A myxoma (
New Latin
Neo-LatinSidwell, Keith ''Classical Latin-Medieval Latin-Neo Latin'' in ; others, throughout. (also known as New Latin and Modern Latin) is the style of written Latin used in original literary, scholarly, and scientific works, first in Italy d ...
from
Greek
Greek may refer to:
Anything of, from, or related to Greece, a country in Southern Europe:
*Greeks, an ethnic group
*Greek language, a branch of the Indo-European language family
**Proto-Greek language, the assumed last common ancestor of all kno ...
'
mucus
Mucus (, ) is a slippery aqueous secretion produced by, and covering, mucous membranes. It is typically produced from cells found in mucous glands, although it may also originate from mixed glands, which contain both Serous fluid, serous and muc ...
') is a
myxoid tumor
A myxoid tumor is a connective tissue tumor with a "myxoid" background, composed of clear, mucoid substance.
This tumoral phenotype is shared by many tumoral entities:
* Myxomas
** Atrial myxoma
** Odontogenic myxoma
** Cutaneous myxoma
** Intramu ...
of primitive
connective tissue
Connective tissue is one of the four primary types of animal tissue, a group of cells that are similar in structure, along with epithelial tissue, muscle tissue, and nervous tissue. It develops mostly from the mesenchyme, derived from the mesod ...
. It is most commonly found in the heart (and is the most common primary tumor of the
heart
The heart is a muscular Organ (biology), organ found in humans and other animals. This organ pumps blood through the blood vessels. The heart and blood vessels together make the circulatory system. The pumped blood carries oxygen and nutrie ...
in adults) but can also occur in other locations.
Types
Table below:
1.SMA,
smooth muscle
Smooth muscle is one of the three major types of vertebrate muscle tissue, the others being skeletal and cardiac muscle. It can also be found in invertebrates and is controlled by the autonomic nervous system. It is non- striated, so-called bec ...
actin
Actin is a family of globular multi-functional proteins that form microfilaments in the cytoskeleton, and the thin filaments in muscle fibrils. It is found in essentially all eukaryotic cells, where it may be present at a concentration of ...
. 2.MSA, muscle-specific
actin
Actin is a family of globular multi-functional proteins that form microfilaments in the cytoskeleton, and the thin filaments in muscle fibrils. It is found in essentially all eukaryotic cells, where it may be present at a concentration of ...
. 3.EMA,
epithelial membrane antigen
Mucin short variant S1, also called polymorphic epithelial mucin (PEM) or epithelial membrane antigen (EMA), is a mucin encoded by the ''MUC1'' gene in humans. Mucin short variant S1 is a glycoprotein with extensive O-linked glycosylation of its e ...
.
Symptoms and signs
Symptoms associated with cardiac myxomas are typically due to the effect of the mass of the tumor obstructing the normal flow of blood within the chambers of the heart. Because pedunculated myxomas are somewhat mobile, symptoms may only occur when the patient is in a particular position.
Some symptoms of myxoma may be associated with the release of
interleukin 6
Interleukin 6 (IL-6) is an interleukin that acts as both a pro-inflammatory cytokine and an anti-inflammatory myokine. In humans, it is encoded by the ''IL6'' gene.
In addition, osteoblasts secrete IL-6 to stimulate osteoclast formation. Smoo ...
(IL-6) by the myxoma.
High levels of IL-6 may be associated with a higher risk of
embolism
An embolism is the lodging of an embolus, a blockage-causing piece of material, inside a blood vessel. The embolus may be a blood clot (thrombus), a fat globule (fat embolism), a bubble of air or other gas (air embolism, gas embolism), amniotic ...
of the myxoma.
Symptoms of a cardiac myxoma include:
*
Dyspnea
Shortness of breath (SOB), known as dyspnea (in AmE) or dyspnoea (in BrE), is an uncomfortable feeling of not being able to breathe well enough. The American Thoracic Society defines it as "a subjective experience of breathing discomfort that ...
on exertion
*
Paroxysmal nocturnal dyspnea
Paroxysmal nocturnal dyspnea or paroxysmal nocturnal dyspnoea (PND) is an attack of severe shortness of breath and coughing that generally occurs at night. It usually awakens the person from sleep, and may be quite frightening. PND, as well as sim ...
*
Fever
Fever or pyrexia in humans is a symptom of an anti-infection defense mechanism that appears with Human body temperature, body temperature exceeding the normal range caused by an increase in the body's temperature Human body temperature#Fever, s ...
*
Weight loss
Weight loss, in the context of medicine, health, or physical fitness, refers to a reduction of the total body mass, by a mean loss of fluid, body fat (adipose tissue), or lean mass (namely bone mineral deposits, muscle, tendon, and other conn ...
