methods: 15 patients with echocardiographically suspected cardiac arterial myxomas underwent 0,5 T-MR imaging of the heart with native T{sub 1}-SE, contrast-enhanced T{sub 1}-SE, Cine-GE, and T{sub 2}-TSE sequences. MR images were evaluated for signal intensity (SI) and lesion`s conspicuity. Results were confirmed histologically (14x) or by follow-up (1x). Results: MRI revealed myxomas in 9 patients, sarcomas in three patients, and thrombi in three patients. Lesion conspicuity was better in Cine-GE and T{sub 2}-TSE compared with native and contrast-enhanced T{sub 1}-SE sequences. Myxomas were characterized by an intermediate SI similar to myocardium in T{sub 1}-SE, high SI similar to water in T{sub 2}-TSE, and low to moderately high enhancement (range 19-75%, mean 48%). Conclusion: Distinct SI characteristics together with anatomical-topographical features (attachment to the interatrial septum, no infiltration of myocardium and vessels) are diagnostic for cardiac myxomas. Cine-GE and T{sub 2}-TSE sequences are the sequences of choice for detection of myxomas and other atrial masses. T{sub 2}-TSE and contrast-enhanced T{sub 1}-weighted sequences are most useful for mass characterisation and differentiation between myxomas, malignant tumors, and thrombi. (orig.) [Deutsch] Ziel: Evaluierung nativer und kontrastverstaerkter T{sub 1}-gesichteter Spin-Echo-Sequenzen (T{sub 1}-SE), Cine-Gradienten-Echo-Sequenzen (GE) sowie T{sub 2}-gewichteter Turbo-Spin-Echo-Sequenzen (T{sub 2}-TSE) in Diagnostik und Differentialdiagnose kardialer Myxome. Methode: 15 Patienten mit echokardiographischem Verdacht auf ein Vorhofmyxom erhielten eine MRT-Untersuchung des Herzens (0,5 Tesla, EKG-getriggerte T{sub 1}-SE nativ-, T{sub 1}-SE KM-, GE-, T{sub 2

  15. The usefulness of magnetic resonance imaging (MRI) in cardiac myxoma

    Energy Technology Data Exchange (ETDEWEB)

    Kawai, Chisato (Tokyo Women' s Medical Coll. (Japan))

    1993-12-01

    The characteristics of cardiac myxoma on magnetic resonance imaging (MRI) were evaluated in 20 patients operated on from 1985 to 1991. MRI studies were performed with an 0.5-T system in 5 patients and an 0.15-T system in 15 patients using ECG gating. T1-weighted images (T1WI) were obtained in all 20 patients, T2-weighted images (T2WI) were obtained in 16, and Gd-DTPA-enhanced images were obtained in 9. MRI was able to correctly locate the myxoma and determine the site of attachment. MRI also correctly determined the shape of 19/20 tumors. The exception was an oval myxoma with a smooth but fibrotic and calcified margin, in which MRI visualized the signal void due to calcification as a villous surface. Myxomas showed an inhomogeneous intermediate intensity on T1WI and an inhomogeneous high intensity on T2WI. These findings were thought to be related to variations in the amount of cellular components, capillaries, and calcification within the myxoid matrix. A relatively high intensity on T1WI and enhancement was observed at the base of the myxomas, where less myxoid matrix and abundant vessels were seen histologically. A low intensity band was noted on T1WI just next to the base of 3 myxomas, and bundles of collagen fibers were observed at the same site histologically. MRI provided information about the internal architecture of these tumors, but the cause of the relatively high intensity area at the tumor based on T1WI remains unproven. In conclusion, MRI was reliable for the diagnosis of cardiac myxoma, and should be performed after cardiac ultrasonography. (author).

  16. Burden of comorbidities among Japanese patients with atrial fibrillation: a case study of dyspepsia

    Directory of Open Access Journals (Sweden)

    Kinoshita Y

    2013-05-01

    Full Text Available Yoshikazu Kinoshita,1 Marco DiBonaventura,2 Bruno Rossi,3 Kazuya Iwamoto,4 Edward C Y Wang,5 Jean-Baptiste Briere51Department of Gastroenterology and Hepatology, Shimane University School of Medicine, Izumo, Japan; 2Health Sciences Practice, Kantar Health, New York, NY, USA; 3Market Access, 4Medical Affairs Cardiovascular and Neurology, 5Health Economics and Outcomes Research, Bayer Yakuhin Ltd, Osaka, JapanBackground: The aim of this study was to investigate the link between atrial fibrillation (AF and dyspepsia, as well as the contribution of dyspepsia to the overall burden of AF.Methods: The 2008, 2009, and 2010 Japan National Health and Wellness Survey (NHWS datasets were used in this study. The NHWS is an Internet-based survey administered to the adult population in Japan using a random stratified sampling framework to ensure demographic representativeness. The presence of dyspepsia was compared between those with and without AF. Among those with AF, the effect of dyspepsia on health status, work productivity, and activity impairment was examined, along with health care resource use using multivariable regression modeling and controlling for baseline differences.Results: Among patients with AF (n = 565, the three most commonly reported comorbidities were hypertension (38.76%, dyspepsia (37.35%, and overactive bladder (28.72%. Patients with AF had 48.59% greater odds of reporting dyspepsia than those without AF (P < 0.05. Patients with dyspepsia used more AF medications (2.05 versus 1.54 and had been diagnosed more recently (9.97 versus 10.58 years. Dyspepsia was associated with significantly worse physical health status (P < 0.05 and significantly more absenteeism, overall work impairment, activity impairment, physician visits, and emergency room visits (all P < 0.05.Conclusion: Patients with AF in Japan experience a number of comorbidities, with dyspepsia being the most common noncardiovascular comorbidity. Given the prevalence and

  17. Resolution of massive left atrial appendage thrombi with rivaroxaban before balloon mitral commissurotomy in severe mitral stenosis: A case report and literature review.

    Science.gov (United States)

    Li, Yuechun; Lin, Jiafeng; Peng, Chen

    2016-12-01

    Data on nonvitamin K antagonist oral anticoagulant being used for the treatment of LAA thrombi are limited only in nonvalvular atrial fibrillation. There are no data on the antithrombotic efficacy and safety of nonvitamin K antagonist oral anticoagulant in the resolution of left atrial appendage (LAA) thrombi in patients with rheumatic mitral stenosis. A 49-year-old woman with known rheumatic mitral stenosis and atrial fibrillation was referred for percutaneous transvenous mitral commissurotomy because of progressive dyspnea on exertion over a period of 3 months. Transesophageal echocardiography (TEE) demonstrated a large LAA thrombus protruding into left atria cavity before the procedure. Direct factor Xa (FXa) inhibitor rivaroxaban (20 mg/d) was started for the patient. After 3 weeks of rivaroxaban treatment TEE showed a relevantly decreased thrombus size, and a complete thrombus resolution was achieved after 5 weeks of anticoagulant therapy with the FXa inhibitor. To the best of our knowledge, this is the first documented case of large LAA thrombus resolution with nonvitamin K antagonist oral anticoagulant in severe mitral stenosis, and in which percutaneous transvenous mitral commissurotomy was performed subsequently. The report indicated that rivaroxaban could be a therapeutic option for mitral stenosis patients with LAA thrombus. Further study is required before the routine use of rivaroxaban in patients with rheumatic mitral stenosis and atrial fibrillation.

  18. Left atrial myoxma presenting as headache in the pediatric patient.

    Science.gov (United States)

    Xu, Jin; Gao, Yanxia; Li, Yi; Yu, Xuezhong; Guo, Shigong; Li, Meilin

    2015-02-01

    Cardiac myxomas rarely occur in children or adolescents. In addition, it is even more rare for the adolescent patient to present with neurological symptoms only. Early diagnosis is difficult because the symptoms of left atrial myxoma are frequently nonspecific. If delayed or left undiagnosed, severe and fatal complications, such as systemic embolism, heart failure, and pulmonary hypertension, may occur. A 13-year-old girl was admitted to our resuscitation room because of loss of consciousness for the preceding 2 h; she had a longstanding history of headache and dizziness for the previous 18 months. Repeated investigations at her local hospital did not reveal any abnormalities. During this admission, routine chest x-ray study found an abnormal bulge of a segment of the pulmonary artery and elevated cardiac enzymes. Emergency bedside echocardiography was performed and revealed a myxoma in the left atria. Subsequent computed tomography head revealed cardiogenic cerebral embolism. When her condition was stable, the patient was taken to the operating room, where a tumorectomy was performed successfully. The patient was then treated with oral anticoagulants and an uneventful recovery was made. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: In order to avoid delayed diagnosis and treatment of its potentially fatal complications, it is important for the emergency clinician to have a high level of suspicion for a cardiac myxoma when attending to young patients that present with syncope. We therefore recommend that, as routine practice, bedside echocardiography to be carried in the emergency department for young patients that present with syncope. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. [Differential diagnosis and management of intramuscular myxomas: A review of our experience].

    Science.gov (United States)

    Granel-Villach, Laura; Alcalde-Sánchez, Miguel; Salvador-Marín, Manuel; García-Calvo, Rafael; Santonja-López, Nuria; Salvador-Sanchís, José Luis

    Intramuscular myxoma is a rare benign soft tissue tumour of mesenchymal origin, which appears as a painless mass of slow growth. Early diagnosis is important in order to differentiate it from other entities, especially soft tissue sarcoma. Two cases, both women with a mean age of 52.5 years (range 40-65) are presented. The first was seen due to growth of a gluteal mass, and the second by coccydynia. Computed tomography and nuclear magnetic resonance were the diagnostic tests of choice. In one case, where there was a single but large lesion, radical extirpation of the gluteal muscle was chosen. In the other case, in which the lesions were multiple, individualised excision of cysts was performed. Postoperative functional limitation was low in both types of surgery, with good oncological results being obtained. Intramuscular myxomas are benign lesions. There are no cases of malignancy or recurrence due to incomplete resection. It has to be determined whether they are single or multiple, since in the latter case, they could be due to syndromes such as Mazabraud syndrome, which is associated with bone fibrous dysplasia, or Albright syndrome that is also associated with pigmented skin spots. Copyright © 2016 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.

  20. Neurogenic pulmonary edema due to ventriculo-atrial shunt dysfunction: a case report.

    Science.gov (United States)

    Cruz, Ana Sofia; Menezes, Sónia; Silva, Maria

    2016-01-01

    Pulmonary edema is caused by the accumulation of fluid within the air spaces and the interstitium of the lung. Neurogenic pulmonary edema is a clinical syndrome characterized by the acute onset of pulmonary edema following a significant central nervous system insult. It may be a less-recognized consequence of raised intracranial pressure due to obstructive hydrocephalus by blocked ventricular shunts. It usually appears within minutes to hours after the injury and has a high mortality rate if not recognized and treated appropriately. We report a patient with acute obstructive hydrocephalus due to ventriculo-atrial shunt dysfunction, proposed to urgent surgery for placement of external ventricular drainage, who presented with neurogenic pulmonary edema preoperatively. She was anesthetized and supportive treatment was instituted. At the end of the procedure the patient showed no clinical signs of respiratory distress, as prompt reduction in intracranial pressure facilitated the regression of the pulmonary edema. This report addresses the importance of recognition of neurogenic pulmonary edema as a possible perioperative complication resulting from an increase in intracranial pressure. If not recognized and treated appropriately, neurogenic pulmonary edema can lead to acute cardiopulmonary failure with global hypoperfusion and hypoxia. Therefore, awareness of and knowledge about the occurrence, clinical presentation and treatment are essential. Copyright © 2013 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

  1. Congenital left atrial appendage aneurysm: Atypical presentation

    Directory of Open Access Journals (Sweden)

    Mehdi Bamous

    2017-01-01

    Full Text Available Congenital left atrial appendage aneurysm is a rare condition caused by dysplasia of the atrial muscles. We report a case of a 14-year-old boy, with a 5-month history of cough and in sinus rhythm. Transthoracic echocardiography and computerized tomographic angiography confirmed the aneurysm of the left atrial appendage which was resected through median sternotomy on cardiopulmonary bypass. This case is presented not only for its rarity but also for its atypical clinical presentation.

  2. Odontogenic myxoma: a clinicopathological study in a South African population.

    Science.gov (United States)

    Titinchi, Fadi; Hassan, Bassam A; Morkel, Jean A; Nortje, Christoffel

    2016-09-01

    Odontogenic myxoma is a benign, locally aggressive neoplasm of the jaws. Prevalence rates range between 0.5% and 17.7% of odontogenic tumours. There are few reports in the literature on this lesion in African populations, and therefore, this study aimed to report on odontogenic myxoma in a South African population over a 40-year period. The clinical records and orthopantomograms of 29 histopathologically diagnosed odontogenic myxoma were retrospectively analysed. Details of age, gender, ethnic origin and clinical, histological as well as radiological features were recorded. The ages of patients ranged from 7 to 44 years with a mean of 21.3 years. The male-to-female ratio was 1:2.6 with the majority of patients being of mixed race and Africans. Clinically, 31% complained of pain while 58.6% had a history of swelling. The majority of odongenic myxomas (62.1%) were located in the mandible with the posterior region being most commonly affected. Multilocular lesions (69.2%) were more common and were significantly larger than unilocular lesions (P myxomas have variable clinical, radiological and histological features. Most of these features in this population were similar to other populations. It is mandatory to use conventional radiographs along with histopathological examination to aid in arriving at an accurate diagnosis. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  3. Extraskeletal multiple myeloma presenting with an atrial mass: a case report and a review of the literature

    Directory of Open Access Journals (Sweden)

    Vigo Federica

    2012-08-01

    Full Text Available Abstract Introduction Extraskeletal presentation at diagnosis or during the course of multiple myeloma is a rare event. The prognosis is usually very poor. At the moment there is no agreed gold standard for the treatment of this presentation. Case presentation A 79-year-old Caucasian woman was treated at our hospital for right atrial myeloma localization. Our patient showed the following signs and symptoms of congestive heart failure: dyspnea, hypotension, cyanosis and facial edema. Surgery was not considered feasible due to the extent of the disease. Our patient underwent external-beam radiation therapy using an intensity modulated technique, thus obtaining a persistent complete remission. Our patient has been in continuous complete local remission for 25 months since the end of radiotherapy. Conclusion The role of radiotherapy is not defined in multiple myeloma with extraskeletal presentation. Our regimen seems to be effective in controlling the disease in this patient. This case report adds to the existing literature as it describes an unusual presentation of the disease and a new therapeutic approach to this rare presentation of multiple myeloma.

  4. Brain Embolism Secondary to Cardiac Myxoma in Fifteen Chinese Patients

    Directory of Open Access Journals (Sweden)

    Youming Long

    2014-01-01

    Full Text Available Background. Heart myxoma-related embolisms commonly involve the central nervous system, but data are lacking in Chinese patients. Methods. 27 patients diagnosed with myxoma were reviewed retrospectively. Results. Among 27 patients, fourteen (51.9% patients were women. Fifteen (55.6% patients had brain embolisms. Rarely, patients were misdiagnosed with central nervous system vasculitis (n = 2, moyamoya disease (n = 1, and neuromyelitis optica (n = 1. We found positive associations between mRS (>3 and female gender (r = 0.873, P10 × 109/L (r = 0.722, P = 0.002, tumour size (r = 0.866, P0.05. Conclusions. Neurologic manifestations in Chinese patients with cardiac myxoma-related stroke were complicated and multifarious. Female gender, infection, other severe complications, low SBP, tumour size, bilateral brain lesions, TACI, and high WBC counts could be associated with a poor prognosis.

  5. Left ventricular cardiac myxoma and sudden death in a dog.

    Science.gov (United States)

    de Nijs, Maria Irene; Vink, Aryan; Bergmann, Wilhelmina; Szatmári, Viktor

    2016-06-22

    Myxoma is a very rare benign cardiac tumor in dogs. This is the first description of a cardiac myxoma originating from the left ventricular outflow tract, presumably causing sudden death. A previously healthy 12-year-old male West Highland white terrier was found dead during its 1-week stay in a kennel. The dog was known to have a cardiac murmur. On necropsy, a pedunculated neoplasia was found attached to the interventricular aspect of the left ventricular outflow tract, resulting in almost complete obstruction of the aorta. As this was the only abnormality identified, the tumor was considered as the cause of sudden death. Histopathologic findings were compatible with a myxoma. Benign intraluminal tumors of the heart are very rare in dogs, but may have fatal consequences. Echocardiography could have revealed the cause of the cardiac murmur of this previously asymptomatic dog. Surgical removal could have been possible, as the tumor was pedunculated.

  6. Brain Embolism Secondary to Cardiac Myxoma in Fifteen Chinese Patients

    Science.gov (United States)

    Long, Youming; Gao, Cong

    2014-01-01

    Background. Heart myxoma-related embolisms commonly involve the central nervous system, but data are lacking in Chinese patients. Methods. 27 patients diagnosed with myxoma were reviewed retrospectively. Results. Among 27 patients, fourteen (51.9%) patients were women. Fifteen (55.6%) patients had brain embolisms. Rarely, patients were misdiagnosed with central nervous system vasculitis (n = 2), moyamoya disease (n = 1), and neuromyelitis optica (n = 1). We found positive associations between mRS (>3) and female gender (r = 0.873, P 10 × 109/L (r = 0.722, P = 0.002), tumour size (r = 0.866, P 0.05). Conclusions. Neurologic manifestations in Chinese patients with cardiac myxoma-related stroke were complicated and multifarious. Female gender, infection, other severe complications, low SBP, tumour size, bilateral brain lesions, TACI, and high WBC counts could be associated with a poor prognosis. PMID:24737987

  7. Mapping strategy for multiple atrial tachyarrhythmias in a transplant heart

    DEFF Research Database (Denmark)

    Jin, Qi; Pehrson, Steen; Jacobsen, Peter Karl

    2015-01-01

    BACKGROUND: Different atrial arrhythmias can coexist in the recipient and donor atria after heart transplantation. CASE PRESENTATION: We report an unusual case of a patient with three different types of atrial arrhythmia after heart transplantation: an atrial fibrillation in the recipient atria, ...

  8. Genetic Variability of Myxoma Virus Genomes

    Science.gov (United States)

    Braun, Christoph; Thürmer, Andrea; Daniel, Rolf; Schultz, Anne-Kathrin; Bulla, Ingo; Schirrmeier, Horst; Mayer, Dietmar; Neubert, Andreas

    2016-01-01

    ABSTRACT Myxomatosis is a recurrent problem on rabbit farms throughout Europe despite the success of vaccines. To identify gene variations of field and vaccine strains that may be responsible for changes in virulence, immunomodulation, and immunoprotection, the genomes of 6 myxoma virus (MYXV) strains were sequenced: German field isolates Munich-1, FLI-H, 2604, and 3207; vaccine strain MAV; and challenge strain ZA. The analyzed genomes ranged from 147.6 kb (strain MAV) to 161.8 kb (strain 3207). All sequences were affected by several mutations, covering 24 to 93 open reading frames (ORFs) and resulted in amino acid substitutions, insertions, or deletions. Only strains Munich-1 and MAV revealed the deletion of 10 ORFs (M007L to M015L) and 11 ORFs (M007L to M008.1L and M149R to M008.1R), respectively. Major differences were observed in the 27 immunomodulatory proteins encoded by MYXV. Compared to the reference strain Lausanne, strains FLI-H, 2604, 3207, and ZA showed the highest amino acid identity (>98.4%). In strains Munich-1 and MAV, deletion of 5 and 10 ORFs, respectively, was observed, encoding immunomodulatory proteins with ankyrin repeats or members of the family of serine protease inhibitors. Furthermore, putative immunodominant surface proteins with homology to vaccinia virus (VACV) were investigated in the sequenced strains. Only strain MAV revealed above-average frequencies of amino acid substitutions and frameshift mutations. Finally, we performed recombination analysis and found signs of recombination in vaccine strain MAV. Phylogenetic analysis showed a close relationship of strain MAV and the MSW strain of Californian MYXV. However, in a challenge model, strain MAV provided full protection against lethal challenges with strain ZA. IMPORTANCE Myxoma virus (MYXV) is pathogenic for European rabbits and two North American species. Due to sophisticated strategies in immune evasion and oncolysis, MYXV is an important model virus for immunological and

  9. Genetic Variability of Myxoma Virus Genomes.

    Science.gov (United States)

    Braun, Christoph; Thürmer, Andrea; Daniel, Rolf; Schultz, Anne-Kathrin; Bulla, Ingo; Schirrmeier, Horst; Mayer, Dietmar; Neubert, Andreas; Czerny, Claus-Peter

    2017-02-15

    Myxomatosis is a recurrent problem on rabbit farms throughout Europe despite the success of vaccines. To identify gene variations of field and vaccine strains that may be responsible for changes in virulence, immunomodulation, and immunoprotection, the genomes of 6 myxoma virus (MYXV) strains were sequenced: German field isolates Munich-1, FLI-H, 2604, and 3207; vaccine strain MAV; and challenge strain ZA. The analyzed genomes ranged from 147.6 kb (strain MAV) to 161.8 kb (strain 3207). All sequences were affected by several mutations, covering 24 to 93 open reading frames (ORFs) and resulted in amino acid substitutions, insertions, or deletions. Only strains Munich-1 and MAV revealed the deletion of 10 ORFs (M007L to M015L) and 11 ORFs (M007L to M008.1L and M149R to M008.1R), respectively. Major differences were observed in the 27 immunomodulatory proteins encoded by MYXV. Compared to the reference strain Lausanne, strains FLI-H, 2604, 3207, and ZA showed the highest amino acid identity (>98.4%). In strains Munich-1 and MAV, deletion of 5 and 10 ORFs, respectively, was observed, encoding immunomodulatory proteins with ankyrin repeats or members of the family of serine protease inhibitors. Furthermore, putative immunodominant surface proteins with homology to vaccinia virus (VACV) were investigated in the sequenced strains. Only strain MAV revealed above-average frequencies of amino acid substitutions and frameshift mutations. Finally, we performed recombination analysis and found signs of recombination in vaccine strain MAV. Phylogenetic analysis showed a close relationship of strain MAV and the MSW strain of Californian MYXV. However, in a challenge model, strain MAV provided full protection against lethal challenges with strain ZA. Myxoma virus (MYXV) is pathogenic for European rabbits and two North American species. Due to sophisticated strategies in immune evasion and oncolysis, MYXV is an important model virus for immunological and pathological research. In

  10. Atrial Fibrillation

    Science.gov (United States)

    ... A-Z Clinical Trials Publications and Resources Health Education and Awareness The Science Science Home Blood Disorders ... heart's two upper chambers—called the atria (AY-tree-uh)—to fibrillate. The ... a difficult decision concerning surgery for patients with atrial fibrillation, the ...

