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Superficial acral fibromyxoma, also known as digital fibromyxoma, is a benign soft tissue tumor. The acral regions, including the palms, soles, fingers, toes, and nail units, are the commonly affected locations. The subungual region of the great toe is the most common site reported in current literature. The tumor is slowly progressive and benign in nature. Histology commonly reveals a fibromyxoid neoplasm with immunoreactivity to CD34 and CD99 markers. We present the case of a 39-year-old female with a nine-year history of repetitive digital trauma presenting with superficial acral fibromyxoma of the thumb-nail bed. Our case is unique due to the tumor location and the patient's prior long history of trauma to the tumor site. [ABSTRACT FROM AUTHOR]

Cardiac myxomas are rare tumors with risks of cardiac outflow obstruction and embolic events. Surgical excision of the tumor at the earliest is the definitive treatment. We report the successful anesthetic management of a 65-year-old female patient with incidental left atrial myxoma for right proximal femur nailing. The patient was asymptomatic with no significant cardiac history. Since fracture reduction cannot be deferred for a prolonged period, the case was taken up under general anesthesia with invasive blood pressure monitoring. [ABSTRACT FROM AUTHOR]

A study published in the British Journal of Surgery examined the use of BromAc, a combination of bromelain and N-acetylcysteine, in treating pseudomyxoma peritonei (PMP), a rare disease characterized by mucin-secreting tumor cells. The trial involved ten patients with recurrent and unresectable PMP who had previously undergone multiple surgeries. The results showed that BromAc treatment resulted in a partial response in 54.5% of treated masses, stabilization in 27.3% of masses, and progression in 18.2% of masses. While the study suggests that intratumoural BromAc may be a promising option for inoperable PMP, further research is needed to confirm these findings. [Extracted from the article]

Myxomas are the most common primary tumors of the adult heart and should be considered in the differential diagnosis of intracavitary cardiac masses, along with thrombi and vegetations.

ABSTRACT Different anesthetic agents are commonly used during procedures performed in aquaculture to minimize stress and maximize fish welfare during handling. A Kinguio fish was treated with a history of a mass near the left eye. In the clinical evaluation, a pedunculated neoformation was found in the periocular region. The fish was submitted to anesthesia for surgical removal of the mass, which was later referred to histopathological evaluation, revealing myxoma. The anesthesia protocol used 1% propofol at a concentration of 5 mg/liter of water and morphine at a dose of 5 mg/kg, intramuscularly. Immediately after the end of the procedure, the fish was returned to the aquarium and its anesthetic recovery was observed. The objective of this report is to describe a surgical procedure in kinguio fish and to determine the efficacy of propofol associated with morphine in this species. As a result, complete immobilization of the fish was obtained with propofol, reaching the fourth stage of anesthesia and the administration of morphine suggested being able to provide effective and long-lasting analgesia. It is concluded that despite the positive results obtained, anesthesia in fish still needs to be extensively investigated to refine analgesia protocols during procedures that cause pain and stress.

Mohamed Omar Hassan,1 Lütfi Öcal,1 Mohamud Mire Waberi,1 Abdijalil Abdullahi Ali,2 Nasra Mohamud Hilowle,3 Said Abdirahman Ahmed1 1Department of Cardiology, Mogadishu Somali Turkish Training and Research Hospital, Mogadishu, Somalia; 2Department of Cardiovascular Surgery, Mogadishu Somali Turkish Training and Research Hospital, Mogadishu, Somalia; 3Department Anesthesia and Reanimation, Mogadishu Somali Turkish Training and Research Hospital, Mogadishu, SomaliaCorrespondence: Said Abdirahman Ahmed, Tel +252615583381, Email saciidcabdi114@gmail.comIntroduction and Importance: A pseudoaneurysm of the left ventricle (LV) is a partial cardiac rupture surrounded by a pericardium that retains a connection with the LV lumen.Case Presentation: We present here a 30-year-old patient who came to our clinic for a routine check-up with no symptoms or complaints. After performing echocardiography, the patient’s echocardiography demonstrated a left ventricular pseudo-aneurysm which had collected a massive amount of thrombus. Three years earlier, the patient had a left atrial myxoma excision with mechanical mitral valve replacement following a presentation with shortness of breath.Clinical discussion: Left ventricular pseudo-aneurysm is a hazardous complication of mostly myocardial infraction and certain cardiac procedures, such as mitral valve replacement, where it may lead to thrombus formation. Due to this condition’s serious risk of lethal rupture and embolization from thrombus formation, as in our case, immediate surgical intervention is essential for its treatment.Conclusion: Left ventricular pseudo-aneurysm is an abnormal finding post-cardiac surgery, and it should be considered during patient evaluation after the surgery immediately and later in life.Keywords: myxoma, pseudo-aneurysm, mitral valve, mechanical valve

