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, 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 table below summarizes the findings that differentiate cardiac myxoma from other conditions that are also intracavitary cardiac masses and cause embolic events:
| Disease | Findings |
|---|---|
| Papillary fibroelastoma | Is a rare benign primary tumor of the heart that typically involves one of the valves of the heart. Presents with syncope, chest pain, myocardial infarction, stroke and sudden cardiac death. They are the third most common type of primary tumor of the heart. There is a slightly increased male predilection.[2][3] |
| Lipoma | Also known as "Lipomatous hypertrophy (LHIS)" is a very rare benign primary cardiac neoplasm. It is the proliferation of mature adipocytes. Lipomas are typically found in adult patients but can affect all ages. A common clinical feature is arrythmias.[4] |
| Rhabdomyoma | Is the most common primary cardiac tumor in children. It is conformed from hamartomatous accumulation of the striated cardiomyocytes. Rhabdomyomas occur with more frequency in the myocardium of the left ventricle or in the interventricular septum. Is commonly associated with tuberous sclerosis, and congenital defects of the heart.[5] |
| Thrombus | Intracardiac thrombi, can occur when there is an elevated risk of blood clots developing, such as: atrial fibrillation (atrial thrombi predominate), mitral stenosis, heart valve replacement and myocardial infarction(ventricular thrombus formation).[6] |
| Metastasis | Secondary malignant tumor of the heart, arising by lymphatic or haematogenous spread of a primary neoplasm. Presents with dyspnea,congestive heart failure, hypotension and malignant pericardial effusion. The most common primary any primary malignancy may metastasize to the heart, however, lung cancer is among the most common.[7] |
References
- ↑ 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.
- ↑ Papillary fibroelastoma of the heart http://radiopaedia.org/articles/papillary-fibroelastoma-of-the-heart Accessed on November 24,2015
- ↑ Papillary fibroelastoma Wikipedia.https://en.wikipedia.org/wiki/Papillary_fibroelastoma Accessed on November 24,2015
- ↑ Lipoma.Radiopedia.http://radiopaedia.org/articles/cardiac-lipoma Accessed on November 24, 2015
- ↑ Rhabdomyoma. t Wikipedia.https://en.wikipedia.org/wiki/Rhabdomyoma Accessed on November 24, 2015
- ↑ Intracardiac thrombi. Radiopedia.http://radiopaedia.org/articles/intracardiac-thrombi Accessed on November 24, 2015
- ↑ Secondary cardiac neoplasm.Radiopedia.http://radiopaedia.org/articles/intracardiac-thrombi Accessed on November 24, 2015