  11. Right Atrial Angiosarcoma with Severe Biventricular Dysfunction and Massive Pericardial Effusion

    Directory of Open Access Journals (Sweden)

    Feridoun Sabzi

    2013-02-01

    Full Text Available This paper presents the case of a 35 year-old woman with symptoms of heart failure from the last month. A physical examination at admission showed paleness, dyspnea, peripheral edema and fatigue. In a two-dimensional echocardiography and transesophageal echocardiography, normal thickness but severe left and right ventricular dysfunction with severe pericardial effusion and thickened pericardium were found. In the enlarged right atrium, an oval-shaped structure was found with features of continuity with lateral right atrial wall and also a bulging of the structure through the orifice of the tricuspid valve to the right ventricle. In the echocardiography, we did not saw any blocking of the tricuspid valve or the inflow from inferior vena cava (IVC or superior vena cava (SVC or coronary sinus. On the basis of the echocardiography examination and clinical presentation, tentative diagnosis of the right atrium myxoma was made. A coronary angiography revealed normal coronary arteries and no feeding of tumor by branch of right coronary artery (RCA. Surgical removal of the tumor was performed without complication. The histopathological examination confirmed the diagnosis of angiosarcoma. In the follow-up echocardiography carried out after three months, severe left ventricular (LV and right ventricular (RV dysfunction continued and was demonstrated. Magnetic resonance imaging revealed no lymphadenopathy or re-growth of the tumor in the mediastinum or pericardium.

  12. Extraskeletal multiple myeloma presenting with an atrial mass: a case report and a review of the literature.

    Science.gov (United States)

    Vigo, Federica; Ciammella, Patrizia; Valli, Riccardo; Cagni, Elisabetta; Iotti, Cinzia

    2012-08-10

    Extraskeletal presentation at diagnosis or during the course of multiple myeloma is a rare event. The prognosis is usually very poor. At the moment there is no agreed gold standard for the treatment of this presentation. A 79-year-old Caucasian woman was treated at our hospital for right atrial myeloma localization. Our patient showed the following signs and symptoms of congestive heart failure: dyspnea, hypotension, cyanosis and facial edema. Surgery was not considered feasible due to the extent of the disease. Our patient underwent external-beam radiation therapy using an intensity modulated technique, thus obtaining a persistent complete remission. Our patient has been in continuous complete local remission for 25 months since the end of radiotherapy. The role of radiotherapy is not defined in multiple myeloma with extraskeletal presentation. Our regimen seems to be effective in controlling the disease in this patient.This case report adds to the existing literature as it describes an unusual presentation of the disease and a new therapeutic approach to this rare presentation of multiple myeloma.

  13. Myxoma virus is a novel oncolytic virus with significant antitumor activity against experimental human gliomas.

    Science.gov (United States)

    Lun, Xueqing; Yang, Wenqing; Alain, Tommy; Shi, Zhong-Qiao; Muzik, Huong; Barrett, John W; McFadden, Grant; Bell, John; Hamilton, Mark G; Senger, Donna L; Forsyth, Peter A

    2005-11-01

    Myxoma virus, a poxvirus previously considered rabbit specific, can replicate productively in a variety of human tumor cells in culture. The purpose of this study was to determine if there was efficacy or toxicities of this oncolytic virus against experimental models of human malignant gliomas in vitro, in vivo, and ex vivo in malignant glioma specimens. In vitro, the majority of glioma cell lines tested (7 of 8, 87.5%) were fully permissive for myxoma virus replication and killed by infection. In vivo, intracerebral (i.c.) myxoma virus inoculation was well tolerated and produced only minimal focal inflammatory changes at the site of viral inoculation. U87 and U251 orthotopic xenograft models were used to assess myxoma virus efficacy in vivo. A single intratumoral injection of myxoma virus dramatically prolonged median survival compared with treatment with UV-inactivated myxoma virus. Median survival was not reached in myxoma virus-treated groups versus 47.3 days (U87; P = 0.0002) and 50.7 days (U251; P = 0.0027) in UV-inactivated myxoma virus-treated groups. Most myxoma virus-treated animals (12 of 13, 92%) were alive and apparently "cured" when the experiment was finished (>130 days). Interestingly, we found a selective and long-lived myxoma virus infection in gliomas in vivo. This is the first demonstration of the oncolytic activity of myxoma virus in vivo. The nonpathogenic nature of myxoma virus outside of the rabbit host, its capacity to be genetically modified, its ability to produce a long-lived infection in human tumor cells, and the lack of preexisting antibodies in the human population suggest that myxoma virus may be an attractive oncolytic agent against human malignant glioma.

  14. Oncolytic myxoma virus: the path to clinic.

    Science.gov (United States)

    Chan, Winnie M; Rahman, Masmudur M; McFadden, Grant

    2013-09-06

    Many common neoplasms are still noncurative with current standards of cancer therapy. More therapeutic modalities need to be developed to significantly prolong the lives of patients and eventually cure a wider spectrum of cancers. Oncolytic virotherapy is one of the promising new additions to clinical cancer therapeutics. Successful oncolytic virotherapy in the clinic will be those strategies that best combine tumor cell oncolysis with enhanced immune responses against tumor antigens. The current candidate oncolytic viruses all share the common property that they are relatively nonpathogenic to humans, yet they have the ability to replicate selectively in human cancer cells and induce cancer regression by direct oncolysis and/or induction of improved anti-tumor immune responses. Many candidate oncolytic viruses are in various stages of clinical and preclinical development. One such preclinical candidate is myxoma virus (MYXV), a member of the Poxviridae family that, in its natural setting, exhibits a very restricted host range and is only pathogenic to European rabbits. Despite its narrow host range in nature, MYXV has been shown to productively infect various classes of human cancer cells. Several preclinical in vivo modeling studies have demonstrated that MYXV is an attractive and safe candidate oncolytic virus, and hence, MYXV is currently being developed as a potential therapeutic for several cancers, such as pancreatic cancer, glioblastoma, ovarian cancer, melanoma, and hematologic malignancies. This review highlights the preclinical cancer models that have shown the most promise for translation of MYXV into human clinical trials. Published by Elsevier Ltd.

  15. Myxoma virus: propagation, purification, quantification, and storage.

    Science.gov (United States)

    Smallwood, Sherin E; Rahman, Masmudur M; Smith, Dorothy W; McFadden, Grant

    2010-05-01

    Myxoma virus (MYXV) is a member of the Poxviridae family and prototype for the genus Leporipoxvirus. It is pathogenic only for European rabbits, in which it causes the lethal disease myxomatosis, and two North American species, in which it causes a less severe disease. MYXV replicates exclusively in the cytoplasm of the host cell. Although not infectious in humans, its genome encodes proteins that can interfere with or modulate host defense mechanisms; it is able to productively infect a number of human cancer cell lines, but not normal human cells, and has also been shown to increase survival time in mouse models of human glioma. These characteristics suggest that MYXV could be a viable therapeutic agent, e.g., in anti-inflammatory or anti-immune therapy, or as an oncolytic agent. MYXV is also an excellent model for poxvirus biology, pathogenesis, and host tropism studies. It is easily propagated in a number of cell lines, including adherent cells and suspension cultures, and minimal purification is required to provide a stock for in vivo and in vitro studies.

  16. Case report: Intra-atrial course of right coronary artery: Evaluation by dual-source CT

    Directory of Open Access Journals (Sweden)

    Johann Christopher

    2011-01-01

    Full Text Available We report a case of an anomalous course of the right coronary artery (RCA through the right atrium, which was evaluated using dual-source CT angiography. There have been a few cases described previously in literature, but most of them were found either during surgery or at autopsy. Although this variant is clinically benign, it has significant consequences during interventional procedures or bypass surgery.

  17. [Atrial defibrillator].

    Science.gov (United States)

    Jung, W; Lüderitz, B

    2000-01-01

    Atrial fibrillation (AF) is a frequent and costly health care problem representing the most common arrhythmia resulting in hospital admission. Total mortality and cardiovascular mortality are significantly increased in patients with AF compared to controls. In addition to symptoms of palpitations, patients with AF have an increased risk of stroke and may also develop decreased exercise tolerance and left ventricular dysfunction. All of these problems may be reversed with restoration and maintenance of sinus rhythm. External electrical cardioversion has been a remarkably effective and safe method for termination of this arrhythmia. Originally described by Lown et al. in 1963, it has been a well accepted mode of acute therapy. However, this technique requires general anesthesia or heavy sedation. Internal atrial defibrillation has been evaluated as an alternative approach to the external technique for over 2 decades. Recent studies have shown that low-energy internal atrial defibrillation using biphasic shocks is an effective and safe means in restoring sinus rhythm in patients with AF and should be considered especially in patients in whom external cardioversion attempts have failed. Implantable Atrial Defibrillator: Recently, a stand alone IAD, the Metrix System (models 3000 and 3020), has entered clinical investigation. Atrial defibrillation is accomplished by a shock delivered between electrodes in the right atrium and the coronary sinus. The right atrium lead has an active fixation in the right atrium. The coronary sinus lead has a natural spiral configuration for retention in the coronary sinus, and can be straightened with a stylet. Both leads are 7 French in diameter and the defibrillation coils are each 6 cm in length. The electrodes may be placed using separate leads, or very soon by using a single bipolar lead. A separate bipolar right ventricular lead is used for R wave synchronization and post shock pacing. The Metrix defibrillator can be used to induce

  18. Intravenous Thrombolysis for Embolic Stroke due to Cardiac Myxoma

    Directory of Open Access Journals (Sweden)

    Mu-Chien Sun

    2011-01-01

    Full Text Available Cardiac myxoma is a rare but curable cause of ischemic stroke. Current guidelines do not address the use of intravenous thrombolysis for embolic stroke caused by cardiac myxoma. The risk of hemorrhage due to occult tumor emboli or microaneurysms is a major concern. We describe a 45-year-old man who had an embolic stroke in the left middle cerebral artery. The initial National Institutes of Health Stroke Scale (NIHSS score was 16. He received intravenous thrombolysis 2 h and 52 min after stroke onset. No intracranial hemorrhage developed. A cardiac mass was found in the left atrium and removed surgically 84 h after stroke. Pathological study showed a myxoma with extensive hemorrhage and thrombus over the surface. At the 3-month follow-up, the NIHSS score was 9 and the modified Rankin scale score was 3. Our experience with this patient supports the hypothesis that intravenous thrombolysis may be safely used in the treatment of embolic stroke due to cardiac myxoma.

  19. miR-218 suppresses cardiac myxoma proliferation by targeting myocyte enhancer factor 2D.

    Science.gov (United States)

    Cao, Quanxing; Dong, Pingshuan; Wang, Yanyu; Zhang, Junwei; Shi, Xinge; Wang, Yongsheng

    2015-05-01

    Cardiac myxoma is the most common type of human heart tumor, yet the molecular mechanism is still poorly understood. In the present study, we found that the level of myocyte enhancer factor 2D (MEF2D), a key regulatory protein for cardiac development, was elevated in specimens of cardiac myxoma, and was positively associated with the proliferation of myxoma cells. MEF2D suppression reduced the proliferation of myxoma cells and its tumorigenicity. Cell cycle progression was also inhibited by MEF2D suppression. miR-218, which is downregulated in myxoma, suppressed MEF2D expression by targeting its mRNA 3'UTR. Altogether, we found that miR-218/MEF2D may be an effective target for myxoma treatment.

  20. [A case of tricuspid pouch associated with ventricular septal defect and functional left ventricular-right atrial communication].

    Science.gov (United States)

    Watanabe, H; Maeda, K; Minowa, T; Shimasaki, T; Shimanuki, T; Kasuya, S; Sakashita, I; Takano, S; Kato, K

    1992-03-01

    We reported a 60-year-old woman with tricuspid pouch associated with ventricular septal defect and subsequent left ventricular-right atrial communication. Preoperative angiographic findings suggested the presence of membranous septal aneurysm, ventricular and atrial septal defects, and tricuspid insufficiency. However, at operation, besides perimembranous inlet type ventricular septal defect, a pouch, 1.5 cm in diameter was found in the adjacent part to the septal leaflet within the anterior one of the tricuspid valve. The ventricular septal defect was closed with a patch. From these findings, it is speculated that the tricuspid pouch was formed by the effect of jet stream through the ventricular septal defect.

  1. Rupture of the left atrial roof due to blunt trauma.

    Science.gov (United States)

    Ryu, Dae Woong; Lee, Sam Youn; Lee, Mi Kyung

    2013-11-01

    Cardiac rupture after blunt trauma is rare and associated with high mortality. The anatomic pattern of blunt cardiac rupture has been demonstrated with the right cardiac chambers more frequently affected than the left. Furthermore, left atrial injury is usually restricted to the atrial appendage and the pulmonary vein-atrial junction. Herein, we report the first case of a 61-year old man with a rupture of the left atrial roof after blunt trauma with minimal thoracic injury.

  2. Rupture of the left atrial roof due to blunt trauma

    OpenAIRE

    Ryu, Dae Woong; Lee, Sam Youn; Lee, Mi Kyung

    2013-01-01

    Cardiac rupture after blunt trauma is rare and associated with high mortality. The anatomic pattern of blunt cardiac rupture has been demonstrated with the right cardiac chambers more frequently affected than the left. Furthermore, left atrial injury is usually restricted to the atrial appendage and the pulmonary vein–atrial junction. Herein, we report the first case of a 61-year old man with a rupture of the left atrial roof after blunt trauma with minimal thoracic injury.

  3. [Monitoring of labor by fetal pulse oximetry in a case of fetal atrial-ventricular block].

    Science.gov (United States)

    Boudineau, M; Fondevila, M; Winer, N; Caroit, Y; Boog, G

    1997-01-01

    We present our experience with fetal pulse oximetry during labor monitoring in a case of fetal atrio-ventricular block. Fetal pulse oximetry is a recent technique of fetal monitoring. It is based on the photometric properties of hemoglobin and reduced hemoglobin. The continuous and noninvasive method measured fetal saturation in oxygen. It can detect fetal hypoxia, cause of acute suffering. Saturation was continuously greater than 40%. Spontaneous delivery raised no problem, either for the fetus or the mother.

  4. Oncolytic Virotherapy Synergism with Signaling Inhibitors: Rapamycin Increases Myxoma Virus Tropism for Human Tumor Cells▿

    OpenAIRE

    Stanford, Marianne M.; Barrett, John W.; Nazarian, Steven H.; Werden, Steven; McFadden, Grant

    2006-01-01

    Myxoma virus is a rabbit-specific poxvirus pathogen that also exhibits a unique tropism for human tumor cells and is dramatically oncolytic for human cancer xenografts. Most tumor cell lines tested are permissive for myxoma infection in a fashion intimately tied to the activation state of Akt kinase. A host range factor of myxoma virus, M-T5, directly interacts with Akt and mediates myxoma virus tumor cell tropism. mTOR is a regulator of cell growth and metabolism downstream of Akt and is spe...

  5. HYPERTHYROIDISM AND ATRIAL FIBRILLATION

    Directory of Open Access Journals (Sweden)

    I. M. Marusenko

    2017-01-01

    simultaneous existence of frequent focal impulses and circular motions of the excitation wave – the mechanism re-entry. Successful treatment of atrial fibrillation in patients with thyrotoxicosis is possible only when euthyroidism is achieved. In most cases, after the elimination of thyrotoxicosis, a spontaneous restoration of the sinus rhythm is observed. The chances of sinus rhythm restoration are lower in elderly patients with concomitant organic diseases of the myocardium or long-term atrial fibrillation. Moreover, even radically cured thyrotoxicosis leads to deterioration in the life prognosis.

  6. African Journal of Neurological Sciences - 2009 Vol. 28 No 1

    African Journals Online (AJOL)

    India. Key-words: Primary myxoma, intracranial tumor. ABSTRACT. Myxomas are benign primary tumors of the heart of mesenchymal origin. Neurological complications attributed to atrial myxoma occurs in 10% to 12% of patients, with ischemic presentation due to cerebral infarct in 83%-89% of cases. Few case reports are ...

  7. [Therapeutic strategies of atrial fibrillation in patients aged 65 and over. Report of 86 cases].

    Science.gov (United States)

    Jaafari, Aïcha; Zakhama, Lilia; Boussabah, Ehlem; Thameur, Moez; Boukhriss, Bessma; Amara, Yosser; Masmoudi, Mourad; Bencheikh, Mamoun; Benyoussef, Soraya

    2004-01-01

    Auricular fibrillation is the most common sustained cardiac arrhythmia, yet the optimal strategy for its management remains unclear. Since the study AFFIRM from which resulted them final were deferred in December 2002, the assumption of responsibility of the fibrillation of the old subject tends to become clarified. 86 patients at least 65 years or more were enrolled in our retrospective study from January 1997 to June 2003. The mean age is 70 years (65 to 82 years) and sex ratio to 0.79. 34% had a history of hypertension and 12% had a coronary artery disease. 2 groups were individualized, according to the year of admission before or after 2002. It comes out from these work 2 points: the restoration of the sinusal rhythm was the first choice. In the event of failure, the option was to maintain fibrillation and this, in the 2 groups. The AVK were founded in the large majority of the cases only after year 2002.

  8. Anomalous muscle bundle in the right atrium; Implication to trans atrial device closure

    Directory of Open Access Journals (Sweden)

    Saji Philip

    2017-09-01

    Full Text Available Intracavitary muscle bands or aberrant bands have been well described in all four chambers of the heart but rarely seen thick muscular band crossing right atrium. We report a case of devisable secundum atrial septal defect with an intra-atrial anomalous muscular band, crossing right atrial wall to the rim of the secundum atrial septal defect warranting surgical closure.

  9. Late infectious endocarditis of surgical patch closure of atrial septal defects diagnosed by 18F-fluorodeoxyglucose gated cardiac computed tomography (18F-FDG-PET/CT): a case report.

    Science.gov (United States)

    Honnorat, Estelle; Seng, Piseth; Riberi, Alberto; Habib, Gilbert; Stein, Andreas

    2016-08-24

    In contrast to percutaneous atrial septal occluder device, surgical patch closure of atrial defects was known to be no infective endocarditis risk. We herein report the first case of late endocarditis of surgical patch closure of atrial septal defects occurred at 47-year after surgery. On September 2014, a 56-year-old immunocompetent French Caucasian man was admitted into the Emergency Department for 3-week history of headache, acute decrease of psychomotor performance and fever at 40 °C. The diagnosis has been evoked during his admission for the management of a brain abscess and confirmed using 18F-fluorodeoxyglucose gated cardiac computed tomography (18F-FDG-PET/CT). Bacterial cultures of surgical deep samples of brain abscess were positive for Streptococcus intermedius and Aggregatibacter aphrophilus as identified by the matrix-assisted laser desorption/ionization-time of flight (MALDI-TOF) mass spectrometry and confirmed with 16S rRNA gene sequencing. The patient was treated by antibiotics for 8 weeks and surgical patch closure removal. In summary, late endocarditis on surgical patch and on percutaneous atrial septal occluder device of atrial septal defects is rare. Cardiac imaging by the 18F-fluorodeoxyglucose gated cardiac computed tomography (18F-FDG-PET/CT) could improve the diagnosis and care endocarditis on surgical patch closure of atrial septal defects while transthoracic and transesophageal echocardiography remained difficult to interpret.