BackgroundPrimary cardiac tumors are uncommon, with the majority being benign myxomas. Cystic myxoma, a particularly rare type of benign cardiac tumor, demands cautious differential diagnosis from other cardiac tumors.Case summaryA 43-year-old male patient presenting with intermittent dyspnea was referred to our department for surgical evaluation. Transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) unveiled an intra-left atrial cyst, which was subsequently found to be blood-filled during a video-assisted microinvasive heart surgery. Pathological examination depicted a cyst wall filled with small stellate and fat spindle cells, along with a mucoid matrix, indicating a diagnosis of cystic myxoma.ConclusionsWe herein presented a rare case of an adult patient with cystic myxoma, initially misdiagnosed as an intracardiac blood cyst (CBC) prior to surgery, and ultimately verified via pathological findings.

We report two cases of rare invasive tumors presenting with transvenous and intracardiac extensions. In one instance, an unusual invasive thymoma type A penetrated into the heart chamber; the other case was an extension of a myxoma into the right atrium that was associated with superior vena cava syndrome. Our interest was stimulated by the rarity of these clinicopathological observations and the unusual clinical features of diagnostic and therapeutic methods presented by these cases.

Aggressive angiomyxoma (AA) is a rare mesenchymal neoplasm, which is commonly diagnosed in females and located in the perineal and pelvic region. Tissue specimens of AA patients often show positivity for estrogen (ER) and progesterone receptors (PgR), while some cases of androgen receptor (AR) positivity have been reported in males. When feasible, surgical excision represent the most effective treatment of AA; however, when experiencing advanced or recurrent disease, local disease control could be achieved with systemic hormonal treatment. To date, evidence regarding AA management in male patients is scarce, and only a few cases have been reported in literature. Hereby, we describe the case of a 59-year-old-man suffering from perineal AA with positivity for androgen receptors (AR) showing a long-lasting disease stability during the treatment with an AR-blocking drug (bicalutamide). A literature review regarding the state of art of AA management with a particular look to male patients is also provided.

Cardiac myxoma (CM) is a potentially life-threatening disease because frequently asymptomatic or debuts with aspecific manifestations. Definitive diagnosis is established by histopathological assessment including tumor and endothelial cell markers. To derive a specific panel of circulating cells antigenically detectable, pre-surgery peripheral blood samples of CM patients were analyzed. Pre-surgery peripheral blood samples from patients with CM were simultaneously analyzed for Circulating tumor cells (CTCs) and circulating endothelial cells (CECs) that were matched with tumor tissue profiles and with patient-derived xenografts (PDXs) distinguishing tumor regions. Moreover, CECs values in CM patients were further matched with CEC's levels in cardiovascular disease and control subjects. The blood-derived cytological specimens detected at least 1–3 CTCs/ml in 10 tested CM samples (p = 0.0001) showing specific CM features preserved in the central zones of the tumor. The central zone of the primary tumor, supported by a vessel density rate (55 ± 7%), with a proliferative profile of 32 ± 3% and a percentage of Calretininpos cells (p = 0.03), is the principal site of CTCs (r = 00) dissemination. The subsets of endothelial cells recognized in the blood were indifferent to their topological distribution within the tumor and corresponding PDXs. With further refinement and validation in large cohorts, multiparametric liquid biopsies can optimally integrate clinically informative datasets and maximize their utility in pre-surgery evaluation of CM patients. Blood-derived culture's protocol provides a versatile method capable of viable analysis of CTCs of non-hematological rare tumors which conventional antibody-mediated analytical platform is unable to perform. Distinctive blood- based cell phenotype contributes to differentiate CM from other differentials assuring its prompt surgical resection by combining blood-based cell biomarkers integrated with clinically informative datasets. [ABSTRACT FROM AUTHOR]

