A Case of Left Atrial Villous-Type Myxoma Mimicking Papillary Fibroelastoma
- VernacularTitle:肉眼的に乳頭状線維弾性腫と鑑別が困難であった villous type 左房粘液腫の1例
- Author:
Takahiro ISHIGAKI
1
;
Yasushige SHINGU
1
;
Nobuyasu KATO
1
;
Satoru WAKASA
1
;
Tomonori OOKA
1
;
Hiroki KATOH
2
;
Yoshiro MATSUI
3
Author Information
- Keywords: myxoma; papillary fibroelastoma; cardiac tumor
- From:Japanese Journal of Cardiovascular Surgery 2019;48(6):405-410
- CountryJapan
- Language:Japanese
- Abstract: A female in her 60 s with a mobile cardiac tumor in the left atrium was referred to our hospital. The tumor was diagnosed as myxoma by echocardiography, CT scan, and MRI. Under cardiac arrest using cardiopulmonary bypass, we resected the tumor through the superior trans-septal approach. We resected two tumors (tumor 1 and 2) with adequate rims of the interatrial septum to avoid recurrence. Although the tumor had a broad base and extended to near the mitral annulus, mitral valve repair was not necessary. Tumor 1 was gelatinous and seemed to be a myxoma ; tumor 2 had a lot of papillary structures attached to the solid mass and presented with the figure of a sea anemone when it was put in saline, which is typical for papillary fibroelastomas. The defect of the interatrial septum was closed with the autologous pericardium. The postoperative course was uneventful. Unexpectedly, both tumor 1 and 2 were diagnosed as myxomas on pathological examination. Tumor 2 (papillary lesion) included a few tumor cells with positive staining of calretinin typical for myxoma and was diagnosed as a “villous-type myxoma”. Because it is difficult to distinguish myxoma from papillary fibroelastoma by pre- and intraoperative findings, it would be recommended to resect tumors with an adequate margin to prevent recurrence.