  10. Primitive neuroectodermal tumour of the kidney with vena caval and atrial tumour thrombus: a case report

    Directory of Open Access Journals (Sweden)

    Ong Poh

    2008-08-01

    Full Text Available Abstract Introduction Renal primitive neuroectodermal tumour is an extremely rare malignancy. Case presentation A 21-year-old woman presented with microscopic haematuria, a palpable right loin mass, dyspnoea, dizziness and fatigue. Initial ultrasound scan of the kidneys revealed an 11 cm right renal mass with venous extension into the inferior vena cava. Computed tomography of the thorax and abdomen revealed an extension of the large renal mass into the right renal vein, inferior vena cava and up to the right atrium. A small paracaval lymph node was noted and three small metastatic nodules were identified within the lung parenchyma. The patient underwent a radical nephrectomy and inferior vena caval tumour (level IV thrombectomy with cardiopulmonary bypass and deep hypothermic circulatory arrest. Immunohistochemical staining of the specimen showed a highly specific cluster of differentiation (CD 99, thus confirming the diagnosis of a primitive neuroectodermal tumour. Conclusion It is important that a renal primitive neuroectodermal tumour be considered, particularly in young patients with a renal mass and extensive thrombus.

  11. Odontogenic myxoma in an 8-year-old Labrador Retriever dog.

    Science.gov (United States)

    Barigye, Robert; Schultz, Jessie; Newell, Teresa K; Dyer, Neil W

    2011-01-01

    Odontogenic myxoma (OM) was diagnosed in an 8-year-old Labrador Retriever dog with an ulcerohemorrhagic mass located on the caudal area of the right maxillary gingiva. The neoplasm was characterized by a low mitotic index and moderate numbers of spindle, stellate, and round cells that were sparsely distributed in an alcian blue reactive myxomatous matrix. Individual neoplastic cells were characterized by small amounts of faintly eosinophilic staining cytoplasm, prominent nucleoli, and stippled amphophilic staining chromatin that was immunoreactive for vimentin but negative for cytokeratin and actin. To the authors' knowledge, this is the first reported case of canine OM from North America, and it shares histomorphologic and histochemical features with 3 other cases reported in dogs elsewhere. Whereas, a literature review suggests untreated canine OM is insidious and locally aggressive, the prognosis in the present dog remains unknown. These findings support previous recommendations for inclusion of canine OM on the World Health Organization list of odontogenic tumors.

  12. [Maze procedure in a case of dextrocardia with atrial septal defect and persistent left superior vena cava].

    Science.gov (United States)

    Muraoka, Arata; Kawada, Masaaki; Misawa, Yoshio

    2014-08-01

    A 52-year-old man was diagnosed with dextrocardia at the age of 1 year and was asymptomatic until 1 year before admission. He was transferred to our hospital for management of atrial fibrillation. A transthoracic echocardiogram showed dextrocardia with atrial septal defect;moderate tricuspid valve regurgitation; and a large, persistent left superior vena cava. A cardiac catheterization study revealed that pulmonary flow/systemic flow (Qp/Qs) was 3.6 and that pulmonary vascular resistance was 2.5 Wood U·m². Intracardiac repair with tricuspid annuloplasty and a maze procedure was scheduled. When establishing cardiopulmonary bypass, venous drainage was initially obtained from the inferior vena cava and the left superior vena cava, and the small superior vena cava was then directly cannulated after opening the right atrium. The patient's postoperative course was uneventful, and serial electrocardiograms have demonstrated maintenance of normal sinus rhythm for 3.5 years after the operation.

  13. Oncolysis of canine tumor cells by myxoma virus lacking the serp2 gene.

    Science.gov (United States)

    Urbasic, Ashlee S; Hynes, Stacy; Somrak, Amy; Contakos, Stacey; Rahman, Masmudur M; Liu, Jia; MacNeill, Amy L

    2012-08-01

    To determine the oncolytic efficacy of an attenuated form of myxoma virus lacking the serp2 gene in canine tumor cells. Primary cells were isolated from tumors that were surgically removed from dogs and from connective tissue obtained from the cadaver of a dog. Cells of various established cell lines from tumors and nontumorous tissues were obtained. Experiments were performed with cells in monolayer culture. Cell cultures were inoculated with wild-type myxoma viruses or myxoma viruses lacking the serp2 gene, and measures of cytopathic effects, viral growth kinetics, and cell death and apoptosis were determined. Myxoma viruses replicated in cells of many of the primary and established canine tumor cell lines. Canine tumor cells in which expression of activated protein kinase B was upregulated were more permissive to myxoma virus infection than were cells in which expression of activated protein kinase B was not upregulated. Myxoma viruses lacking the serp2 gene caused more cytopathic effects in canine tumor cells because of apoptosis than did wild-type myxoma viruses. Results of the present study indicated myxoma viruses lacking the serp2 gene may be useful for treatment of cancer in dogs. Impact for Human Medicine-Results of the present study may be useful for development of novel oncolytic treatments for tumors in humans.

  14. Targeting human medulloblastoma: oncolytic virotherapy with myxoma virus is enhanced by rapamycin.

    Science.gov (United States)

    Lun, Xue Qing; Zhou, Hongyuan; Alain, Tommy; Sun, Beichen; Wang, Limei; Barrett, John W; Stanford, Marianne M; McFadden, Grant; Bell, John; Senger, Donna L; Forsyth, Peter A

    2007-09-15

    We have shown previously the oncolytic potential of myxoma virus in a murine xenograft model of human glioma. Here, we show that myxoma virus used alone or in combination with rapamycin is effective and safe when used in experimental models of medulloblastoma in vitro and in vivo. Nine of 10 medulloblastoma cell lines tested were susceptible to lethal myxoma virus infection, and pretreatment of cells with rapamycin increased the extent of in vitro oncolysis. Intratumoral injection of live myxoma virus when compared with control inactivated virus prolonged survival in D341 and Daoy orthotopic human medulloblastoma xenograft mouse models [D341 median survival: 21 versus 12.5 days; P = 0.0008; Daoy median survival: not reached (three of five mice apparently "cured" after 223 days) versus 75 days; P = 0.0021]. Rapamycin increased the extent of viral oncolysis, "curing" most Daoy tumor-bearing mice and reducing or eliminating spinal cord and ventricle metastases. Rapamycin enhanced tumor-specific myxoma virus replication in vivo and prolonged survival of D341 tumor-bearing mice (median survival of mice treated with live virus (LV) and rapamycin, versus LV alone, versus rapamycin alone, versus inactivated virus: 25 days versus 19, 13, and 11 days, respectively; P myxoma virus oncolysis. These observations suggest that myxoma virus may be an effective oncolytic agent against medulloblastoma and that combination therapy with signaling inhibitors that modulate activity of the phosphatidylinositol 3-kinase/Akt pathway will further enhance the oncolytic potential of myxoma virus.

  15. Oncolytic virotherapy synergism with signaling inhibitors: Rapamycin increases myxoma virus tropism for human tumor cells.

    Science.gov (United States)

    Stanford, Marianne M; Barrett, John W; Nazarian, Steven H; Werden, Steven; McFadden, Grant

    2007-02-01

    Myxoma virus is a rabbit-specific poxvirus pathogen that also exhibits a unique tropism for human tumor cells and is dramatically oncolytic for human cancer xenografts. Most tumor cell lines tested are permissive for myxoma infection in a fashion intimately tied to the activation state of Akt kinase. A host range factor of myxoma virus, M-T5, directly interacts with Akt and mediates myxoma virus tumor cell tropism. mTOR is a regulator of cell growth and metabolism downstream of Akt and is specifically inhibited by rapamycin. We report that treatment of nonpermissive human tumor cell lines, which normally restrict myxoma virus replication, with rapamycin dramatically increased virus tropism and spread in vitro. This increased myxoma replication is concomitant with global effects on mTOR signaling, specifically, an increase in Akt kinase. In contrast to the effects on human cancer cells, rapamycin does not increase myxoma virus replication in rabbit cell lines or permissive human tumor cell lines with constitutively active Akt. This indicates that rapamycin increases the oncolytic capacity of myxoma virus for human cancer cells by reconfiguring the internal cell signaling environment to one that is optimal for productive virus replication and suggests the possibility of a potentially therapeutic synergism between kinase signaling inhibitors and oncolytic poxviruses for cancer treatment.

  16. Myxoma Virus and the Leporipoxviruses: An Evolutionary Paradigm

    OpenAIRE

    Kerr, Peter J.; June Liu; Isabella Cattadori; Elodie Ghedin; Read, Andrew F.; Holmes, Edward C.

    2015-01-01

    Myxoma virus (MYXV) is the type species of the Leporipoxviruses, a genus of Chordopoxvirinae, double stranded DNA viruses, whose members infect leporids and squirrels, inducing cutaneous fibromas from which virus is mechanically transmitted by biting arthropods. However, in the European rabbit (Oryctolagus cuniculus), MYXV causes the lethal disease myxomatosis. The release of MYXV as a biological control for the wild European rabbit population in Australia, initiated one of the great experime...

  17. Molecular characterisation of virulence graded field isolates of myxoma virus

    OpenAIRE

    Parra Francisco; Alonso Jose; Baragaño Aroa; Nicieza Ines; Dalton Kevin P

    2010-01-01

    Abstract Background Myxoma virus (MV) has been endemic in Europe since shortly after its deliberate release in France in 1952. While the emergence of more resistant hosts and more transmissible and attenuated virus is well documented, there have been relatively few studies focused on the sequence changes incurred by the virus as it has adapted to its new host. In order to identify regions of variability within the MV genome to be used for phylogenetic studies and to try to investigate causes ...

  18. [Transitory transesophageal atrial electric stimulation. Preliminary report on 19 cases and considerations on the method, indications and results (author's transl)].

    Science.gov (United States)

    Pistolese, M; Richichi, G; Catalano, V; Boccadamo, R

    1975-01-01

    Literature provides sufficient evidence that transitory electric stimulation via esophagus (SATE) - after the first positive experimental attempts on dogs - can be applied to man with a simple, rapid and harmless method. The study covers 19 patients subjected to high frequency transesophageal atrial stimulation by way of a bipolar electrode inserted through a nasogastric tube and connected to an external generator capable of producing tension impulses. Said impulses are variable up to 150 volts, lasting 2.5 microsec. with a frequency of up to 450/min. The 19 patients can be divided into 2 groups. The first including 15 patients on which SATE was effected for diagnostic purposes: in coronary deficiency (8 patients), in the disease of sinus node (3 patients), and lastly in the research for the A-V-block latent in 4 patients with acute post-infarctual A-V-block which regressed during the immediate clinical course of the illness. The other group includes 4 patients in which the atrial stimulation indication was the treatment of rapid, paroxysmic atrial rhythms, inaffected by drugs. By using impulses of 25-30 volts, the AA. have obtained a stable stimulation.

  19. Primary cardiac sarcoma: reports of two cases and a review of current literature

    Directory of Open Access Journals (Sweden)

    Kadir Isaac

    2007-07-01

    Full Text Available Abstract Primary cardiac sarcomas are rare tumors with an unfavourable prognosis. Complete surgical resection is currently the only mode of therapy proven to show any benefit. We report the cases of two patients presenting with features of obstruction and embolism and a presumed diagnosis of left atrial myxoma. At operation they were unexpectedly found to have large tumours raising strong suspicions of malignancy. Due to the extensive involvement of intracardiac structures with little possibility of reconstruction together with poor general condition of the patient, debulking was deemed to be the only viable option. Subsequent histology confirmed the diagnosis of sarcoma in both patients. Surgery produced immediate and effective symptom relief. The first patient died four months after the operation and second patient is still alive at 12 months after her operation. A brief review of literature on cardiac sarcoma is presented.

  20. Myxoma virus is oncolytic for human pancreatic adenocarcinoma cells.

    Science.gov (United States)

    Woo, Yanghee; Kelly, Kaitlyn J; Stanford, Marianne M; Galanis, Charles; Chun, Yun Shin; Fong, Yuman; McFadden, Grant

    2008-08-01

    Viral oncolytic therapy, which seeks to exploit the use of live viruses to treat cancer, has shown promise in the treatment of cancers resistant to conventional anticancer therapies. Among the most difficult to treat cancers is advanced pancreatic adenocarcinoma. Our study investigates the ability of a novel oncolytic agent, myxoma virus, to infect, productively replicate in, and kill human pancreatic cancer cells in vitro. The myxoma virus vMyxgfp was tested against a panel of human pancreatic adenocarcinoma cell lines. Infectivity, viral proliferation, and tumor cell kill were assessed. Infection of tumor cells was assessed by expression of the marker gene enhanced green fluorescent protein (e-GFP). vMyxgfp had the ability to infect all pancreatic cancer cell lines tested. Killing of tumor cells varied among the 6 cell lines tested, ranging from >90% cell kill at 7 days for the most sensitive Panc-1 cells, to 39% in the most resistant cell line Capan-2. Sensitivity correlated to replication of virus, and was found to maximally exhibit a four-log increase in foci-forming units for the most sensitive Panc-1 cells within 72 h. Our study demonstrates for the first time the ability of the myxoma virus to productively infect, replicate in, and lyse human pancreatic adenocarcinoma cells in vitro. These data encourage further investigation of this virus, which is pathogenic only in rabbits, for treatment of this nearly uniformly fatal cancer.

  1. [Study in the killing effect of Myxoma virus to C6 glioma cell in vitro].

    Science.gov (United States)

    Zang, Meng; Zhang, Qiu-Sheng; Liang, Shi-Jie; Ji, Tao; Lin, Heng-Zhou; Li, Wei-Ping

    2012-02-01

    To evaluate the susceptibility of C6 glioma cells to Myxoma virus and the killing effect of Myxoma virus to the C6 glioma cells in vitro. C6 glioma cells were infected with myxoma virus, used death virus as the negative control, 5-FU as the positive control, DEMD as blank control. The number of living cells were counted every 24 h, and Western-Blot method, inverted microscope and MTT assay were applicated to observe the cell morphology and survival rate in each group. The cell number were decreased rapidly in virus effected group and 5-FU group, with significant differences to the negative and blank control groups. And cells in virus effected group appeared cytopathic effect. C6 glioma cells were susceptible to myxoma virus and myxoma virus had killing effect to C6 glioma cells in vitro.

  2. Deglutition-Induced Atrial Fibrillation

    Science.gov (United States)

    Malik, Amyn; Ali, Syed Sohail; Rahmatullah, Amin

    2005-01-01

    We present the case of 38-year-old woman who experienced palpitations on swallowing, which were later found to be atrial fibrillation. Her symptoms improved on treatment with disopyramide and verapamil. Within 9 months, she was weaned from both medications without recurrence of symptoms. PMID:16429915

  3. Emerging risk factors and the dose-response relationship between physical activity and lone atrial fibrillation: a prospective case-control study.

    Science.gov (United States)

    Calvo, Naiara; Ramos, Pablo; Montserrat, Silvia; Guasch, Eduard; Coll-Vinent, Blanca; Domenech, Mònica; Bisbal, Felipe; Hevia, Sara; Vidorreta, Silvia; Borras, Roger; Falces, Carles; Embid, Cristina; Montserrat, Josep Maria; Berruezo, Antonio; Coca, Antonio; Sitges, Marta; Brugada, Josep; Mont, Lluís

    2016-01-01

    The role of high-intensity exercise and other emerging risk factors in lone atrial fibrillation (Ln-AF) epidemiology is still under debate. The aim of this study was to analyse the contribution of each of the emerging risk factors and the impact of physical activity dose in patients with Ln-AF. Patients with Ln-AF and age- and sex-matched healthy controls were included in a 2:1 prospective case-control study. We obtained clinical and anthropometric data transthoracic echocardiography, lifetime physical activity questionnaire, 24-h ambulatory blood pressure monitoring, Berlin questionnaire score, and, in patients at high risk for obstructive sleep apnoea (OSA) syndrome, a polysomnography. A total of 115 cases and 57 controls were enrolled. Conditional logistic regression analysis associated height [odds ratio (OR) 1.06 [1.01-1.11

  4. Significance of intravascular and intracardiac movement of the cardiac catheter in ventriculo-atrial shunts (review of 655 cases).

    Science.gov (United States)

    Ahyai, A

    1979-01-01

    Proper placement of ventriculo-atrial shunts can be complicated by three phenomena: 1. Movement of the cardiac catheter intravascularly into the internal jugular vein as noted on chest X-ray. 2. Movement of the cardiac catheter during intraoperative X-ray leading to blurring and hence problems in accurate localization. 3. No sign on X-ray of the catheter tip or even of the catheter itself despite previous X-ray visualization and good function, a problem to be obviated by better radiopaque markings.

  5. NRGTM RF powered transseptal needle: a useful technique for transcatheter atrial septostomy and Fontan fenestration: report of three cases

    Directory of Open Access Journals (Sweden)

    Tevfik Karagöz

    2014-10-01

    Full Text Available Transseptal puncture (TSP is a frequently performed procedure for gaining access to the left atrium for catheter ablation, hemodynamic assessment of the left heart, left ventricular assist device implantation, percutaneous left atrial appendage closure or mitral valvuloplasty during childhood and adulthood. The standard technique for transseptal puncture applies mechanical pressure on the fossa ovalis with a Brockenbrough needle. However, this method is not feasible when the fossa ovalis is thick and aneurysmatic. In such patients, the radiofrequency ablation energy systems can be offered as a better alternative for TSP. Here, we aimed to demonstrate the outcome of transseptal puncture performed with an NRGTM RF powered transseptal needle in three patients.

  6. Acute Renal Infarction Presenting with Acute Abdominal Pain Secondary to Newly Discovered Atrial Fibrillation: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Sherif Ali Eltawansy

    2014-01-01

    Full Text Available We report an 85-year-old female with known history of recurrent diverticulitis presented with abdominal pain. It was believed that the patient again needed to be treated for another diverticulitis and was started on the routine treatment. The initial CT scan of abdomen showed renal infarcts bilaterally that were confirmed by a CT with and without intravenous contrast secondary to unknown cause. An ECG found accidentally that the patient was in atrial fibrillation, which was the attributed factor to the renal infarctions. Subsequently, the patient was started on the appropriate anticoagulation and discharged.

  7. Atrial fibrillation associated with a thyroid stimulating hormone-secreting adenoma of the pituitary gland leading to a presentation of acute cardiac decompensation: A case report

    Directory of Open Access Journals (Sweden)

    George Jyothis T

    2008-02-01

    Full Text Available Abstract Introduction Hyperthyroidism is a well established cause of atrial fibrillation (AF. Thyroid Stimulating Hormone-secreting pituitary tumours are rare causes of pituitary hyperthyroidism. Whilst pituitary causes of hyperthyroidism are much less common than primary thyroid pathology, establishing a clear aetiology is critical in minimising complications and providing appropriate treatment. Measuring Thyroid Stimulating Hormone (TSH alone to screen for hyperthyroidism may be insufficient to appropriately evaluate the thyroid status in such cases. Case presentation A 63-year-old Caucasian man, previously fit and well, presented with a five-day history of shortness of breath associated with wheeze and dry cough. He denied symptoms of hyperthyroidism and his family, social and past history were unremarkable. Initial investigation was in keeping with a diagnosis of atrial fibrillation (AF with fast ventricular response leading to cardiac decompensation. TSH 6.2 (Normal Range = 0.40 – 4.00 mU/L, Free T3 of 12.5 (4.00 – 6.8 pmol/L and Free T4 51(10–30 pmol/L. Heterophilic antibodies were ruled out. Testosterone was elevated at 43.10 (Normal range: 10.00 – 31.00 nmol/L with an elevated FSH, 18.1 (1.0–7.0 U/L and elevated LH, 12.4 (1.0–8.0 U/L. Growth Hormone, IGF-1 and prolactin were normal. MRI showed a 2.4 cm pituitary macroadenoma. Visual field tests showed a right inferotemporal defect. While awaiting neurosurgical removal of the tumour, the patient was commenced on antithyroid medication (carbimazole and maintained on this until successful trans-sphenoidal excision of the macroadenoma had been performed. AF persisted post-operatively, but was electrically cardioverted subsequently and he remains in sinus rhythm at twelve months follow-up off all treatment. Conclusion This case reiterates the need to evaluate thyroid function in all patients presenting with atrial fibrillation. TSH-secreting pituitary adenomas must be considered

  8. Robotic atrial septal defect closure and tricuspid annuloplasty in a case of situs inversus totalis with dextrocardia.