(see
cachexia
Cachexia () is a syndrome that happens when people have certain illnesses, causing muscle loss that cannot be fully reversed with improved nutrition. It is most common in diseases like cancer, Heart failure, congestive heart failure, chronic o ...
)
* Lightheadedness or
syncope (Loss of consciousness)
*
Hemoptysis
Hemoptysis or haemoptysis is the discharge of blood or blood-stained sputum, mucus through the mouth coming from the bronchi, larynx, vertebrate trachea, trachea, or lungs. It does not necessarily involve coughing. In other words, it is the airw ...
* Sudden death
*
Tachycardia
Tachycardia, also called tachyarrhythmia, is a heart rate that exceeds the normal resting rate. In general, a resting heart rate over 100 beats per minute is accepted as tachycardia in adults. Heart rates above the resting rate may be normal ...
or milder heartrate, i.e. 75–100 cycl/min
Location
Ocular myxoma
Myxoma is a rare, benign stromal tumor of mesenchymal origin often confused with other conjunctival stromal tumors. Conjunctival myxomas are thought to originate in
Tenon's capsule
Tenon's capsule (), also known as the Tenon capsule, fascial sheath of the eyeball () or the fascia bulbi, is a thin membrane which envelops the eyeball from the optic nerve to the corneal limbus, separating it from the orbital fat and forming a ...
and can masquerade as
conjunctival lymphoma,
lymphangioma
Lymphatic malformations are benign slow-flow type of vascular malformation of the lymphatic system characterized by lymphatic vessels which do not connect to the normal lymphatic circulation. The term ''lymphangioma'' is outdated and newer rese ...
,
ocular surface squamous neoplasia
Conjunctival squamous cell carcinoma (conjunctival SCC) and corneal intraepithelial neoplasia comprise ocular surface squamous neoplasia (OSSN). SCC is the most common malignancy of the conjunctiva in the US, with a yearly incidence of 1–2.8 per ...
(OSSN), or
amelanotic melanoma
Amelanotic melanoma is a type of skin cancer in which the cells do not make any melanin. They can be pink, red, purple or of normal skin color, and are therefore difficult to diagnose correctly. They can occur anywhere on the body, just as a typic ...
.
*
Atrial myxoma
A myxoma is a rare benign tumor of the heart. Myxomata are the most common primary cardiac tumor in adults, and are most commonly found within the left atrium near the valve of the fossa ovalis. Myxoma may also develop in the other heart chambers. ...
*
Cutaneous myxoma
*
Odontogenic myxoma
Atrial myxoma
Myxomas are usually located in either the
left
Left may refer to:
Music
* ''Left'' (Hope of the States album), 2006
* ''Left'' (Monkey House album), 2016
* ''Left'' (Helmet album), 2023
* "Left", a song by Nickelback from the album ''Curb'', 1996
Direction
* Left (direction), the relativ ...
or
right atrium
The atrium (; : atria) is one of the two upper chambers in the heart that receives blood from the circulatory system. The blood in the atria is pumped into the heart ventricles through the atrioventricular mitral and tricuspid heart valves.
...
of the heart; about 86 percent occur in the
left atrium
The atrium (; : atria) is one of the two upper chambers in the heart that receives blood from the circulatory system. The blood in the atria is pumped into the heart ventricles through the atrioventricular mitral and tricuspid heart valves.
...
.
Myxomas are typically
pedunculated
A peduncle is an elongated stalk of tissue. Sessility is the state of not having a peduncle; a sessile mass or structure lacks a stalk.
In medicine, a mass such as a cyst or polyp is said to be ''pedunculated'' if it is supported by a peduncle ...
, with a stalk that is attached to the
interatrial septum
The interatrial septum is the wall of tissue that separates the right and left atria of the heart.
Structure
The interatrial septum is a that lies between the left atrium and right atrium of the human heart. The interatrial septum lies at ang ...
. The most common location for attachment of the stalk is the
fossa ovalis region of the interatrial septum.
An
atrial myxoma
A myxoma is a rare benign tumor of the heart. Myxomata are the most common primary cardiac tumor in adults, and are most commonly found within the left atrium near the valve of the fossa ovalis. Myxoma may also develop in the other heart chambers. ...
may create an extra
heart sound
Heart sounds are the noises generated by the beating heart and the resultant flow of blood through it. Specifically, the sounds reflect the turbulence created when the heart valves snap shut. In cardiac auscultation, an examiner may use a stetho ...
, audible to
auscultation
Auscultation (based on the Latin verb ''auscultare'' "to listen") is listening to the internal sounds of the body, usually using a stethoscope. Auscultation is performed for the purposes of examining the circulatory system, circulatory and resp ...
just after
S2. It is most seen on
echocardiography
Echocardiography, also known as cardiac ultrasound, is the use of ultrasound to examine the heart. It is a type of medical imaging, using standard ultrasound or Doppler ultrasound. The visual image formed using this technique is called an ec ...
