Myxoma differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Ph.D. [2] Ahmad Al Maradni, M.D. [3] Maria Fernanda Villarreal, M.D. [4]

Overview

Cardiac myxoma should be differentiated from other cardiac tumors including papillary fibroelastoma, lipoma, rhabdomyoma, rhabdomyosarcoma, and cardiac metastasis. Primarily, cardiac myxoma should be differentiated from other diseases that more commonly cause mitral valve obstruction and embolic events,such as thrombi or infectious endocarditis.[1]

Differentiating Myxoma from other Diseases

Differential diagnosis of intracardiac masses requires histological analysis (myxoma requires the presence of lepidic cells and the absence of mitosis) and a direct assessment of the specific location (endocardial/myocardial/pericardial.

The differential diagnosis include other cardiac tumors, such as:

  • Is a benign tumor of the valvular endocardium, with an average onset in adults (˜60 years). In contrast with cardiac myxomas, papillary fibroelastoma tend to be smaller in size, the tumor is usually 1–2 cm in size.
  • Also known as "Lipomatous hypertrophy (LHIS)" is a very rare benign proliferation of mature adipocytes.Lipomas are typically found in adult patients but can affect all ages. A common clinical feature is arrythmias.
  • Is the most common primary cardiac tumor in children. It is conformed from hamartomatous accumulation of the striated cardiomyocytes. Rhabdomyomas occur with more frequently in the myocardium of the left ventricle or in the interventricular septum. Is associated with tuberous sclerosis, and congenital defects of the heart.

References

  1. Hartig I, Kraatz EG, Beurich HW, Moosig F (2014). "[Atrial myxoma with clinical signs of systemic inflammatory disease.]". Z Rheumatol. doi:10.1007/s00393-013-1347-y. PMID 24599357.


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