    Science.gov (United States)

    Onan, Burak; Aydin, Unal; Kahraman, Zeynep; Bakir, Ihsan

    2017-03-01

    Situs inversus totalis (SIT) with dextrocardia is an uncommon congenital positional anomaly, which is characterized by a symmetrical 'mirror-image' orientation of all organs in relation to the midline. Although sternotomy and thoracotomy is traditionally used in patients with SIT with dextrocardia, a totally endoscopic robotic surgery is an alternative surgical approach to intracardiac anomalies. Placement of robotic ports, transthoracic aortic clamp, cardioplegia delivery, and peripheral vascular cannulation is made from the left side of the chest, as a mirror orientation of the right-sided robotic cardiac procedures. Here, we present a patient who underwent concomitant robotic atrial septal defect closure and tricuspid annuloplasty with posterior plication using the da Vinci surgical system.

  9. Mixoma de vulva em cão Vulvar myxoma in a dog

    Directory of Open Access Journals (Sweden)

    E.F. Nascimento

    2000-02-01

    Full Text Available This report describes the pathological findings of a myxoma in the vulva of a seven-year-old German Shepherd bitch, with history of mass increase in the vulva. After surgery, tipical and microscopic aspects were detected.

  10. Protection against myxomatosis and rabbit viral hemorrhagic disease with recombinant myxoma viruses expressing rabbit hemorrhagic disease virus capsid protein.

    OpenAIRE

    Bertagnoli, Stéphane; Gelfi, Jacqueline; Le Gall, Ghislaine; Boilletot, Eric; Vautherot, Jean-François; Rasschaert, Denis; Laurent, Sylvie; Petit, Frédérique; Boucraut-Baralon, Corine; Milon, Alain

    1996-01-01

    Two myxoma virus-rabbit hemorrhagic disease virus (RHDV) recombinant viruses were constructed with the SG33 strain of myxoma virus to protect rabbits against myxomatosis and rabbit viral hemorrhagic disease. These recombinant viruses expressed the RHDV capsid protein (VP60). The recombinant protein, which is 60 kDa in size, was antigenic, as revealed by its reaction in immunoprecipitation with antibodies raised against RHDV. Both recombinant viruses induced high levels of RHDV- and myxoma vir...

  11. Calcified amorphous tumor of the heart in an adult female: a case report

    Directory of Open Access Journals (Sweden)

    Gupta Ruchika

    2010-08-01

    Full Text Available Abstract Introduction Cardiac calcified amorphous tumor is a rare, non-neoplastic intra-cavity cardiac mass composed of calcium deposits in a background of amorphous degenerating fibrinous material. Only a few cases of this rare lesion have been reported in the available literature. Clinico-pathological differentiation of this lesion from calcified atrial myxoma, calcified thrombi or other cardiac neoplasms is extremely difficult; hence pathologic examination is the mainstay of diagnosis. To the best of our knowledge this entity has not been reported in the Indian literature. Case presentation A 40-year-old woman of Indian origin presented with progressive dyspnea, fatigue and cough. She was diagnosed as having a calcified right atrial mass. The mass was excised. Histologic examination revealed the mass to be composed of amorphous eosinophilic fibrin with dense calcification. No myxomatous tissue was seen and a final diagnosis of calcified amorphous tumor of the heart was rendered. Conclusions Calcified amorphous tumor is a rare cardiac lesion with an excellent outcome following complete surgical removal. Since clinico-radiologic differentiation from other cardiac masses is not possible in most cases, histopathological examination is the only modality for diagnosis. Hence, histopathologists should be aware of this rare entity in the differential diagnoses of cardiac mass.

  12. Alcohol consumption and risk of atrial fibrillation

    DEFF Research Database (Denmark)

    Tolstrup, Janne Schurmann; Wium-Andersen, Marie Kim; Ørsted, David Dynnes

    2016-01-01

    BACKGROUND: The aim of this study was to test the hypothesis that alcohol consumption, both observational (self-reported) and estimated by genetic instruments, is associated with a risk of atrial fibrillation and to determine whether people with high cardiovascular risk are more sensitive towards...... register. As a measure of alcohol exposure, both self-reported consumption and genetic variations in alcohol metabolizing genes (ADH1B/ADH1C) were used as instrumental variables. The endpoint was admission to hospital for atrial fibrillation as recorded in a validated hospital register. RESULTS: A total...... of 3493 cases of atrial fibrillation occurred during follow-up. High alcohol consumption was associated with a risk of atrial fibrillation among men, but not among women. Among the men who drank 28-35 and 35+ drinks/week, the hazards ratios were 1.40 (95% confidence interval 1.09-1.80) and 1.62 (95...

  13. [Clinical experiences on correction of congenital heart diseases with robotic technology: a report of 160 cases].

    Science.gov (United States)

    Yang, Ming; Gao, Chang-qing; Xiao, Cang-song; Wang, Gang; Wang, Jia-li; Wu, Yang

    2012-08-28

    To summarize the clinical experiences on correction of congenital heart disease with robotic technology at a single center. Between January 2007 and May 2012, this retrospective study recruited 160 consecutive patients undergoing robotic surgery for congenital heart diseases. There were 74 males and 86 females with a median age of 35 years (range: 11-62). The procedures included secundum-type atrial septal defect repair (n = 130), ostium primum defect repair (n = 1), perimembranous ventricular septal defect repair (n = 21), mitral valve repair for anterior leaflet cleft (n = 7) and mitral valve repair plus left atrial myxoma resection (n = 1). Cardiopulmonary bypass graft was established through cannulation of right femoral artery, vein and right internal jugular vein under the guidance of transesophageal ultrasound. Myocardial protection was performed with cold blood cardioplegic solution or HTK solution and a transthoracic Chitwood clamp was used to occlude ascending aorta. Via three 8-mm ports and one 15-mm port in right chest, the microscopic instruments were manipulated to complete defect closure or mitral valve plasty, utilizing da Vinci S or da Vinci SI robotic system. Echocardiography was performed intraoperatively and at pre-discharge. Routine follow-ups were conducted. The clinical data of operating time, cardiopulmonary bypass time and follow-up examinations were retrospectively analyzed. All cases were treated successfully without a conversion into median sternotomy. No operative mortality or severe surgical complications were observed. Seventy-six cases of secundum-type atrial septal defect were completed on beating heart. The learning curves were noted for operating time of beating heart group and cross clamp time of arrest heart group. No residual shunt, malignant arrhythmia or mitral valve regurgitation was detected on intraoperative or postoperative echocardiography and during a median follow-up period of (29.1 ± 16.3) months. Robotic minimal

  14. Robotic resection of giant left ventricular myxoma causing outflow tract obstruction.

    Science.gov (United States)

    Onan, Burak; Kahraman, Zeynep; Erturk, Mehmet; Erkanli, Korhan

    2017-05-01

    We report a 38-year-old female, who presented with progressive dyspnea and fatigue. Echocardiography revealed a giant and freely mobile left ventricular myxoma causing left ventricular outflow tract (LVOT) obstruction. The patient underwent totally endoscopic robotic excision of a giant left ventricular myxoma. The tumor was completely removed through the mitral valve orifice with a left atriotomy incision. © 2017 Wiley Periodicals, Inc.

  15. Myxoma Virus Is a Novel Oncolytic Virus with Significant Antitumor Activity against Experimental Human Gliomas

    OpenAIRE

    Lun, Xueqing; Yang, Wenqing; Alain, Tommy; Shi, Zhong-Qiao; Muzik, Huong; Barrett, John W.; McFadden, Grant; Bell, John; Hamilton, Mark G.; Senger, Donna L.; Forsyth, Peter A.

    2005-01-01

    Myxoma virus, a poxvirus previously considered rabbit specific, can replicate productively in a variety of human tumor cells in culture. The purpose of this study was to determine if there was efficacy or toxicities of this oncolytic virus against experimental models of human malignant gliomas in vitro, in vivo, and ex vivo in malignant glioma specimens. In vitro, the majority of glioma cell lines tested (7 of 8, 87.5%) were fully permissive for myxoma virus replication and killed by infectio...

  16. Protection against myxomatosis and rabbit viral hemorrhagic disease with recombinant myxoma viruses expressing rabbit hemorrhagic disease virus capsid protein.

    Science.gov (United States)

    Bertagnoli, S; Gelfi, J; Le Gall, G; Boilletot, E; Vautherot, J F; Rasschaert, D; Laurent, S; Petit, F; Boucraut-Baralon, C; Milon, A

    1996-08-01

    Two myxoma virus-rabbit hemorrhagic disease virus (RHDV) recombinant viruses were constructed with the SG33 strain of myxoma virus to protect rabbits against myxomatosis and rabbit viral hemorrhagic disease. These recombinant viruses expressed the RHDV capsid protein (VP60). The recombinant protein, which is 60 kDa in size, was antigenic, as revealed by its reaction in immunoprecipitation with antibodies raised against RHDV. Both recombinant viruses induced high levels of RHDV- and myxoma virus-specific antibodies in rabbits after immunization. Inoculations by the intradermal route protected animals against virulent RHDV and myxoma virus challenges.

  17. Can We Predict Individual Combined Benefit and Harm of Therapy? Warfarin Therapy for Atrial Fibrillation as a Test Case.

    Directory of Open Access Journals (Sweden)

    Guowei Li

    Full Text Available To construct and validate a prediction model for individual combined benefit and harm outcomes (stroke with no major bleeding, major bleeding with no stroke, neither event, or both in patients with atrial fibrillation (AF with and without warfarin therapy.Using the Kaiser Permanente Colorado databases, we included patients newly diagnosed with AF between January 1, 2005 and December 31, 2012 for model construction and validation. The primary outcome was a prediction model of composite of stroke or major bleeding using polytomous logistic regression (PLR modelling. The secondary outcome was a prediction model of all-cause mortality using the Cox regression modelling.We included 9074 patients with 4537 and 4537 warfarin users and non-users, respectively. In the derivation cohort (n = 4632, there were 136 strokes (2.94%, 280 major bleedings (6.04% and 1194 deaths (25.78% occurred. In the prediction models, warfarin use was not significantly associated with risk of stroke, but increased the risk of major bleeding and decreased the risk of death. Both the PLR and Cox models were robust, internally and externally validated, and with acceptable model performances.In this study, we introduce a new methodology for predicting individual combined benefit and harm outcomes associated with warfarin therapy for patients with AF. Should this approach be validated in other patient populations, it has potential advantages over existing risk stratification approaches as a patient-physician aid for shared decision-making.

  18. [Left atrial appendage in rheumatic mitral valve disease: The main source of embolism in atrial fibrillation].

    Science.gov (United States)

    García-Villarreal, Ovidio A; Heredia-Delgado, José A

    To demonstrate that surgical removal of the left atrial appendage in patients with rheumatic mitral valve disease and long standing persistent atrial fibrillation decreases the possibility of stroke. This also removes the need for long-term oral anticoagulation after surgery. A descriptive, prospective, observational study was conducted on 27 adult patients with rheumatic mitral valve disease and long standing persistent atrial fibrillation, who had undergone mitral valve surgery and surgical removal of the left atrial appendage. Oral anticoagulation was stopped in the third month after surgery. The end-point was the absence of embolic stroke. An assessment was also made of postoperative embolism formation in the left atrium using transthoracic echocardiography. None of the patients showed embolic stroke after the third post-operative month. Only one patient exhibited transient ischaemic attack on warfarin therapy within the three postoperative months. Left atrial thrombi were also found in 11 (40.7%) cases during surgery. Of these, 6 (54.5%) had had embolic stroke, with no statistical significance (P=.703). This study suggests there might be signs that the left atrial appendage may be the main source of emboli in rheumatic mitral valve disease, and its resection could eliminate the risk of stroke in patients with rheumatic mitral valve disease and long-standing persistent atrial fibrillation. Copyright © 2016 Instituto Nacional de Cardiología Ignacio Chávez. Publicado por Masson Doyma México S.A. All rights reserved.

  19. Atrial Arrhythmias and Their Implications for Space Flight - Introduction

    Science.gov (United States)

    Polk, J. D.; Barr, Y. R.; Bauer, P.; Hamilton, D. R.; Kerstman, E.; Tarver, B.

    2010-01-01

    This panel will discuss the implications of atrial arrhythmias in astronauts from a variety of perspectives; including historical data, current practices, and future challenges for exploration class missions. The panelists will present case histories, outline the evolution of current NASA medical standards for atrial arrhythmias, discuss the use of predictive tools, and consider potential challenges for current and future missions.

  20. Atrial fibrillation in an adolescent--the agony of ecstasy.

    Science.gov (United States)

    Madhok, Ashish; Boxer, Robert; Chowdhury, Devyani

    2003-10-01

    Ecstasy (MDMA), a popular drug of abuse among teenagers, is thought to be "relatively" safe. A case of atrial fibrillation following the ingestion of ecstasy in a previously well adolescent is presented. Emergency room physicians should consider ecstasy abuse in the differential diagnosis of young patients presenting with atrial fibrillation.

  1. Atrial Fibrillation and Hyperthyroidism

    Directory of Open Access Journals (Sweden)

    Jayaprasad N

    2005-10-01

    Full Text Available Atrial fibrillation occurs in 10 – 15% of patients with hyperthyroidism. Low serum thyrotropin concentration is an independent risk factor for atrial fibrillation. Thyroid hormone contributes to arrythmogenic activity by altering the electrophysiological characteristics of atrial myocytes by shortening the action potential duration, enhancing automaticity and triggered activity in the pulmonary vein cardio myocytes. Hyperthyroidism results in excess mortality from increased incidence of circulatory diseases and dysrhythmias. Incidence of cerebral embolism is more in hyperthyroid patients with atrial fibrillation, especially in the elderly and anti-coagulation is indicated in them. Treatment of hyperthyroidism results in conversion to sinus rhythm in up to two-third of patients. Beta-blockers reduce left ventricular hypertrophy and atrial and ventricular arrhythmias in patients with hyperthyroidism. Treatment of sub clinical hyperthyroidism is controversial. Optimizing dose of thyroxine treatment in those with replacement therapy and beta-blockers is useful in exogenous subclinical hyperthyroidism.

  2. Echocardiographic diagnosis of left ventricular-right atrial communication (Gerbode-type defect) in an adult with chronic renal failure: a case report.

    Science.gov (United States)

    Eroglu, Serpil; Sade, Elif; Bozbas, Huseyin; Pirat, Bahar; Yildirir, Aylin; Muderrisoglu, Haldun

    2008-03-01

    Left ventricular-right atrial communication, known as a Gerbode-type defect, is a rare form of ventricular septal defect. It is usually congenital, but rarely acquired. Clinical presentation is associated with the volume of the shunt. Transthoracic echocardiography is the most useful diagnostic method. We present a 63-year-old man with chronic renal failure and left ventricular-right atrial shunt.

  3. [Atrial fibrillation and stroke].

    Science.gov (United States)

    Aamodt, Anne Hege; Sandset, Per Morten; Atar, Dan; Tveit, Arnljot; Russell, David

    2013-08-06

    More than 70,000 Norwegians have atrial fibrillation, which is a major risk factor for ischemic stroke. A large proportion of ischemic strokes caused by atrial fibrillation could be prevented if patients receive optimal prophylactic treatment. This article describes the risk for ischemic stroke in patients with atrial fibrillation, and discusses who should receive prophylactic treatment and which therapy provides the best prevention. The article is based on recently published European, American and Canadian guidelines, a search in PubMed and the authors' own clinical experience. The new risk score CHA2DS2-VASc is better than the CHADS2 score for identifying patients with atrial fibrillation who have a truly low risk of ischemic stroke and are not in need of antithrombotic treatment. Oral anticoagulation therapy is recommended for patients with two or more risk factors for thromboembolism in addition to atrial fibrillation (CHA2DS2-VASc ≥ 2). Patients with atrial fibrillation and a single additional risk factor (CHA2DS2-VASc =1) an individual assessment should be made as to who should receive oral anticoagulants, and for patients with CHA2DS2-VASc = 0 antithrombotic treatment is not recommended. New oral anticoagulants are at least as effective as warfarin for preventing ischemic stroke in patients with nonvalvular atrial fibrillation, they carry a lower risk of cerebral haemorrhage, especially intracranial haemorrhage and are more practical in use. Platelet inhibitors have a minimal role in stroke prevention in patients with atrial fibrillation. Risks stratifying patients using the CHA2DS2-VASc score is a better method for assessing which patients with atrial fibrillation who should receive oral anticoagulation. The introduction of new oral anticoagulants will simplify preventive treatment and hopefully lead to a more efficient anticoagulation treatment in a larger number of patients with atrial fibrillation.

  4. Surgical Treatment of Primary Intracardiac Myxoma: 20-Year Experience in “Shahid Modarres Hospital”—A Tertiary University Hospital—Tehran, Iran

    Science.gov (United States)

    Ansari Aval, Zahra; Ghaderi, Hamid; Tatari, Hassan; Foroughi, Mahnoosh; Mirjafari, Seyedeh Adeleh; Forozeshfard, Mohammad; Fani, Kamal; Khaheshi, Isa

    2015-01-01

    Although cardiac tumors are not common they may vary in terms of race and surgical approach in different countries. Method. Patients data of 20 years was collected and evaluated in the “Shahid Modarres Hospital”—a tertiary university hospital—Tehran, Iran. Results. 42 patients with cardiac myxoma (all cases in 20 years) were included in study, 17 males and 25 females, age difference: 13 to 76 years (mean 50.6). Most of patients were in functional classes I, II. 35 patients complained of dyspnea and 3 patients had embolic events. 97.6% of tumors were primary (41 patients) and one tumor was recurrent (2.4%), 85.7% of tumors (36 cases) were located in LA, and 88.1% of tumors (37 cases) were pediculated. 40 patients (95%) had one tumor. In 22 patients (52.3%) after tumor resection septal defects were repaired primarily while in 18 patients (42.8%) the defects were repaired with pericardial patch and In one patient, tumor resected without any septal defect. Mean tumor size was about 5.22 cm (range of 2.2 to 8.2 cm). Postoperatively, 33 patients discharged from hospital without any complication. Discussion. The research reveals that patients' age and gender were similar to that of other studies in other countries while tumor's incidence seems to be higher. 3 patients were diagnosed after remote embolic event and one patient was diagnosed after MI reflecting relatively high tumor complications and late diagnosis. Conclusion. In our study mean time from diagnosis to operation was too long. The patients had more preoperative embolic events and complication. However, size of myxoma and location of that was as same as its rate in the other literature. As recommendation we suggested that in all patients with vague chest pain or remote embolic events cardiac myxomas should be ruled out. PMID:25688375

  5. Electrophysiological Mechanisms of Atrial Flutter

    Directory of Open Access Journals (Sweden)

    Ching- Tai Tai

    2006-04-01

    Full Text Available Atrial flutter (AFL is a common arrhythmia in clinical practice. Several experimental models such as tricuspid regurgitation model, tricuspid ring model, sterile pericarditis model and atrial crush injury model have provided important information about reentrant circuit and can test the effect of antiarrhythmic drugs. Human atrial flutter has typical and atypical forms. Typical atrial flutter rotates around tricuspid annulus and uses the crista terminalis and sometimes sinus venosa as the boundary. The IVC-tricuspid isthmus is a slow conduction zone and the target of radiofrequency ablation. Atypical atrial flutter may arise from the right or left atrium. Right atrial flutter includes upper loop reentry, free wall reentry and figure of eight reentry. Left atrial flutter includes mitral annular atrial flutter, pulmonary vein-related atrial flutter and left septal atrial flutter. Radiofrequency ablation of the isthmus between the boundaries can eliminate these arrhythmias.

  6. Cetirizine-Induced atrial fibrillation

    Directory of Open Access Journals (Sweden)

    Altuğ Osken

    2016-01-01

    Full Text Available Atrial fibrillation (AF is the most common observed arrhythmia in clinical practice. In the literature, AF events associated with drug induction are available. Cetirizine is a second-generation histamine antagonist used in the treatment of allergies, angioedema, and urticaria. We wish to present an atypical case who took cetirizine medication for relieving symptoms of upper tract respiratory system infection, experienced rapid ventricular response AF and treated successfully. To best of our knowledge, this is the first case of cetirizine-induced AF.