, as a pedunculated mass that is heterogeneous in appearance. A left atrial myxoma will cause an increase in
pulmonary capillary wedge pressure.
The
differential diagnosis
In healthcare, a differential diagnosis (DDx) is a method of analysis that distinguishes a particular disease or condition from others that present with similar clinical features. Differential diagnostic procedures are used by clinicians to di ...
include other cardiac tumors such as
lipoma
A lipoma is a benign tumor made of adipose tissue, fat tissue. They are generally soft to the touch, movable, and painless. They usually occur just under the skin, but occasionally may be deeper. Most are less than in size. Common locations inc ...
s and
rhabdomyoma
A rhabdomyoma is a benign tumor of striated muscle. Rhabdomyomas may be either cardiac or extracardiac (occurring outside the heart). Extracardiac forms of rhabdomyoma are sub-classified into three distinct types: adult type, fetal type, and genita ...
s (and rarely
teratoma
A teratoma is a neoplasia, tumor made up of several types of biological tissue, tissue, such as hair, muscle, Human tooth, teeth, or bone. Teratomata typically form in the tailbone (where it is known as a sacrococcygeal teratoma), ovary, or test ...
s). These other tumors of the heart are typically not pedunculated, however, and are more likely to
infiltrate
Infiltration may refer to:
Science, medicine, and engineering
*Infiltration (hydrology), downward movement of water into soil
*Infiltration (HVAC), a heating, ventilation, and air conditioning term for air leakage into buildings
*Infiltration (me ...
the muscle of the heart. Cardiac
magnetic resonance imaging
Magnetic resonance imaging (MRI) is a medical imaging technique used in radiology to generate pictures of the anatomy and the physiological processes inside the body. MRI scanners use strong magnetic fields, magnetic field gradients, and ...
(MRI) can help non-invasively diagnose cardiac tumors. However, diagnosis usually requires examination of a
tissue sample
In medicine, sampling is gathering of matter from the body to aid in the process of a medical diagnosis and/or evaluation of an indication for treatment, further medical tests or other procedures. In this sense, the sample is the gathered matter ...
by a
pathologist
Pathology is the study of disease. The word ''pathology'' also refers to the study of disease in general, incorporating a wide range of biology research fields and medical practices. However, when used in the context of modern medical treatme ...
.
Treatment
Myxomas are usually removed surgically. The surgeon removes the myxoma, along with at least 5 surrounding millimeters of atrial septum. The septum is then repaired, using material from the
pericardium
The pericardium (: pericardia), also called pericardial sac, is a double-walled sac containing the heart and the roots of the great vessels. It has two layers, an outer layer made of strong inelastic connective tissue (fibrous pericardium), ...
.
Epidemiology
Cardiac myxomas predominantly appear in females in their 30s to 40s. Myxomas are the most common primary cardiac tumor affecting adults,
accounting for one quarter to half of primary cardiac tumors seen in clinical practice.
See also
*
Myxoid tumor
A myxoid tumor is a connective tissue tumor with a "myxoid" background, composed of clear, mucoid substance.
This tumoral phenotype is shared by many tumoral entities:
* Myxomas
** Atrial myxoma
** Odontogenic myxoma
** Cutaneous myxoma
** Intramu ...
*
Cutaneous myxoma
*
Carney complex
Carney complex and its subsets LAMB syndrome and NAME syndrome are autosomal dominant conditions comprising myxomas of the heart and skin, hyperpigmentation of the skin ( lentiginosis), and endocrine overactivity. It is distinct from Carney triad ...
*
Myxomatosis
Myxomatosis is a disease caused by '' Myxoma virus'', a poxvirus in the genus '' Leporipoxvirus''. The natural hosts are tapeti (''Sylvilagus brasiliensis'') in South and Central America, and brush rabbits (''Sylvilagus bachmani'') in North ...
*
Primary tumors of the heart
Primary tumors of the heart are extremely rare tumors that arise from the normal tissues that make up the heart. The incidence of primary cardiac tumors has been found to be approximately 0.02%. This is in contrast to secondary tumors of the heart, ...
*
Myxomatous degeneration
A myxoma (New Latin from Greek 'mucus') is a myxoid tumor of primitive connective tissue. It is most commonly found in the heart (and is the most common primary tumor of the heart in adults) but can also occur in other locations.
Types
Table ...
References
External links
*
Myxomatous degeneration at Wikidoc
{{Heart and thymus neoplasia
Heart neoplasia
Connective/soft tissue tumors and sarcomas