Fig. 19.1
Contrast-enhanced chest CTA axial images show a low-density lobulated mass (black arrows) in the right atrium, extending through the tricuspid valve into the right ventricle (blue arrow) in a teenage patient diagnosed with atrial myxoma
Smooth contour; some masses may be villous in appearance
Pulmonary infarcts or other evidence of emboli
Intratumoral calcification
Possible protrusion of mass through atrioventricular (AV) valves on gated imaging [3]
19.2.4 MRI Findings
19.2.5 Echocardiography Findings
Narrow stalk
Hyperechoic mass in characteristic location, which may contain calcifications
May have internal lucencies
Dynamic tumor [6]
19.2.6 Imaging Recommendations
MRI and echocardiography are valuable in evaluating characteristic and dynamic features.
19.3 Differential Diagnosis
Rhabdomyoma
Hypertrophic cardiomyopathy
Metastatic disease
Rhabdomyosarcoma
Fibroma
Lipoma
Thrombus
19.4 Pathology
The intracavitary cardiac mass is often based in the atrium and results in symptoms of outflow obstruction.
19.4.1 Etiology
The etiology is unknown. Cardiac myxomas are of often sporadic; up to 7 % have a familial association, and there may be an association with Carney complex [3], an autosomal dominant condition resulting in recurrent myxomas, skin lesions, endocrine neoplasms, testicular cancers, or schwannomas. Other associated syndromes include LAMB (lentigines, atrial myxoma, blue nevi) and NAME (nevi, atrial myxoma, myxoid neurofibroma, and ephelides).
19.4.2 Frequency
Cardiac myxoma is common in adults but also occurs in the pediatric population. It is the third most common benign tumor in children, but is almost never seen in fetuses or infants.
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