  7. Cerebral Aneurysm in the Evolution of Cardiac Myxoma: Clinical and Physiopathological Interpretations; El aneurisma cerebral en la evolucion del mixoma cardiaco: planteamientos clinicos y fisopatologicos

    Energy Technology Data Exchange (ETDEWEB)

    Rodriguez, R.; Garcia, M. L. [Hospital General Universitario Morales Meseguer. Murcia (Spain)

    2003-07-01

    We present the case of a patient with stroke, cerebral aneurysms (small distal and large proximal) who had been treated for cardiac myxoma 18 years earlier. We compared the imaging findings (localization, size, density and associated cerebral lesions) with those of other publications. The data obtained from other works and those that we could derive from our patient suggest that the cerebral aneurysms are responsible for neurological symptoms observed some time after removal of the tumor. On the other hand, such aneurysms tend to grow larger and more proximal with increasing time after surgery. (Author) 15 refs.

  8. Left atrial size in patients with cryptogenic stroke as a predictor of occurrence of atrial fibrillation

    Directory of Open Access Journals (Sweden)

    Antonio Cruz Culebras

    2017-04-01

    Full Text Available Objective: To determine whether the left atrial size can predict the development of atrial fibrillation (AF in patients with embolic stroke of undetermined source (ESUS. Methods: Patients with ischemic stroke were included prospectively (January 2015-July 2015 when ESUS was suspected. Clinical and cardiac imaging data were recorded. Patients with cardiac failure were excluded. Results: a total of 55 patients were included. Medium age was 71 years. The proportion of patients who developed AF during the follow-up (1 year was 23, 63%. 10 % of patients did not have any vascular risk factor. Basal ECG was normal in 98% of cases. The left atrial size volume was 36, 08 ml in patients who developed AF and 27, 14 ml in patients who did not. Conclusions: In patients with ESUS, left atrial size dimensions do not predict the occurrence of AF.

  9. Host-specificity of myxoma virus: Pathogenesis of South American and North American strains of myxoma virus in two North American lagomorph species.

    Science.gov (United States)

    Silvers, L; Barnard, D; Knowlton, F; Inglis, B; Labudovic, A; Holland, M K; Janssens, P A; van Leeuwen, B H; Kerr, P J

    2010-03-24

    The pathogenesis of South American and North American myxoma viruses was examined in two species of North American lagomorphs, Sylvilagus nuttallii (mountain cottontail) and Sylvilagus audubonii (desert cottontail) both of which have been shown to have the potential to transmit the South American type of myxoma virus. Following infection with the South American strain (Lausanne, Lu), S. nuttallii developed both a local lesion and secondary lesions on the skin. They did not develop the classical myxomatosis seen in European rabbits (Oryctolagus cuniculus). The infection at the inoculation site did not resolve during the 20-day time course of the trial and contained transmissible virus titres at all times. In contrast, S. audubonii infected with Lu had very few signs of disseminated infection and partially controlled virus replication at the inoculation site. The prototype Californian strain of myxoma virus (MSW) was able to replicate at the inoculation site of both species but did not induce clinical signs of a disseminated infection. In S. audubonii, there was a rapid response to MSW characterised by a massive T lymphocyte infiltration of the inoculation site by day 5. MSW did not reach transmissible titres at the inoculation site in either species. This might explain why the Californian myxoma virus has not expanded its host-range in North America. Crown Copyright 2009. Published by Elsevier B.V. All rights reserved.

  10. Next step in the ongoing arms race between myxoma virus and wild rabbits in Australia is a novel disease phenotype

    Science.gov (United States)

    Kerr, Peter J.; Cattadori, Isabella M.; Liu, June; Sim, Derek G.; Dodds, Jeff W.; Brooks, Jason W.; Kennett, Mary J.; Holmes, Edward C.

    2017-01-01

    In host–pathogen arms races, increases in host resistance prompt counteradaptation by pathogens, but the nature of that counteradaptation is seldom directly observed outside of laboratory models. The best-documented field example is the coevolution of myxoma virus (MYXV) in European rabbits. To understand how MYXV in Australia has continued to evolve in wild rabbits under intense selection for genetic resistance to myxomatosis, we compared the phenotypes of the progenitor MYXV and viral isolates from the 1950s and the 1990s in laboratory rabbits with no resistance. Strikingly, and unlike their 1950s counterparts, most virus isolates from the 1990s induced a highly lethal immune collapse syndrome similar to septic shock. Thus, the next step in this canonical case of coevolution after a species jump has been further escalation by the virus in the face of widespread host resistance. PMID:28808019

  11. Next step in the ongoing arms race between myxoma virus and wild rabbits in Australia is a novel disease phenotype.

    Science.gov (United States)

    Kerr, Peter J; Cattadori, Isabella M; Liu, June; Sim, Derek G; Dodds, Jeff W; Brooks, Jason W; Kennett, Mary J; Holmes, Edward C; Read, Andrew F

    2017-08-29

    In host-pathogen arms races, increases in host resistance prompt counteradaptation by pathogens, but the nature of that counteradaptation is seldom directly observed outside of laboratory models. The best-documented field example is the coevolution of myxoma virus (MYXV) in European rabbits. To understand how MYXV in Australia has continued to evolve in wild rabbits under intense selection for genetic resistance to myxomatosis, we compared the phenotypes of the progenitor MYXV and viral isolates from the 1950s and the 1990s in laboratory rabbits with no resistance. Strikingly, and unlike their 1950s counterparts, most virus isolates from the 1990s induced a highly lethal immune collapse syndrome similar to septic shock. Thus, the next step in this canonical case of coevolution after a species jump has been further escalation by the virus in the face of widespread host resistance.

  12. Isolated Myxoma in the External Auditory Canal of a 10-Year-Old Girl.

    Science.gov (United States)

    Lee, Dong Hee; Jeong, Su Hee; Kim, Hojong; Shin, Eunhye

    2015-12-01

    Myxoma is a benign connective tissue tumor that is most commonly found in the heart. Because myxoma of the external ear is extremely rare, its diagnosis may be easily delayed or it may be misdiagnosed as another disease. Moreover, because it can be a part of Carney complex (autosomal dominant syndrome), its correct diagnosis is very important. We experienced a 10-year-old girl who had a mass on the posterior surface of the tragus at the entrance of the left ear canal. Fine-needle aspiration revealed mucoid content of the cystic mass, but its cytology did not confirm the diagnosis. The whole mass was surgically removed, and the diagnosis was confirmed as myxoma with a stellate spindle cell proliferation in the hypocellular matrix. Thorough examination failed to determine any presentation of Carney complex, and her final diagnosis was isolated myxoma of the external auditory canal. This is the first reported study regarding myxoma of the external auditory canal in the Korean literature.

  13. Systemic therapy with oncolytic myxoma virus cures established residual multiple myeloma in mice.

    Science.gov (United States)

    Bartee, Eric; Bartee, Mee Y; Bogen, Bjarne; Yu, Xue-Zhong

    2016-01-01

    Multiple myeloma is an incurable malignancy of plasma B-cells. Traditional chemotherapeutic regimes often induce initial tumor regression; however, virtually all patients eventually succumb to relapse caused by either reintroduction of disease during autologous transplant or expansion of chemotherapy resistant minimal residual disease. It has been previously demonstrated that an oncolytic virus known as myxoma can completely prevent myeloma relapse caused by reintroduction of malignant cells during autologous transplant. The ability of this virus to treat established residual disease in vivo, however, remained unknown. Here we demonstrate that intravenous administration of myxoma virus into mice bearing disseminated myeloma results in the elimination of 70-90% of malignant cells within 24 hours. This rapid debulking was dependent on direct contact of myxoma virus with residual myeloma and did not occur through destruction of the hematopoietic bone marrow niche. Importantly, systemic myxoma therapy also induced potent antimyeloma CD8(+) T cell responses which localized to the bone marrow and were capable of completely eradicating established myeloma in some animals. These results demonstrate that oncolytic myxoma virus is not only effective at preventing relapse caused by reinfusion of tumor cells during stem cell transplant, but is also potentially curative for patients bearing established minimal residual disease.

  14. Myxoma Virus Induces Ligand Independent Extrinsic Apoptosis in Human Myeloma Cells.

    Science.gov (United States)

    Bartee, Mee Y; Dunlap, Katherine M; Bartee, Eric

    2016-04-01

    Multiple myeloma is a clonal malignancy of plasma B cells. Although recent advances have improved overall prognosis, virtually all myeloma patients still succumb to relapsing disease. Therefore, novel therapies to treat this disease remain urgently needed. We have recently shown that treatment of human multiple myeloma cells with an oncolytic virus known as myxoma results in rapid cell death even in the absence of viral replication; however, the specific mechanisms and pathways involved remain unknown. To determine how myxoma virus eliminates human multiple myeloma cells, we queried the apoptotic pathways that were activated after viral infection using immunoblot analysis and other cell biology approaches. Our results indicate that myxoma virus infection initiates apoptosis in multiple myeloma cells through activation of the extrinsic initiator caspase-8. Caspase-8 activation subsequently results in cleavage of BH3 interacting-domain death agonist and loss of mitochondrial membrane potential causing secondary activation of caspase-9. Activation of caspase-8 appears to be independent of extrinsic death ligands and instead correlates with depletion of cellular inhibitors of apoptosis. We hypothesize that this depletion results from virally mediated host-protein shutoff because a myxoma construct that overexpresses the viral decapping enzymes displays improved oncolytic potential. Taken together, these results suggest that myxoma virus eliminates human multiple myeloma cells through a pathway unique to oncolytic poxviruses, making it an excellent therapeutic option for the treatment of relapsed or refractory patients. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Systemic therapy with oncolytic myxoma virus cures established residual multiple myeloma in mice

    Directory of Open Access Journals (Sweden)

    Eric Bartee

    2016-01-01

    Full Text Available Multiple myeloma is an incurable malignancy of plasma B-cells. Traditional chemotherapeutic regimes often induce initial tumor regression; however, virtually all patients eventually succumb to relapse caused by either reintroduction of disease during autologous transplant or expansion of chemotherapy resistant minimal residual disease. It has been previously demonstrated that an oncolytic virus known as myxoma can completely prevent myeloma relapse caused by reintroduction of malignant cells during autologous transplant. The ability of this virus to treat established residual disease in vivo, however, remained unknown. Here we demonstrate that intravenous administration of myxoma virus into mice bearing disseminated myeloma results in the elimination of 70–90% of malignant cells within 24 hours. This rapid debulking was dependent on direct contact of myxoma virus with residual myeloma and did not occur through destruction of the hematopoietic bone marrow niche. Importantly, systemic myxoma therapy also induced potent antimyeloma CD8+ T cell responses which localized to the bone marrow and were capable of completely eradicating established myeloma in some animals. These results demonstrate that oncolytic myxoma virus is not only effective at preventing relapse caused by reinfusion of tumor cells during stem cell transplant, but is also potentially curative for patients bearing established minimal residual disease.

  16. Effects of beta-blockade on atrial and atrioventricular nodal refractoriness, and atrial fibrillatory rate during atrial fibrillation in pigs

    NARCIS (Netherlands)

    van den Berg, MP; van de Ven, LLM; Witting, W; Crijns, JGM; Haaksma, J; Bel, KJ; de Langen, CDJ; Lie, KI

    1997-01-01

    Despite their widespread use in atrial fibrillation, the effects of beta-adrenoceptor blockers on atrial and atrioventricular (AV) nodal refractoriness, and atrial fibrillatory rate during atrial fibrillation have been incompletely characterised. In particular, it is unknown whether additional

  17. Genome scale evolution of myxoma virus reveals host-pathogen adaptation and rapid geographic spread.

    Science.gov (United States)

    Kerr, Peter J; Rogers, Matthew B; Fitch, Adam; Depasse, Jay V; Cattadori, Isabella M; Twaddle, Alan C; Hudson, Peter J; Tscharke, David C; Read, Andrew F; Holmes, Edward C; Ghedin, Elodie

    2013-12-01

    The evolutionary interplay between myxoma virus (MYXV) and the European rabbit (Oryctolagus cuniculus) following release of the virus in Australia in 1950 as a biological control is a classic example of host-pathogen coevolution. We present a detailed genomic and phylogeographic analysis of 30 strains of MYXV, including the Australian progenitor strain Standard Laboratory Strain (SLS), 24 Australian viruses isolated from 1951 to 1999, and three isolates from the early radiation in Britain from 1954 and 1955. We show that in Australia MYXV has spread rapidly on a spatial scale, with multiple lineages cocirculating within individual localities, and that both highly virulent and attenuated viruses were still present in the field through the 1990s. In addition, the detection of closely related virus lineages at sites 1,000 km apart suggests that MYXV moves freely in geographic space, with mosquitoes, fleas, and rabbit migration all providing means of transport. Strikingly, despite multiple introductions, all modern viruses appear to be ultimately derived from the original introductions of SLS. The rapidity of MYXV evolution was also apparent at the genomic scale, with gene duplications documented in a number of viruses. Duplication of potential virulence genes may be important in increasing the expression of virulence proteins and provides the basis for the evolution of novel functions. Mutations leading to loss of open reading frames were surprisingly frequent and in some cases may explain attenuation, but no common mutations that correlated with virulence or attenuation were identified.

  18. Atrial tachyarrhythmia in adult congenital heart disease

    Science.gov (United States)

    Karbassi, Arsha; Nair, Krishnakumar; Harris, Louise; Wald, Rachel M; Roche, S Lucy

    2017-01-01

    The adult congenital heart disease (ACHD) population continues to grow and most cardiologists, emergency room physicians and family doctors will intermittently come into contact with these patients. Oftentimes this may be in the setting of a presentation with atrial tachyarrhythmia; one of the commonest late complications of ACHD and problem with potentially serious implications. Providing appropriate initial care and ongoing management of atrial tachyarrhythmia in ACHD patients requires a degree of specialist knowledge and an awareness of certain key issues. In ACHD, atrial tachyarrhythmia is usually related to the abnormal anatomy of the underlying heart defect and often occurs as a result of surgical scar or a consequence of residual hemodynamic or electrical disturbances. Arrhythmias significantly increase mortality and morbidity in ACHD and are the most frequent reason for ACHD hospitalization. Intra-atrial reentrant tachycardia and atrial fibrillation are the most prevalent type of arrhythmia in this patient group. In hemodynamically unstable patients, urgent cardioversion is required. Acute management of the stable patient includes anticoagulation, rate control, and electrical or pharmacological cardioversion. In ACHD, rhythm control is the preferred management strategy and can often be achieved. However, in the long-term, medication side-effects can prove problematic. Electrophysiology studies and catheter ablation are important treatments modalities and in certain cases, surgical or percutaneous treatment of the underlying cardiac defect has a role. ACHD patients, especially those with complex CHD, are at increased risk of thromboembolic events and anticoagulation is usually required. Female ACHD patients of child bearing age may wish to pursue pregnancies. The risk of atrial arrhythmias is increased during pregnancy and management of atrial tachyarrhythmia during pregnancy needs specific consideration. PMID:28706585

  19. Atrial Fibrillation and Stroke

    Science.gov (United States)

    ... faulty heart valves, lung disease, and stimulant or alcohol abuse. Some people will have no identifiable cause for their AF. × Definition Atrial fibrillation (AF) describes the rapid, irregular beating ...

  20. Design, Challenges, and Implications of Quality Improvement Projects Using the Electronic Medical Record: Case Study: A Protocol to Reduce the Burden of Postoperative Atrial Fibrillation.

    Science.gov (United States)

    Ebinger, Joseph E; Porten, Brandon R; Strauss, Craig E; Garberich, Ross F; Han, Christopher; Wahl, Sharon K; Sun, Benjamin C; Abdelhadi, Raed H; Henry, Timothy D

    2016-09-01

    Postoperative atrial fibrillation (POAF) is a frequent complication of cardiac surgery, which results in increased morbidity, mortality, length of stay, and hospital costs. We developed and followed a process map to implement a protocol to decrease POAF: (1) identify stakeholders and form a working committee, (2) formal literature and guideline review, (3) retrospective analysis of current institutional data, (4) data modeling to determine expected effects of change, (4) protocol development and implementation into the electronic medical record, and (5) ongoing review of data and protocol adjustment. Retrospective analysis demonstrated that POAF occurred in 29.8% of all cardiovascular surgery cases. Median length of stay was 2 days longer (P$200 000 annually could be saved. A clinically based electronic medical record tool was implemented into the electronic medical record to aid preoperative clinic providers in identifying patients eligible for prophylactic amiodarone. Initial results during the 9-month period after implementation demonstrated a reduction in POAF in patients using the protocol, compared with those who qualified but did not receive amiodarone and those not evaluated (11.1% versus 38.7% and 38.8%; P=0.022); however, only 17.3% of patients used the protocol. A standardized methodological approach to quality improvement and electronic medical record integration has potential to significantly decrease the incidence of POAF, length of stay, and total variable cost in patients undergoing elective coronary artery bypass graft and valve surgeries. This framework for quality improvement interventions may be adapted to similar clinical problems beyond POAF. © 2016 American Heart Association, Inc.

  1. Genetic aspects of lone atrial fibrillation

    DEFF Research Database (Denmark)

    Andreasen, Laura; Nielsen, Jonas B; Olesen, Morten S

    2015-01-01

    Atrial fibrillation (AF) is the most common cardiac arrhythmia. A subgroup of patients presents with AF without traditional risk factors and is diagnosed before the age of 60 years. Such patients are commonly referred as having "lone AF" and comprise 10-20% of all cases. A number of studies have ...

  2. Atrial fibrillation: non cardiologist physicians approach

    Directory of Open Access Journals (Sweden)

    Forero-Gómez, Julián Eduardo

    2017-10-01

    Full Text Available Atrial fibrillation is the most frequent arrhythmia. Its classification according to pattern and clinical type allows to decide the therapeutic strategy to use, that most include control of symptoms and prevention of cardioembolic events. The election of the treatment depends on the presence of triggering events, risk factors for thromboembolism, risk factors for bleeding, cardiac function, patient funcionality, medication costoefectiveness and health care access. The type of anticoagulant has to be supported on the type of atrial fibrillation and the presence of contraindications, documented ineffective anticoagulation or high risk of failure to warfarin. In case of contraindications for anticoagulation this could still be used in high bleeding risk patients, when risk factors are controllable or corrected; leaving left atrial appendage closure as an option for patients that remain in high risk for bleeding events.

  3. Intraoperative evaluation of right ventricular outflow tract myxoma by real time three-dimensional transesophageal echocardiography.

    Science.gov (United States)

    Chen, Chan; Gu, Jun; Meng, Wei; Song, Haibo; Zhu, Da; Zhang, Shu; Zhang, Eryong

    2014-07-01

    Cardiac myxoma arising form right ventricular outflow tract (RVOT) is extremely rare, but could cause major clinical sequelae and pose considerable diagnostic and therapeutic challenges. Here, we report the intraoperative application of real time three-dimensional transesophageal echocardiography (RT3DTEE) in the assessment of a patient with a RVOT myxoma. RT3DTEE clearly assess the characteristics of the mass, such as the size, shape, attachment points, and composition. With the intraoperative guidance of RT3DTEE, the patient underwent successful removal of the mass. © 2014, Wiley Periodicals, Inc.

  4. Combined percutaneous balloon mitral valvuloplasty and left atrial appendage occlusion device implantation for rheumatic mitral stenosis and atrial fibrillation

    Energy Technology Data Exchange (ETDEWEB)

    Murdoch, Dale, E-mail: dale_murdoch@health.qld.gov.au [The Prince Charles Hospital, Brisbane (Australia); The University of Queensland, Brisbane (Australia); McAulay, Laura [The Prince Charles Hospital, Brisbane (Australia); Walters, Darren L. [The Prince Charles Hospital, Brisbane (Australia); The University of Queensland, Brisbane (Australia)

    2014-11-15

    Rheumatic heart disease is a common cause of cardiovascular morbidity and mortality worldwide, mostly in developing countries. Mitral stenosis and atrial fibrillation often coexist, related to both structural and inflammatory changes of the mitral valve and left atrium. Both predispose to left atrial thrombus formation, commonly involving the left atrial appendage. Thromboembolism can occur, with devastating consequences. We report the case of a 62 year old woman with rheumatic heart disease resulting in mitral stenosis and atrial fibrillation. Previous treatment with warfarin resulted in life-threatening gastrointestinal bleeding and she refused further anticoagulant therapy. A combined procedure was performed, including percutaneous balloon mitral valvuloplasty and left atrial appendage occlusion device implantation with the Atritech® Watchman® device. No thromboembolic or bleeding complications were encountered at one year follow-up. Long-term follow-up in a cohort of patients will be required to evaluate the safety and efficacy of this strategy.