Carney complex (CNC) is an ultrarare disorder causing cutaneous and cardiac myxomas, primary pigmented nodular adrenocortical disease, hypophyseal adenoma, and gonadal tumours. Genetic alterations are often missed under routine genetic testing. Pathogenic variants in PRKAR1A are identified in most cases, while large exonic or chromosomal deletions have only been reported in a few cases. Our aim was to identify the causal genetic alteration in our kindred with a clinical diagnosis of CNC and prove its pathogenic role by functional investigation. Targeted testing of PRKAR1A gene, whole exome and whole genome sequencing (WGS) were performed in the proband, one clinically affected and one unaffected relative. WGS identified a novel, large, 10,662 bp (10.6 kbp; LRG_514t1:c.-10403_-7 + 265del; hg19, chr17:g.66498293_66508954del) deletion in the promoter of PRKAR1A in heterozygous form in the affected family members. The exact breakpoints and the increased enzyme activity in deletion carriers compared to wild type carrier were proved. Segregation analysis and functional evaluation of PKA activity confirmed the pathogenic role of this alteration. A novel deletion upstream of the PRKAR1A gene was proved to be the cause of CNC. Our study underlines the need for WGS in molecular genetic testing of patients with monogenic disorders where conventional genetic analysis fails. [ABSTRACT FROM AUTHOR]

Introduction: The incidence and prevalence of cardiac tumours remain one of the lowest amongst all tumours. The estimated prevalence of cardiac tumours is 0.001-0.03%, whereas metastatic involvement of the heart is far commoner, with an estimated prevalence between 2.3- 18.3%. Materials and methods: We retrospectively reviewed our experience with benign intracardiac tumours over a period of 1 year at a single center. There were 20 patients, all of whom were managed surgically. Here we discuss the clinical presentations, operative management, operative outcomes, and follow up of this select group of patients. Intracardiac tumours constitute a rare entity of cardiac disease. The presentations of this pathology can be extremely variable. Sometimes detection maybe incidental on routine evaluation and at times they may present with the aftermath of systemic embolization, or rarely causing mechanical obstruction impacting cardiac output and function. We focused on the variability of clinical presentations, operative methods, perioperative challenges, histopathological studies, operative outcomes and follow up data. The follow up period ranged from 7 months to 28 months (mean 16 months). Results: A total of 20 patients were evaluated. About 70% of these tumours were LA myxomas (14 patients). 8 of these LA myxomas presented with vague constitutional symptoms of fatigue, low grade fever and episodes of palpitations. The rest 6-two presented with features of CHF, two with history of stroke and two with history of acute aortobifemoral occlusion. Of the 14 patients, 10 were in atrial fibrillation. All LA myxomas were left sided, except two particular cases where the large tumour invaded the IAS completely and partially bulged upon the right atrial cavity. Conclusion: Benign cardiac tumours can have a wide array of clinical presentations. The histopathology of the tumour mass determines the outcomes in the immediate and long-term period. These tumours are usually operable with reasonably excellent surgical outcomes. Histopathologic study of the excised tumour mass is mandatory and helps determine the future treatment course. [ABSTRACT FROM AUTHOR]

Cortical lesions (CLs) detected with double inversion recovery (DIR) magnetic resonance imaging (MRI) are very helpful in differentiating multiple sclerosis (MS) from other neuroinflammatory diseases of the central nervous system (CNS), that is, neuromyelitis optica spectrum disorders (NMOSDs). Furthermore, CLs are closely related to motor and cognitive impairment. We report a case of a 48-year-old female MS patient who developed several CLs during anti-CD20 therapy. Some CLs disappeared during follow-up MRIs. In the suspicion of a treatment failure, the screening for the autologous hematopoietic stem cell transplant (AHSCT) was performed with the evidence of an atrial myxoma. In MS patients with new CLs, a comorbid ischemic pathology should be considered and carefully investigated. [ABSTRACT FROM AUTHOR]