  5. Prevention of EBV lymphoma development by oncolytic myxoma virus in a murine xenograft model of post-transplant lymphoproliferative disease

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Manbok, E-mail: manbok66@dankook.ac.kr [Department of Molecular Genetics and Microbiology, University of Florida, Gainesville, FL 32610 (United States); Rahman, Masmudur M. [Department of Molecular Genetics and Microbiology, University of Florida, Gainesville, FL 32610 (United States); Cogle, Christopher R. [Department of Hematology/Oncology, University of Florida, Gainesville, FL 32610 (United States); McFadden, Grant [Department of Molecular Genetics and Microbiology, University of Florida, Gainesville, FL 32610 (United States)

    2015-07-10

    Epstein–Barr virus (EBV) has been associated with a variety of epithelial and hematologic malignancies, including B-, T- and NK cell-lymphomas, Hodgkin's disease (HD), post-transplant lymphoproliferative diseases (LPDs), nasopharyngeal and gastric carcinomas, smooth muscle tumors, and HIV-associated lymphomas. Currently, treatment options for EBV-associated malignancies are limited. We have previously shown that myxoma virus specifically targets various human solid tumors and leukemia cells in a variety of animal models, while sparing normal human or murine tissues. Since transplant recipients of bone marrow or solid organs often develop EBV-associated post-transplant LPDs and lymphoma, myxoma virus may be of utility to prevent EBV-associated malignancies in immunocompromised transplant patients where treatment options are frequently limited. In this report, we demonstrate the safety and efficacy of myxoma virus purging as a prophylactic strategy for preventing post-transplant EBV-transformed human lymphomas, using a highly immunosuppressed mouse xenotransplantation model. This provides support for developing myxoma virus as a potential oncolytic therapy for preventing EBV-associated LPDs following transplantation of bone marrow or solid organ allografts. - Highlights: • Myxoma virus effectively infects and purges EBV lymphoma cells in vivo. • Oncolytic myxoma virus effectively eradicates oncogenic EBV tumorigenesis. • Ex vivo pre-treatment of myxoma virus can be effective as a preventive treatment modality for post-transplant lymphoproliferative diseases.

  6. Recurrent left atrial and left ventricular thrombosis due to heparin-induced thrombocytopenia: case report and short review.

    Science.gov (United States)

    Kuhl, Thomas; Wendt, Stefanie; Langebartels, Georg; Kröner, Axel; Wahlers, Thorsten

    2013-09-01

    The combination of heparin-induced thrombocytopenia (HIT) II, left ventricular failure with extracorporeal membrane oxygenation (ECMO) therapy, and recurrent left ventricular thrombosis is rare and predicts a poor outcome. In this case, HIT II occurred after an ischemic cardiogenic shock. We initiated ECMO and intra-aortic balloon pump therapy during coronary artery bypass grafting and ventricular thrombectomy. Despite continued therapeutic therapy with heparin and later argatroban, the patient developed solid and recurrent thrombotic masses in the left atrium and left ventricle. Georg Thieme Verlag KG Stuttgart · New York.

  7. Atrial Arrhythmias in Astronauts - Summary of a NASA Summit

    Science.gov (United States)

    Barr, Yael R.; Watkins, Sharmila D.; Polk, J. D.

    2010-01-01

    Background and Problem Definition: To evaluate NASA s current standards and practices related to atrial arrhythmias in astronauts, Space Medicine s Advanced Projects Section at the Johnson Space Center was tasked with organizing a summit to discuss the approach to atrial arrhythmias in the astronaut cohort. Since 1959, 11 cases of atrial fibrillation, atrial flutter, or supraventricular tachycardia have been recorded among active corps crewmembers. Most of the cases were paroxysmal, although a few were sustained. While most of the affected crewmembers were asymptomatic, those slated for long-duration space flight underwent radiofrequency ablation treatment to prevent further episodes of the arrhythmia. The summit was convened to solicit expert opinion on screening, diagnosis, and treatment options, to identify gaps in knowledge, and to propose relevant research initiatives. Summit Meeting Objectives: The Atrial Arrhythmia Summit brought together a panel of six cardiologists, including nationally and internationally renowned leaders in cardiac electrophysiology, exercise physiology, and space flight cardiovascular physiology. The primary objectives of the summit discussions were to evaluate cases of atrial arrhythmia in the astronaut population, to understand the factors that may predispose an individual to this condition, to understand NASA s current capabilities for screening, diagnosis, and treatment, to discuss the risks associated with treatment of crewmembers assigned to long-duration missions or extravehicular activities, and to discuss recommendations for prevention or management of future cases. Summary of Recommendations: The summit panel s recommendations were grouped into seven categories: Epidemiology, Screening, Standards and Selection, Treatment of Atrial Fibrillation Manifesting Preflight, Atrial Fibrillation during Flight, Prevention of Atrial Fibrillation, and Future Research

  8. Molecular characterisation of virulence graded field isolates of myxoma virus

    Directory of Open Access Journals (Sweden)

    Parra Francisco

    2010-02-01

    Full Text Available Abstract Background Myxoma virus (MV has been endemic in Europe since shortly after its deliberate release in France in 1952. While the emergence of more resistant hosts and more transmissible and attenuated virus is well documented, there have been relatively few studies focused on the sequence changes incurred by the virus as it has adapted to its new host. In order to identify regions of variability within the MV genome to be used for phylogenetic studies and to try to investigate causes of MV strain attenuation we have molecularly characterised nine strains of MV isolated in Spain between the years 1992 and 1995 from wide ranging geographic locations and which had been previously graded for virulence by experimental infection of rabbits. Results The findings reported here show the analysis of 16 genomic regions accounting for approximately 10% of the viral genomes. Of the 20 genes analysed 5 (M034L, M069L, M071L, M130R and M135R were identical in all strains and 1 (M122R contained only a single point mutation in an individual strain. Four genes (M002L/R, M009L, M036L and M017L showed insertions or deletions that led to disruption of the ORFs. Conclusions The findings presented here provide valuable tools for strain differentiation and phylogenetic studies of MV isolates and some clues as to the reasons for virus attenuation in the field.

  9. Molecular characterisation of virulence graded field isolates of myxoma virus.

    Science.gov (United States)

    Dalton, Kevin P; Nicieza, Ines; Baragaño, Aroa; Alonso, Jose Manuel Martín; Parra, Francisco

    2010-02-26

    Myxoma virus (MV) has been endemic in Europe since shortly after its deliberate release in France in 1952. While the emergence of more resistant hosts and more transmissible and attenuated virus is well documented, there have been relatively few studies focused on the sequence changes incurred by the virus as it has adapted to its new host. In order to identify regions of variability within the MV genome to be used for phylogenetic studies and to try to investigate causes of MV strain attenuation we have molecularly characterised nine strains of MV isolated in Spain between the years 1992 and 1995 from wide ranging geographic locations and which had been previously graded for virulence by experimental infection of rabbits. The findings reported here show the analysis of 16 genomic regions accounting for approximately 10% of the viral genomes. Of the 20 genes analysed 5 (M034L, M069L, M071L, M130R and M135R) were identical in all strains and 1 (M122R) contained only a single point mutation in an individual strain. Four genes (M002L/R, M009L, M036L and M017L) showed insertions or deletions that led to disruption of the ORFs. The findings presented here provide valuable tools for strain differentiation and phylogenetic studies of MV isolates and some clues as to the reasons for virus attenuation in the field.

  10. Evolutionary history and attenuation of myxoma virus on two continents.

    Science.gov (United States)

    Kerr, Peter J; Ghedin, Elodie; DePasse, Jay V; Fitch, Adam; Cattadori, Isabella M; Hudson, Peter J; Tscharke, David C; Read, Andrew F; Holmes, Edward C

    2012-01-01

    The attenuation of myxoma virus (MYXV) following its introduction as a biological control into the European rabbit populations of Australia and Europe is the canonical study of the evolution of virulence. However, the evolutionary genetics of this profound change in host-pathogen relationship is unknown. We describe the genome-scale evolution of MYXV covering a range of virulence grades sampled over 49 years from the parallel Australian and European epidemics, including the high-virulence progenitor strains released in the early 1950s. MYXV evolved rapidly over the sampling period, exhibiting one of the highest nucleotide substitution rates ever reported for a double-stranded DNA virus, and indicative of a relatively high mutation rate and/or a continually changing selective environment. Our comparative sequence data reveal that changes in virulence involved multiple genes, likely losses of gene function due to insertion-deletion events, and no mutations common to specific virulence grades. Hence, despite the similarity in selection pressures there are multiple genetic routes to attain either highly virulent or attenuated phenotypes in MYXV, resulting in convergence for phenotype but not genotype.

  11. Evolutionary history and attenuation of myxoma virus on two continents.

    Directory of Open Access Journals (Sweden)

    Peter J Kerr

    Full Text Available The attenuation of myxoma virus (MYXV following its introduction as a biological control into the European rabbit populations of Australia and Europe is the canonical study of the evolution of virulence. However, the evolutionary genetics of this profound change in host-pathogen relationship is unknown. We describe the genome-scale evolution of MYXV covering a range of virulence grades sampled over 49 years from the parallel Australian and European epidemics, including the high-virulence progenitor strains released in the early 1950s. MYXV evolved rapidly over the sampling period, exhibiting one of the highest nucleotide substitution rates ever reported for a double-stranded DNA virus, and indicative of a relatively high mutation rate and/or a continually changing selective environment. Our comparative sequence data reveal that changes in virulence involved multiple genes, likely losses of gene function due to insertion-deletion events, and no mutations common to specific virulence grades. Hence, despite the similarity in selection pressures there are multiple genetic routes to attain either highly virulent or attenuated phenotypes in MYXV, resulting in convergence for phenotype but not genotype.

  12. Atrial fibrillation is an independent risk factor for ventricular fibrillation: a large-scale population-based case-control study

    NARCIS (Netherlands)

    Bardai, Abdennasser; Blom, Marieke T.; van Hoeijen, Daniel A.; van Deutekom, Hanneke W. M.; Brouwer, Henk J.; Tan, Hanno L.

    2014-01-01

    Atrial fibrillation (AF) is associated with sudden cardiac death. We aimed to study whether AF is associated with ventricular fibrillation (VF), the most common cause of sudden cardiac death and whether this association is independent of confounders, ie, concomitant disease, use of antiarrhythmic or

  13. Feasibility of dual-chamber (DDD) pacing via a single-pass (VDD) pacing lead employing a floating atrial ring (dipole): case series, future considerations, and refinements.

    Science.gov (United States)

    Kassotis, John; Voigt, Louis; Mongwa, Mbu; Reddy, C V R

    2005-01-01

    The objective of this study was to assess the feasibility of DDD pacing from a standard single-pass VDD pacemaker system. Over the past 2 decades significant advances have been made in the development of single-pass VDD pacing systems. These have been shown in long-term prospective studies to effectively preserve atrioventricular (AV)synchrony in patients with AV block and normal sinus node function. What remains problematic is the development of a single-pass pacing system capable of DDD pacing. Such a lead configuration would be useful in those patients with peripheral venous anomalies and in younger patients with congenital anomalies, which may require lead revisions in the future. In addition, with the increased use of resynchronization (biventricular pacing) therapy, the availability of a reliable single-pass lead will minimize operative time, enhance patient safety, and minimize the amount of hardware within the heart. The feasibility of DDD pacing via a Medtronic Capsure VDD-2 (Model #5038) pacing lead was evaluated. Twenty patients who presented with AV block and normal sinus node function were recruited for this study. Atrial pacing thresholds and sensitivities were assessed intraoperatively in the supine position with various respiratory maneuvers. Five patients who agreed to participate in long-term follow-up received a dual-chamber generator and were evaluated periodically over a 12-month period. Mean atrial sensitivity was 2.35 +/- 0.83 mV at the time of implantation. Effective atrial stimulation was possible in all patients at the time of implantation (mean stimulation threshold 3.08 +/- 1.04 V at 0.5 ms [bipolar], 3.34 +/- 0.95 V at 0.5 ms [unipolar]). Five of the 20 patients received a Kappa KDR701 generator, and atrial electrical properties were followed up over a 1-year period. There was no significant change in atrial pacing threshold or incidence of phrenic nerve stimulation over the 1-year follow-up. A standard single-pass VDD pacing lead

  14. Üç Boyutlu Ekokardiyografide Triküspit Kapak Stenozu ile Başvuran Sağ Atriyal Mixoma

    OpenAIRE

    Çakıcı, Musa; Süner, Arif; Polat, Mustafa; Çetin, Mustafa

    2013-01-01

    A case of myxoma has been reported as the source of tricuspid valve stenosis was detected with threedimensional echocardiography. Therefore, it is important for clinicians to detect the myxoma early via echocardiography to prevent complications, such as syncope, sudden death, and thromboembolic events. This report presents the case of a 56-year-old male whose clinical manifestation of right atrial myxoma was an dyspnea

  15. Changing axis deviation with changing bundle branch block and new-onset of atrial fibrillation during acute myocardial infarction.

    Science.gov (United States)

    Patanè, Salvatore; Marte, Filippo; Di Bella, Gianluca

    2009-03-06

    Paroxysmal atrial fibrillation is considered a frequent complication of acute myocardial infarction.It has been rarely reported alternating right and left bundle branch block associated with atrial fibrillation. It has also been rarely reported changing axis deviation with left bundle branch block also during atrial fibrillation and acute myocardial infarction. We present a case of changing axis deviation with changing bundle branch block and new-onset of atrial fibrillation in a 96-year-old Italian man with acute myocardial infarction.

  16. Myxoma virus combined with rapamycin treatment enhances adoptive T cell therapy for murine melanoma brain tumors.

    Science.gov (United States)

    Thomas, Diana L; Doty, Rosalinda; Tosic, Vesna; Liu, Jia; Kranz, David M; McFadden, Grant; Macneill, Amy L; Roy, Edward J

    2011-10-01

    Adoptive transfer of tumor-specific T cells has shown some success for treating metastatic melanoma. We evaluated a novel strategy to improve adoptive therapy by administering both T cells and oncolytic myxoma virus to mice with syngeneic B16.SIY melanoma brain tumors. Adoptive transfer of activated CD8(+) 2C T cells that recognize SIY peptide doubled survival time, but SIY-negative tumors recurred. Myxoma virus killed B16.SIY cells in vitro, and intratumoral injection of virus led to selective and transient infection of the tumor. Virus treatment recruited innate immune cells to the tumor and induced IFNβ production in the brain, resulting in limited oncolytic effects in vivo. To counter this, we evaluated the safety and efficacy of co-administering 2C T cells, myxoma virus, and either rapamycin or neutralizing antibodies against IFNβ. Mice that received either triple combination therapy survived significantly longer with no apparent side effects, but eventually relapsed. Importantly, rapamycin treatment did not impair T cell-mediated tumor destruction, supporting the feasibility of combining adoptive immunotherapy and rapamycin-enhanced virotherapy. Myxoma virus may be a useful vector for transient delivery of therapeutic genes to a tumor to enhance T cell responses.

  17. Myxoma virus and oncolytic virotherapy: a new biologic weapon in the war against cancer.

    Science.gov (United States)

    Stanford, Marianne M; McFadden, Grant

    2007-09-01

    Oncolytic virotherapy is an innovative alternative to more conventional cancer therapies. The ability of some viruses to specifically target and kill malignant cancerous cells while leaving normal tissue unscathed has opened a large repertoire of new and selective cancer killing therapeutic candidates. Poxviruses, such as vaccinia virus, have a long history of use in humans as live vaccines and have more recently been studied as potential platforms for delivery of immunotherapeutics and attenuated variants of vaccinia have been explored as oncolytic candidates. In contrast, the poxvirus myxoma virus is a novel oncolytic candidate that has no history of use in humans directly, as it has a distinct and absolute host species tropism to lagomorphs (rabbits). Myxoma virus has been recently shown to be able to also selectively infect and kill human tumor cells, a unique tropism that is linked to dysregulated intracellular signalling pathways found in the majority of human cancers. This review outlines the existing knowledge on the tropism of myxoma virus for human cancer cells, as well as preclinical data exhibiting its ability to infect and clear tumors in animal models of cancer. This is an exciting new therapeutic option for treating cancer, and myxoma virus joins a growing group of oncolytic virus candidates that are being developed as a new class of cancer therapies in man.

  18. Ressecção de mixoma ventricular esquerdo após acidente vascular cerebral embólico Resection of left ventricular myxoma after embolic stroke

    Directory of Open Access Journals (Sweden)

    Marcus Vinicius Ferraz de Arruda

    2008-12-01

    Full Text Available Mixoma cardíaco é o tumor primário mais comum do coração. Sua principal localização é no átrio esquerdo, mas pode surgir em qualquer câmara cardíaca. Os sintomas clínicos são variáveis, mas dispnéia e embolia são os mais freqüentes. Relatamos o caso de um jovem com acidente vascular cerebral isquêmico embólico causado por um grande mixoma no ventrículo esquerdo. O paciente foi submetido a cirurgia três semanas após o acidente vascular cerebral. O tumor foi ressecado com cuidado, sem fragmentar. O tratamento cirúrgico foi eficaz. Enfatizamos a raridade da presente localização, juntamente com uma revisão da literatura atual.Cardiac myxoma is the most common primary tumor of the heart. The tumor is located mainly in the left atrium but can arise from any heart chamber. Clinical symptoms are variable but dyspnea and embolism are the most frequent. We report a case of a young man that had embolic ischemic stroke caused by a large left ventricular myxoma. The patient underwent surgery three weeks after the stroke. The tumor was carefully resected without fragmentation. Surgical treatment was effective. We emphasize the rarity of this location together with a review of the current literature.

  19. Monitoring the spread of myxoma virus in rabbit Oryctolagus cuniculus populations on the southern tablelands of New South Wales, Australia. I. Natural occurrence of myxomatosis.

    Science.gov (United States)

    Merchant, J C; Kerr, P J; Simms, N G; Robinson, A J

    2003-02-01

    A survey of rabbit populations in the southern tablelands of New South Wales, Australia, was carried out to establish the pattern of occurrence of myxomatosis in preparation for a deliberate release of myxoma virus. Myxomatosis was first detected in December and cases were found on most sites through to May. The serological profiles of rabbit populations suggested that their susceptibility to myxoma virus was generally low in winter and highest in spring and summer reflecting the presence of increasing numbers of susceptible young rabbits. This was consistent with the pattern of rabbit breeding, as determined from the distribution of births and reproductive activity in females and males, which occurred maximally in spring and early summer. The serology and age structure of rabbit populations on sites suggested that some rabbit populations can escape an annual myxomatosis epizootic. Although fleas were present on rabbits throughout the year and therefore not considered to be a limiting factor in the spread of myxomatosis, their numbers peaked at times coincident with peak rabbit breeding. It was concluded that mid to late spring was an optimal time for a deliberate release.

  20. Serum atrial natriuretic peptide (ANP) as an objective indicator for the diagnosis of neurogenic shock: animal experiment and human case report.

    Science.gov (United States)

    Zhao, Min-Zhu; Li, Yong-Guo; Zhang, Peng; Xiong, Jin-Cheng; Zhu, Shi-Sheng; Xiao, Xuan; Li, Jian-Bo

    2017-03-01

    In forensic medicine, the diagnosis of death due to neurogenic shock is considered to be an aporia, as lacking objective indicators and presenting atypical symptoms in autopsy. Medico-legal disputes and complaints occasionally result from this ambiguity. To explore potential objective indicators of neurogenic shock, we set up a model of neurogenic shock by applying an external mechanical force on the carotid sinus baroreceptor in rabbits. The serum atrial natriuretic peptide (ANP) level was measured by radioimmunoassay in the control group (n = 8), survival group (n = 15) and death group (n = 5) both before and after the insult. The serum ANP level showed a significant increase after the insult in the death group compared with the serum obtained before the insult (P = 0.006), while the serum ANP level after the insult in the survival group and control group was not statistically significant compared with the serum obtained before the insult (P = 0.332 and P = 0.492, respectively). To verify the repeatability of the model and the postmortem behavior of serum ANP, five healthy adult rabbits underwent the same procedure as the experimental group. The mortality rate was consistent with the former experiment (20 %). There were no significant changes in serum ANP level in vitro and in vivo (within 48 and 24 h, respectively). But there was a significant decrease in serum ANP level at 48 h postmortem in vivo (P = 0.001). A female patient who expired due to neurogenic shock during a hysteroscopy was reported. Neither fatal primary disease nor evidence for mechanical injuries or intoxication was found according to the autopsy. The serum ANP level was assayed as a supplementary indicator and was found to be three-fold higher than the normal maximum limit. Combined with the animal experiment, this case highlights that serum ANP has the potential to be an objective indicator for the diagnosis of death due to neurogenic shock.

  1. Atrial natriuretic peptide in patients with heart failure and chronic atrial fibrillation : Role of duration of at atrial fibrillation

    NARCIS (Netherlands)

    Van Den Berg, MP; Crijns, HJGM; Van Veldhuisen, DJ; Van Gelder, IC; De Kam, PJ; Lie, KI

    The purpose of this study was to analyze the determinants of atrial natriuretic peptide level in patients with congestive heart failure and atrial fibrillation. In particular, the duration of atrial fibrillation was analyzed because atrial fibrillation per se might have a specific effect on atrial

  2. Pharmacological Treatment for Atrial Fibrillation

    Directory of Open Access Journals (Sweden)

    Kaoru Sugi, MD PhD

    2005-01-01

    Full Text Available Pharmacological treatment for atrial fibrillation has a variety of purposes, such as pharmacological defibrillation, maintenance of sinus rhythm, heart rate control to prevent congestive heart failure and prevention of both cerebral infarction and atrial remodeling. Sodium channel blockers are superior to potassium channel blockers for atrial defibrillation, while both sodium and potassium channel blockers are effective in the maintenance of sinus rhythm. In general, digitalis or Ca antagonists are used to control heart rate during atrial fibrillation to prevent congestive heart failure, while amiodarone or bepridil also reduce heart rates during atrial fibrillation. Anticoagulant therapy with warfarin is recommended to prevent cerebral infarction and angiotensin converting enzyme antagonists or angiotensin II receptor blockers are also used to prevent atrial remodeling. One should select appropriate drugs for treatment of atrial fibrillation according to the patient's condition.

  3. Ex vivo virotherapy with myxoma virus does not impair hematopoietic stem and progenitor cells.

    Science.gov (United States)

    Villa, Nancy Y; Bais, Swarna; Chan, Winnie M; Meacham, Amy M; Wise, Elizabeth; Rahman, Masmudur M; Moreb, Jan S; Rosenau, Emma H; Wingard, John R; McFadden, Grant; Cogle, Christopher R

    2016-03-01

    Relapsing disease is a major challenge after hematopoietic cell transplantation for hematological malignancies. Myxoma virus (MYXV) is an oncolytic virus that can target and eliminate contaminating cancer cells from auto-transplant grafts. The aims of this study were to examine the impact of MYXV on normal hematopoietic stem and progenitor cells and define the optimal treatment conditions for ex vivo virotherapy. Bone marrow (BM) and mobilized peripheral blood stem cells (mPBSCs) from patients with hematologic malignancies were treated with MYXV at various time, temperature and incubation media conditions. Treated BM cells from healthy normal donors were evaluated using flow cytometry for MYXV infection, long-term culture-initiating cell (LTC-IC) assay and colony-forming cell (CFC) assay. MYXV initiated infection in up to 45% of antigen-presenting monocytes, B cells and natural killer cells; however, these infections were uniformly aborted in >95% of all cells. Fresh graft sources showed higher levels of MYXV infection initiation than cryopreserved specimens, but in all cases less than 10% of CD34(+) cells could be infected after ex vivo MYXV treatment. MYXV did not impair LTC-IC colony numbers compared with mock treatment. CFC colony types and numbers were also not impaired by MYXV treatment. MYXV incubation time, temperature or culture media did not significantly change the percentage of infected cells, LTC-IC colony formation or CFC colony formation. Human hematopoietic cells are non-permissive for MYXV. Human hematopoietic stem and progenitor cells were not infected and thus unaffected by MYXV ex vivo treatment. Copyright © 2015 International Society for Cellular Therapy. Published by Elsevier Inc. All rights reserved.

  4. [Left ventricular-right atrial communication with a residual ventricular septal defect: a case report of successful VSD patch closure with tricuspid valvuloplasty using folded patch].

    Science.gov (United States)

    Kanazawa, M; Katoh, T; Suzuki, K; Fujimura, Y; Tsuboi, H; Esato, K

    1992-12-01

    A 18-year-old woman with combination of left ventricular right atrial communication (LV-RA communication) and residual ventricular septal defect (VSD) was presented. She underwent the radical operation of atrial septal defect, VSD and infundibular pulmonary stenosis at the age 11 years. Surgery was performed under the diagnosis of LV-RA communication and residual VSD. Two small defect were existed at the septal leaflet of the tricuspid valve, which communicated to left ventricle. The part of patch being used as closure of VSD at the previous operation, including perforated part of the septal leaflet was resected. A folded patch was used to reinforce the residual VSD and valvuloplasty was made using the remaining intact tricuspid tissues. Post-operative clinical course was uneventful. Shunt flow from LV to RA was not demonstrated in the postoperative left ventricular angiocardiography.

  5. Myxoma Virus and the Leporipoxviruses: An Evolutionary Paradigm

    Science.gov (United States)

    Kerr, Peter J.; Liu, June; Cattadori, Isabella; Ghedin, Elodie; Read, Andrew F.; Holmes, Edward C.

    2015-01-01

    Myxoma virus (MYXV) is the type species of the Leporipoxviruses, a genus of Chordopoxvirinae, double stranded DNA viruses, whose members infect leporids and squirrels, inducing cutaneous fibromas from which virus is mechanically transmitted by biting arthropods. However, in the European rabbit (Oryctolagus cuniculus), MYXV causes the lethal disease myxomatosis. The release of MYXV as a biological control for the wild European rabbit population in Australia, initiated one of the great experiments in evolution. The subsequent coevolution of MYXV and rabbits is a classic example of natural selection acting on virulence as a pathogen adapts to a novel host species. Slightly attenuated mutants of the progenitor virus were more readily transmitted by the mosquito vector because the infected rabbit survived longer, while highly attenuated viruses could be controlled by the rabbit immune response. As a consequence, moderately attenuated viruses came to dominate. This evolution of the virus was accompanied by selection for genetic resistance in the wild rabbit population, which may have created an ongoing co-evolutionary dynamic between resistance and virulence for efficient transmission. This natural experiment was repeated on a continental scale with the release of a separate strain of MYXV in France and its subsequent spread throughout Europe. The selection of attenuated strains of virus and resistant rabbits mirrored the experience in Australia in a very different environment, albeit with somewhat different rates. Genome sequencing of the progenitor virus and the early radiation, as well as those from the 1990s in Australia and Europe, has shown that although MYXV evolved at high rates there was no conserved route to attenuation or back to virulence. In contrast, it seems that these relatively large viral genomes have the flexibility for multiple pathways that converge on a similar phenotype. PMID:25757062

  6. Myxoma Virus and the Leporipoxviruses: An Evolutionary Paradigm

    Directory of Open Access Journals (Sweden)

    Peter J. Kerr

    2015-03-01

    Full Text Available Myxoma virus (MYXV is the type species of the Leporipoxviruses, a genus of Chordopoxvirinae, double stranded DNA viruses, whose members infect leporids and squirrels, inducing cutaneous fibromas from which virus is mechanically transmitted by biting arthropods. However, in the European rabbit (Oryctolagus cuniculus, MYXV causes the lethal disease myxomatosis. The release of MYXV as a biological control for the wild European rabbit population in Australia, initiated one of the great experiments in evolution. The subsequent coevolution of MYXV and rabbits is a classic example of natural selection acting on virulence as a pathogen adapts to a novel host species. Slightly attenuated mutants of the progenitor virus were more readily transmitted by the mosquito vector because the infected rabbit survived longer, while highly attenuated viruses could be controlled by the rabbit immune response. As a consequence, moderately attenuated viruses came to dominate. This evolution of the virus was accompanied by selection for genetic resistance in the wild rabbit population, which may have created an ongoing co-evolutionary dynamic between resistance and virulence for efficient transmission. This natural experiment was repeated on a continental scale with the release of a separate strain of MYXV in France and its subsequent spread throughout Europe. The selection of attenuated strains of virus and resistant rabbits mirrored the experience in Australia in a very different environment, albeit with somewhat different rates. Genome sequencing of the progenitor virus and the early radiation, as well as those from the 1990s in Australia and Europe, has shown that although MYXV evolved at high rates there was no conserved route to attenuation or back to virulence. In contrast, it seems that these relatively large viral genomes have the flexibility for multiple pathways that converge on a similar phenotype.

  7. Myxoma virus and the Leporipoxviruses: an evolutionary paradigm.

    Science.gov (United States)

    Kerr, Peter J; Liu, June; Cattadori, Isabella; Ghedin, Elodie; Read, Andrew F; Holmes, Edward C

    2015-03-06

    Myxoma virus (MYXV) is the type species of the Leporipoxviruses, a genus of Chordopoxvirinae, double stranded DNA viruses, whose members infect leporids and squirrels, inducing cutaneous fibromas from which virus is mechanically transmitted by biting arthropods. However, in the European rabbit (Oryctolagus cuniculus), MYXV causes the lethal disease myxomatosis. The release of MYXV as a biological control for the wild European rabbit population in Australia, initiated one of the great experiments in evolution. The subsequent coevolution of MYXV and rabbits is a classic example of natural selection acting on virulence as a pathogen adapts to a novel host species. Slightly attenuated mutants of the progenitor virus were more readily transmitted by the mosquito vector because the infected rabbit survived longer, while highly attenuated viruses could be controlled by the rabbit immune response. As a consequence, moderately attenuated viruses came to dominate. This evolution of the virus was accompanied by selection for genetic resistance in the wild rabbit population, which may have created an ongoing co-evolutionary dynamic between resistance and virulence for efficient transmission. This natural experiment was repeated on a continental scale with the release of a separate strain of MYXV in France and its subsequent spread throughout Europe. The selection of attenuated strains of virus and resistant rabbits mirrored the experience in Australia in a very different environment, albeit with somewhat different rates. Genome sequencing of the progenitor virus and the early radiation, as well as those from the 1990s in Australia and Europe, has shown that although MYXV evolved at high rates there was no conserved route to attenuation or back to virulence. In contrast, it seems that these relatively large viral genomes have the flexibility for multiple pathways that converge on a similar phenotype.

  8. Myxoma and vaccinia viruses bind differentially to human leukocytes.

    Science.gov (United States)

    Chan, Winnie M; Bartee, Eric C; Moreb, Jan S; Dower, Ken; Connor, John H; McFadden, Grant

    2013-04-01

    Myxoma virus (MYXV) and vaccinia virus (VACV), two distinct members of the family Poxviridae, are both currently being developed as oncolytic virotherapeutic agents. Recent studies have demonstrated that ex vivo treatment with MYXV can selectively recognize and kill contaminating cancerous cells from autologous bone marrow transplants without perturbing the engraftment of normal CD34(+) hematopoietic stem and progenitor cells. However, the mechanism(s) by which MYXV specifically recognizes and eliminates the cancer cells in the autografts is not understood. While little is known about the cellular attachment factor(s) exploited by MYXV for entry into any target cells, VACV has been shown to utilize cell surface glycosaminoglycans such as heparan sulfate (HS), the extracellular matrix protein laminin, and/or integrin β1. We have constructed MYXV and VACV virions tagged with the Venus fluorescent protein and compared their characteristics of binding to various human cancer cell lines as well as to primary human leukocytes. We report that the binding of MYXV or VACV to some adherent cell lines could be partially inhibited by heparin, but laminin blocked only VACV binding. In contrast to cultured fibroblasts, the binding of MYXV and VACV to a wide spectrum of primary human leukocytes could not be competed by either HS or laminin. Additionally, MYXV and VACV exhibited very different binding characteristics against certain select human leukocytes, suggesting that the two poxviruses utilize different cell surface determinants for the attachment to these cells. These results indicate that VACV and MYXV can exhibit very different oncolytic tropisms against some cancerous human leukocytes.

  9. The viral tropism of two distinct oncolytic viruses, reovirus and myxoma virus, is modulated by cellular tumor suppressor gene status

    OpenAIRE

    Kim, M.; Williamson, CT; Prudhomme, J.; Bebb, DG; Riabowol, K; Lee, PWK; Lees-Miller, SP; Mori, Y; Rahman, MM; McFadden, G; Johnston, RN

    2010-01-01

    Replication-competent oncolytic viruses hold great potential for the clinical treatment of many cancers. Importantly, many oncolytic virus candidates, such as reovirus and myxoma virus, preferentially infect cancer cells bearing abnormal cellular signaling pathways. Reovirus and myxoma virus are highly responsive to activated Ras and Akt signaling pathways, respectively, for their specificity for viral oncolysis. However, considering the complexity of cancer cell populations, it is possible t...

  10. [Low energy transcatheter atrial defibrillation in one patient with refractory atrial fibrillation].

    Science.gov (United States)

    Asenjo, R; Morris, R; Llancaqueo, M; Lopetegui, M; Marín, G; Morales, P

    1998-03-01

    Most cases of atrial fibrillation are converted with antiarrhythmic medications or external electric defibrillation. However, in some refractory patients, an internal transcatheter defibrillation must be attempted. We report a 50 years old male with an atrial fibrillation of one year duration that was refractory to pharmacological treatment and in whom external cardioversion was unsuccessful. After the application of a bifasic shock of 10 joules between a catheter in the right atrium and another one located at the coronary sinus, the patient was converted to sinus rhythm. At two months of follow up, the patient continues in sinus rhythm.

  11. Increased amount of atrial fibrosis in patients with atrial fibrillation secondary to mitral valve disease

    NARCIS (Netherlands)

    Geuzebroek, Guillaume S. C.; van Amersfoorth, Shirley C. M.; Hoogendijk, Mark G.; Kelder, Johannes C.; van Hemel, Norbert M.; de Bakker, Jacques M. T.; Coronel, Ruben

    2012-01-01

    Objective: Atrial fibrosis is related to atrial fibrillation but may differ in patients with mitral valve disease or lone atrial fibrillation. Therefore, we studied atrial fibrosis in patients with atrial fibrillation + mitral valve disease or with lone atrial fibrillation and compared it with

  12. Iatrogenic intra-atrial macro-reenterant tachycardia following transcatheter closure of atrial septal defect treated by radiofrequency ablation

    Directory of Open Access Journals (Sweden)

    Ibrahim Marai

    2011-01-01

    Full Text Available Percutaneous closure of an atrial septal defect (ASD has been established as a safe and effective alternative to surgical management. We describe a case of a 41-year-old patient in whom an Amplatzer septal occluder device was used to close a moderately large ASD and who subsequently developed incessant intra-atrial macro-reenterant tachycardia. The tachycardia was terminated by radiofrequency ablation guided by electroanatomical mapping.

  13. Mechanisms of atrial flutter following epicardial high intensity focused ultrasound left atrial ablative procedures during concomitant cardiac surgery

    Directory of Open Access Journals (Sweden)

    Ahmed El-Damaty

    2014-12-01

    Conclusions: Re-entrant atrial flutter post-HIFU epicor Maze is caused by slow conduction at entry and exit sites from the otherwise isolated posterior LA wall. In both cases, gaps were found close to the LSPV and RIPV which may reflect difficulty in achieving proper contact between the HIFU device and the left atrial wall at these sites. These gaps are amenable to catheter ablation.

  14. INTRACARDIAC ATRIAL DEFIBRILLATION

    Science.gov (United States)

    Dosdall, Derek J.; Ideker, Raymond E.

    2007-01-01

    Intravascular ventricular defibrillation and intravascular atrial defibrillation have many similarities, some of which are as follows. An important factor influencing the outcome of the shock is the potential gradient field created throughout the ventricles or the atria by the shock. A minimum potential gradient is required throughout the ventricles and probably the atria to defibrillate. The value of this minimum potential gradient is affected by several factors including the duration, tilt, and number of phases of the waveform. For shock strengths near the defibrillation threshold, earliest activation following failed shocks arises in a region in which the potential gradient is low. The defibrillation threshold energy can be decreased by adding a third and even a fourth defibrillation electrode in regions where the shock potential gradient is low for the shock field created by the first two defibrillation electrodes and giving two sequential shocks, each through a different set of electrodes. However, the addition of more electrodes and sequential shocks complicates both the device and its implantation. Since patients are conscious when the atrial defibrillation shock is given, they experience pain during the shock, which is one of the main drawbacks of intravascular atrial defibrillation. Unfortunately, the pain threshold for defibrillation shocks is so low that a shock of less than 1 Joule is uncomfortable and is not much less painful than shocks several times stronger. Therefore, even though electrode configurations exist that have lower atrial defibrillation threshold energy requirements than the atrial defibrillation threshold with standard defibrillation electrode configurations used in implantable cardioverter/defibrillators (ICDs) for ventricular defibrillation, they are not clinically practical because their shocks are almost as painful as with the standard ICD electrode configurations and they would cause the ICD to be more complicated and to take

  15. LA mass shadow after removal of LA myxoma.

    Science.gov (United States)

    Raut, Monish S; Dubey, Sumir; Maheshwari, Arun; Sharma, Manish

    2016-09-01

    Inverted left atrial tissue is mostly identified when the heart is empty while coming off bypass. During echocardiography a new, echodense mobile mass in the left atrium without attachment is visualized. Such a picture can easily produce not only confusion in the diagnosis but also mitral valve obstruction, hemodynamic instability, and a possibility of appendage necrosis. Inability to identify such inverted tissue can lead to unwanted interventions with additional cardiopulmonary bypass time. Copyright © 2015 Cardiological Society of India. Published by Elsevier B.V. All rights reserved.

  16. YKL-40 levels and atrial fibrillation in the general population

    DEFF Research Database (Denmark)

    Marott, Sarah C W; Benn, Marianne; Johansen, Julia S

    2013-01-01

    BACKGROUND: Atrial fibrillation is associated with inflammation. In contrast to inflammatory markers like C-reactive protein (CRP) and fibrinogen produced in the liver, YKL-40 is produced at the site of inflammation including in the myocardium. We hypothesized that elevated plasma YKL-40 levels a...... individuals from the cross-sectional Copenhagen General Population Study including 337 cases with atrial fibrillation. A YKL-40 level >95% percentile (>204μg/L) versus 95% percentile versus...... associate with increased risk of atrial fibrillation. METHOD AND RESULTS: We measured plasma YKL-40 in 8731 participants from the prospective Copenhagen City Heart Study including 896 individuals who developed atrial fibrillation during up to 18years of follow-up. Additionally, we measured YKL-40 in 6621...

  17. Left atrial appendage occlusion: pilot study of a fourth-generation, minimally invasive device.

    Science.gov (United States)

    Fumoto, Hideyuki; Gillinov, A Marc; Saraiva, Roberto M; Horai, Tetsuya; Anzai, Tomohiro; Takaseya, Tohru; Shiose, Akira; Arakawa, Yoko; Vince, D Geoffrey; Dessoffy, Raymond; Fukamachi, Kiyotaka

    2012-01-01

    Exclusion of the left atrial appendage is proposed to reduce the risk of stroke in patients with atrial fibrillation. The aim of this study was to evaluate the feasibility and efficacy of a fourth-generation atrial exclusion device developed for minimally invasive applications. The novel atrial exclusion device consists of two polymer beams and two elastomeric bands that connect the two beams at either end. Fifteen mongrel dogs were implanted with the device at the base of the left atrial appendage through a median sternotomy and were evaluated at 30 (n = 7), 90 (n = 6), and 180 (n = 2) days after implantation by epicardial echocardiography, left atrial and coronary angiography, gross pathology, and histology. Left atrial appendage exclusion was completed without hemodynamic instability. Coronary angiography revealed that the left circumflex artery was patent in all cases. A new endothelial tissue layer developed, as expected, on the occluded orifice of the left atrium. This novel atrial exclusion device achieved easy, reliable, and safe exclusion of the left atrial appendage, with favorable histological results in a canine model for up to 6 months. Clinical application could provide a new therapeutic option for reducing the risk of stroke in patients with atrial fibrillation.

  18. Acute atrial fibrillation during dengue hemorrhagic fever

    Directory of Open Access Journals (Sweden)

    Veloso Henrique Horta

    2003-01-01

    Full Text Available Dengue fever is a viral infection transmitted by the mosquito, Aedes aegypti. Cardiac rhythm disorders, such as atrioventricular blocks and ventricular ectopic beats, appear during infection and are attributed to viral myocarditis. However, supraventricular arrhythmias have not been reported. We present a case of acute atrial fibrillation, with a rapid ventricular rate, successfully treated with intravenous amiodarone, in a 62-year-old man with dengue hemorrhagic fever, who had no structural heart disease.

  19. Mixoma auricular izquierdo asociado a insuficiencia severa de válvula mitral en paciente de género femenino de 31 años de edad: reporte de caso Left atrial mixoma associated with severe mitral valve insufficiency in a 31 years old female patient: a case report

    National Research Council Canada - National Science Library

    Fernando Manzur J; Cristian Barbosa; Agustín Puello

    2011-01-01

    ... válvula mitral severa que requirió plastia valvular. Fue dada de alta al sexto día post-quirúrgico.We report the case of a 31 years old female patient without pathological antecedents, with a left atrial mixoma that measured 9 cm x 8 cm...

  20. Assessment of atrial diastolic function in patients with hypertrophic cardiomyopathy by cine magnetic resonance imaging.

    Science.gov (United States)

    Grassedonio, Emanuele; Todiere, Giancarlo; La Grutta, Ludovico; Toia, Patrizia; Gentile, Giovanni D; Galia, Massimo; Midiri, Federico; Pepe, Alessia; Midiri, Massimo; Aquaro, Giovanni Donato

    2015-08-01

    This study was conducted to assess the role of atrial function by cardiac magnetic resonance (CMR) for the evaluation of diastolic physiology in patients with hypertrophic cardiomyopathy (HCM) compared to healthy controls. We enrolled 23 consecutive patients affected by HCM and 43 healthy subjects as age-matched control cases (CC). CMR was performed through acquisition of cine steady-state free precession sequences using a 1.5-T scanner. Image postprocessing was carried out using Tracking Tool software. Atrial volumes were significantly higher in patients with HCM compared to CC: maximum atrial volume (p = 0.007) and minimum atrial volume (p = 0.01). A statistically significant difference was also observed in atrial ejection fraction in patients with HCM (p study demonstrated that in HCM patients with early diastolic dysfunction the parameters of left atrial function assessed by CMR are impaired before the ventricular diastolic indexes such as the early peak filling rate and the active peak filling rate.

  1. Mazabraud's Syndrome Coexisting with a Uterine Tumor Resembling an Ovarian Sex Cord Tumor (UTROSCT): a Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Calisir, Cuneyt; Inan, Ulukan; Yavas, Ulas Savas; Isiksoy, Serap; Kaya, Tamer [Eskisehir Osmangazi University, Eskiseh (Korea, Republic of)

    2007-10-15

    Intramuscular myxoma is a relatively uncommon benign soft tissue tumor. Its association with fibrous dysplasia of bone represents a rare syndrome described by Mazabraud and Girard in 1957. The relationship between fibrous dysplasia and myxoma remains unclear. A common histogenesis has been proposed for both lesions. Wirth et al. has suggested a basic metabolic error of both tissues during the initial growth period, restricted to the region of bone involvement. Myxomas may appear at any age, but have a predilection for older individuals, occurring most commonly during the sixth and seventh decades of life. They are often located in the large muscles of the thigh, shoulder and buttocks. The majority of intramuscular myxomas are solitary. Cross-sectional techniques are essential in the preoperative planning of excision of soft tissue tumors. The ability to evaluate soft tissue myxomas is best accomplished with MR imaging. Myxomas typically demonstrate the following MR features: very sharply defined contour and homogeneous signal intensity. In particular, the lesions are significantly low in signal intensity on T1-weighted images and high in signal intensity on T2-weighted images. In the patient of this case, the MR appearance was in agreement with previously reported cases.

  2. Myxoma of the penis in an African pygmy hedgehog (Atelerix albiventris).

    Science.gov (United States)

    Takami, Yoshinori; Yasuda, Namie; Une, Yumi

    2017-01-20

    A penile tumor (4 × 2.5 × 1 cm) was surgically removed from an African pygmy hedgehog (Atelerix albiventris) aged 3 years and 5 months. The tumor was continuous with the dorsal fascia of the penile head. Histopathologically, tumor cells were pleomorphic (oval-, short spindle- and star-shaped cells) with low cell density. Abundant edematous stroma was weakly positive for Alcian blue staining and positive for colloidal iron reaction. Tumor cells displayed no cellular atypia or karyokinesis. Tumor cell cytoplasm was positive for vimentin antibody, while cytoplasm and nuclei were positive for S-100 protein antibody. Tumor cell ultrastructure matched that of fibroblasts, and the rough endoplasmic reticulum was enlarged. The tumor was diagnosed as myxoma. This represents the first report of myxoma in a hedgehog.

  3. Odontogenic myxoma of maxillary sinus: CT and MR-pathologic correlation

    Energy Technology Data Exchange (ETDEWEB)

    Asaumi, Jun-ichi E-mail: asaumi@dent.okayama-u.ac.jp; Konouchi, Hironobu; Hisatomi, Miki; Kishi, Kanji

    2001-01-01

    We showed the characteristic features of odontogenic myxoma in the maxillary sinus with computed tomography (CT), magnetic resonance imaging (MRI), and histopathological findings. CT images showed a multilocular soft tissue mass with bone destruction and thinning, and the characteristic finding of this lesion as strands of fine lacelike density. MRI revealed intermediate signal intensity on T1-weighted image and high signal intensity on T2-weighted image. MRI showed the erosive extent of the lesion into the adjacent structures. In contrast T1-weighted image, the peripheral portion of the lesion with a relatively large quantity of collagen bundles was enhanced, while the central portion with only mucoid component was not. The CT and MRI appearances correlated well with the histologic features and therefore were considered to be a useful tool for diagnosis of myxoma.

  4. Coronary artery disease, left ventricular hypertrophy and diastolic dysfunction are associated with stroke in patients affected by persistent non-valvular atrial fibrillation: a case-control study.

    Science.gov (United States)

    Palmiero, Pasquale; Maiello, Maria; Passantino, Andrea

    2009-06-30

    Persistent non-valvular atrial fibrillation (NVAF) is associated with an increased risk of cardiovascular events such as stroke, and its rate is expected to rise because of the ageing population. The absolute rate of stroke depends on age and comorbidity. Risk stratification for stroke in patients with NVAF derives from populations enrolled in randomized clinical trials. However, participants in clinical trials are often not representative of the general population. Many stroke risk stratification scores have been used, but they do not include transthoracic echocardiogram (TTE), pulsate wave Doppler (PWD) and tissue Doppler imaging (TDI), simple and non- invasive diagnostic tools. The role of TTE, PWD and TDI findings has not been previously determined. Our study goal was to determine the association between TTE and PWD findings and stroke prevalence in a population of NVAF prone outpatients.PATIENTS WERE DIVIDED INTO TWO GROUPS: P for stroke prone and F for stroke free. There were no statistically significant differences between the two groups concerning cardiovascular risk factors, age (p=0.2), sex (p=0.2), smoking (p=0.3), diabetes (p=0.1) and hypercholesterolemia (p=0.2); hypertension was statistically significant (pdisease, previous acute myocardial infarction (AMI) (pdisease, with and without AMI, LVH and left ventricular diastolic dysfunction, but not left atrial dilatation. M-B mode echocardiography and PWD examination help to identify high-risk stroke patients among NVAF subjects; therefore, they may help in the selection of appropriate therapy for each patient.

  5. Mixoma odontogénico, un reto para el diagnóstico Odontogenic myxoma, a challenge to diagnosis

    Directory of Open Access Journals (Sweden)

    Josefa Dolores Miranda Tarragó

    2008-12-01

    Full Text Available Se presenta un paciente masculino, de 41 años de edad, piel blanca, con hábitos de fumar e ingerir bebidas alcohólicas que al examen físico manifiesta lesión tumoral de 3,3 cm. de diámetro, con aspecto de roseta, ocupando el área desdentada de reborde alveolar inferior derecho correspondiente a primer y segundo molares. En la radiografía panorámica se observó área radiolúcida multilocular que respeta el borde de la mandíbula, con una cortical irregular en algunas áreas. El diagnóstico histopatológico utilizando la coloración de hematoxilina y eosina fue de mixoma odontogénico. El paciente fue tratado quirúrgicamente y se confirmó el diagnóstico utilizando la coloración de azul alciano, que fue positiva. El mixoma odontogénico por ser un tumor que no tiene características clínicas ni radiográficas patognomónicas, síntomas imprecisos, comportamiento agresivo local y recidivas frecuentes debe ser siempre tenido en cuenta en los diagnósticos diferenciales de los tumores del maxilar y la mandíbula.The case of a 41-year-old male white patient who smokes and drinks alcoholic beverages and that on the physical examination manifests a rosette-like tumoral lesion of 3.3 cm of diameter that ocuppies the edentulous area of the inferior right alveolar crest of the mandible corresponding to the first and second molars is presented. In the panoramic radiography, it was observed a radiolucid multiocular area that respects the border of the mandible with an irregular cortical in some areas. An odontogenic myxoma was histopathologically diagnosed by using hematoxylin and eosin staining. The patient was surgically treated and the diagnosis was confirmed by alcian blue staining, which yielded positive. As the odontogenic myxoma is a tumor with neither clinical nor pathognomic radiographic characteristics, inaccurate symptoms, local aggresive behavior and frequent relapses, it should always be taken into account in the differential

  6. Modulation of the Myxoma Virus Plaque Phenotype by Vaccinia Virus Protein F11

    OpenAIRE

    Irwin, Chad R; Evans, David H.

    2012-01-01

    Vaccinia virus (VACV) produces large plaques consisting of a rapidly expanding ring of infected cells surrounding a lytic core, whereas myxoma virus (MYXV) produces small plaques that resemble a focus of transformed cells. This is odd, because bioinformatics suggests that MYXV carries homologs of nearly all of the genes regulating Orthopoxvirus attachment, entry, and exit. So why does MYXV produce foci? One notable difference is that MYXV-infected cells produce few of the actin microfilaments...

  7. The immunoregulatory properties of oncolytic myxoma virus and their implications in therapeutics.

    Science.gov (United States)

    Liu, Jia; Wennier, Sonia; McFadden, Grant

    2010-12-01

    Myxoma virus (MYXV) is a poxvirus with a strict rabbit-specific host-tropism for pathogenesis. The immunoregulatory factors encoded by MYXV can suppress some functions of immune effectors from other species. We review their mechanisms of action, implications in therapeutics and the potential to improve MYXV as an oncolytic agent in humans. Copyright © 2010 Institut Pasteur. Published by Elsevier SAS. All rights reserved.

  8. Partial sequencing of recent Portuguese myxoma virus field isolates exhibits a high degree of genetic stability.

    Science.gov (United States)

    Muller, A; Silva, E; Abrantes, J; Esteves, P J; Ferreira, P G; Carvalheira, J C; Nowotny, N; Thompson, G

    2010-01-06

    To study genetic changes underlying myxoma virus evolution in its new host, the European rabbit (Oryctolagus cuniculus), we sequenced selected genomic regions of nine recent virulent field strains and a live attenuated vaccine strain ("MAV", Germany). DNA was extracted from cell culture passaged myxoma virus. A total of 4863 bp (approximately 3% of the genome) of 10 regions spanning 12 genes of the myxoma viruses was sequenced and compared to the original virulent strain "Lausanne" and its attenuated field derivative strain "6918". The field strains displayed a maximum of three (strains C43, C95) and a minimum of one (strains CD01, CD05) nucleotide substitutions. These were distributed through all analysed coding regions, except gene M022L (major envelope protein), where all strains were identical to "Lausanne" and "6918". Two new single nucleotide insertions were observed in some of the field strains: within the intergenic region M014L/M015L and within gene M009L, where it leads to a frameshift. These insertions were located after homopolymeric regions. The vaccine strain displayed 37 nucleotide substitutions, predominantly (95%) located in genes M022L and M036L. Interestingly, regions M009L and M014L/M015L of the vaccine were not amplified successfully, suggesting major genomic changes that could account for its attenuated phenotype. Our results support a high degree of genetic stability of myxoma virus over the past five decades. None of the analysed genome regions by its own seems sufficient for the genetic characterisation of field strains.

  9. Systemic therapy with oncolytic myxoma virus cures established residual multiple myeloma in mice

    OpenAIRE

    Bartee, Eric; Bartee, Mee Y.; Bogen, Bjarne; Yu, Xue-Zhong

    2016-01-01

    Multiple myeloma is an incurable malignancy of plasma B-cells. Traditional chemotherapeutic regimes often induce initial tumor regression; however, virtually all patients eventually succumb to relapse caused by either reintroduction of disease during autologous transplant or expansion of chemotherapy resistant minimal residual disease. It has been previously demonstrated that an oncolytic virus known as myxoma can completely prevent myeloma relapse caused by reintroduction of malignant cells ...

  10. Myxoma Virus Infection Promotes NK Lysis of Malignant Gliomas In Vitro and In Vivo

    OpenAIRE

    Henry Ogbomo; Zemp, Franz J.; Xueqing Lun; Jiqing Zhang; Danuta Stack; Rahman, Masmudur M.; Grant McFadden; Christopher H Mody; Forsyth, Peter A.

    2013-01-01

    Myxoma virus (MYXV) is a well-established oncolytic agent against different types of tumors. MYXV is also known for its immunomodulatory properties in down-regulating major histocompatibility complex (MHC) I surface expression (via the M153R gene product, a viral E3-ubiquitin ligase) and suppressing T cell killing of infected target cells. MHC I down-regulation, however, favors NK cell activation. Brain tumors including gliomas are characterized by high MHC I expression with impaired NK activ...

  11. Histological evaluation of intratumoral myxoma virus treatment in an immunocompetent mouse model of melanoma

    OpenAIRE

    Doty RA; Liu J; McFadden G; Roy EJ; MacNeill AL

    2013-01-01

    Rosalinda A Doty,1 Jia Liu,2 Grant McFadden,2 Edward J Roy,3 Amy L MacNeill11Department of Pathobiology, University of Illinois, Urbana, IL, 2Department of Molecular Genetics and Microbiology, University of Florida, Gainesville, FL, 3Department of Molecular and Integrative Physiology, University of Illinois, Urbana, IL, USAAbstract: Two recombinant myxoma viruses (MYXV expressing a fluorescent protein [MYXV-Tred] and MYXV-Tred encoding murine interleukin-15 [MYXV-IL15]) were evaluated for the...

  12. Occlusion of left atrial appendage in patients with atrial fibrillation

    Directory of Open Access Journals (Sweden)

    О. Н. Ганеева

    2015-10-01

    Full Text Available The article reviews a new method of prophylaxis of thromboembolitic complications, specifically occlusion of left atrial appendage, in patients with atrial fibrillation. Indications and contraindications for the procedure, as well as a step-by-step process of the intervention itself are described. Special emphasis is placed on the up-to-date evidence and the review of clinical trials.

  13. The orosomucoid 1 protein (α1 acid glycoprotein is overexpressed in odontogenic myxoma

    Directory of Open Access Journals (Sweden)

    García-Muñoz Alejandro

    2012-08-01

    Full Text Available Abstract Background Odontogenic myxoma (OM is a benign, but locally invasive, neoplasm occurring in the jaws. However, the molecules implicated in its development are unknown. OM as well as Dental Follicle (DF, an odontogenic tissue surrounding the enamel organ, is derived from ectomesenchymal/mesencyhmal elements. To identify some protein that could participate in the development of this neoplasm, total proteins from OM were separated by two-dimensional electrophoresis and the profiles were compared with those obtained from DF, used as a control. Results We identified eight proteins with differential expression; two of them were downregulated and six upregulated in OM. A spot consistently overexpressed in odontogenic myxoma, with a molecular weight of 44-kDa and a pI of 3.5 was identified as the orosomucoid 1 protein. Western blot experiments confirmed the overexpression of this protein in odontogenic myxoma and immunohistochemical assays showed that this protein was mainly located in the cytoplasm of stellate and spindle-shaped cells of this neoplasm. Conclusion Orosomucoid 1, which belongs to a group of acute-phase proteins, may play a role in the modulation of the immune system and possibly it influences the development of OM.

  14. Molecular and serological analysis of the epidemiology of myxoma virus in rabbits.

    Science.gov (United States)

    Kerr, P J; Hone, J; Perrin, L; French, N; Williams, C K

    2010-07-14

    The epidemiology of myxoma virus was studied by serology and molecular analysis of restriction fragment length polymorphisms (RFLPs) in genomic DNA. 159 isolates of myxoma virus were made over a period of 5 spring/summer epidemics from 12 field sites in south-eastern Australia. Virus isolates were classified into 10 genetic types using RFLPs detected with a panel of nine restriction endonucleases. Between 3 and 6 different genetic types were found during spring/summer periods across all sites and up to 3 different genetic types were isolated during an epidemic on a single site. The predominant type tended to change each year. A widespread mutation was identified in two genetic types with replacement of the 3' two-thirds of the M009L gene at the left hand inverted terminal repeat junction with a duplication of the region containing the M156R, M154L and M153R genes from the right hand end of the genome. This demonstrated how myxoma virus can potentially evolve by expansion of the inverted terminal repeat boundaries. (c) 2009. Published by Elsevier B.V. All rights reserved.

  15. Myxoma virus attenuates expression of activating transcription factor 4 (ATF4) which has implications for the treatment of proteasome inhibitor-resistant multiple myeloma.

    Science.gov (United States)

    Dunlap, Katherine M; Bartee, Mee Y; Bartee, Eric

    2015-01-01

    The recent development of chemotherapeutic proteasome inhibitors, such as bortezomib, has improved the outcomes of patients suffering from the plasma cell malignancy multiple myeloma. Unfortunately, many patients treated with these drugs still suffer relapsing disease due to treatment-induced upregulation of the antiapoptotic protein Mcl1. We have recently demonstrated that an oncolytic poxvirus, known as myxoma, can rapidly eliminate primary myeloma cells by inducing cellular apoptosis. The efficacy of myxoma treatment on proteasome inhibitor-relapsed or -refractory myeloma, however, remains unknown. We now demonstrate that myxoma-based elimination of myeloma is not affected by cellular resistance to proteasome inhibitors. Additionally, myxoma virus infection specifically prevents expression of Mcl1 following induction of the unfolded protein response, by blocking translation of the unfolded protein response activating transcription factor (ATF)4. These results suggest that myxoma-based oncolytic therapy represents an attractive option for myeloma patients whose disease is refractory to chemotherapeutic proteasome inhibitors due to upregulation of Mcl1.

  16. Right Atrial Diverticulosis and Early-onset Arrhythmia: Rare Cause of Incessant Neonatal Arrhythmia.

    Science.gov (United States)

    Aggarwal, Neeraj; Joshi, Raja; Joshi, Reena K; Agarwal, Mridul

    2017-06-15

    Atrial flutter not responding to medications could be secondary to structural malformations of heart. A 5-year-old child with resistant arrhythmia, with onset in neonatal period. Multiple right atrial diverticuli were detected on CT angiography and cardiac catheterization. Patient reverted to sinus rhythm following surgical excision of diverticuli. In cases of intractable supraventricular tachycardia, structural anomalies of atrium should be suspected.

  17. Mobile Right Atrial Thrombi in a Patient with the Hemoglobin SC Disease

    Directory of Open Access Journals (Sweden)

    H. O. Savage

    2011-01-01

    Full Text Available The formation of Intracardiac thrombi is rare in the absence of structural heart disease or atrial fibrillation. We describe a case of spontaneous right atrial thrombus formation that occurred in a patient with a hypercoagulable condition who had been sub optimally anticoagulated.

  18. Long-term outcome of electrical cardioversion in patients with chronic atrial flutter

    NARCIS (Netherlands)

    Crijns, HJGM; VanGelder, IC; Tieleman, RG; Brugemann, J; DeKam, PJ; Gosselink, ATM; BinkBoelkens, MTE; Lie, KI

    Objective-To determine she long-term outcome of serial electrical cardioversion therapy in patients with chronic atrial flutter. Design-Prospective study, case series. Setting-University hospital. Patients-50 consecutive patients with chronic (> 24 hours) atrial flutter without a previous relapse on

  19. Right Atrial Appendage Aneurysm in a Newborn Diagnosed with Fetal Echocardiography

    Science.gov (United States)

    Yartaşı Tik, Elif; Öztarhan, Kazım; Dedeoğlu, Reyhan; Çetinkaya, Merih

    2016-01-01

    Right atrial appendage aneurysm is a very rare condition which can be asymptomatic or can cause arrhythmia or life-threatening thromboembolism. We report a case of newborn with right atrial appendage aneurysm who was diagnosed with fetal echocardiography. Anticoagulant therapy was applied to prevent thromboembolism and he is still going on follow-up without any complaint. PMID:27703828

  20. Atrial fibrillation: inflammation in disguise?

    NARCIS (Netherlands)

    Lappegard, K.T.; Hovland, A.; Pop, G.A.M.; Mollnes, T.E.

    2013-01-01

    Atrial fibrillation is highly prevalent, and affected patients are at an increased risk of a number of complications, including heart failure and thrombo-embolism. Over the past years, there has been increasing interest in the role of inflammatory processes in atrial fibrillation, from the first