Background Ebstein anomaly (EA) is a rare congenital abnormality of the tricuspid valve which can lead to progressive right heart dilatation and arrhythmias. While often seen in conjunction with other congenital cardiac lesions, such as atrial septal defects, it is not normally associated with atrial myxomas. Case summary We present a case report of an incidental finding of a right atrial myxoma in the context of undiagnosed EA, in a 16-year-old male who presented with appendicitis. Subtle cardiomegaly on routine chest X-ray prompted further investigation, which demonstrated characteristic findings of both conditions and culminated in surgical repair using the Cone procedure. At 4-month follow-up, the patient was asymptomatic, and transthoracic echocardiography demonstrated a mean gradient of 4.5 mmHg across the tricuspid valve with mild regurgitation. Discussion The combination of EA with right-sided myxoma is exceedingly rare, and, in this case, it may be that the apical displacement of the tricuspid valve was protective against right atrioventricular obstruction. We are reminded that although subtle abnormalities on routine investigations can be of limited significance, they can also indicate more serious underlying pathology and so consideration should be given to an appropriate cascade of further investigations to yield a timely diagnosis and enable prompt treatment. [ABSTRACT FROM AUTHOR]

Background: Sepsis and thrombo-embolic disease are well known complications of thalassemia major. Intracardiac thrombi are however rare and can lead to diagnostic dilemmas. Case presentation: We report the case of a 20-year-old female splenectomised thalassaemia major patient with severe iron overload, who presented with life threatening sepsis associated with a liver abscess. Discovery of a large oscillating intra cardiac lesion on 2D echocardiogram confirmed by Contrast Enhanced Computed Tomography (CECT) chest in the right atrium extending from the left hepatic vein through the inferior vena cava complicated the clinical course. After a prolonged Intensive Care Unit (ICU) stay supported with antibiotics and anticoagulation, she recovered with evidence of resolution of the intra cardiac thrombus. Conclusions: Early recognition and prompt aggressive treatment of sepsis in patients with thalassemia is essential to prevent complications. Intracardiac thrombosis is a potentially treatable cause for an intra cardiac mass in patients with thalassemia major, which should not be missed. [ABSTRACT FROM AUTHOR]

Background: The timing of cardiac surgery with cardiopulmonary bypass (CPB) for intracranial hemorrhage is controversial. Case presentation: We report the case of an 82-year-old woman who was transferred to our hospital because of a head injury. Brain computed tomography (CT) revealed traumatic intracranial hemorrhage, and transthoracic echocardiography revealed a giant right atrial myxoma. After confirming the disappearance of intracranial hemorrhage on brain CT, cardiac surgery with CPB was performed, which was uneventful. Conclusions: For an uneventful surgery, the optimal timing of cardiac surgery with CPB in patients with giant right atrial myxoma and intracranial hemorrhage should be based on brain CT. [ABSTRACT FROM AUTHOR]

Background: Redo heart surgery has become increasingly common but involves additional high surgical risk, especially redo surgery after coronary artery bypass grafting (CABG). Case presentation: In this study, we report the case of a 57-year-old Chinese male with left atrium myxoma who had previously undergone CABG. Common surgical methods usually include aortic cross-clamping, administering cold cardioplegia perfusion to protect the myocardium, opening the heart, and then removing the tumor. However, for patients with previous CABG, redo thoracotomy and ascending aortic cross-clamping present a greater risk of damage to the grafted vessels. In this study, we chose a right lateral mini-thoracotomy incision and hypothermia-induced ventricular fibrillation to minimize damage and avoid any adverse effects on the bridge vasculature. The patient recovered uneventfully and was discharged seven days after surgery. Conclusions: For patients with previous CABG, minimally invasive right thoracotomy under perfused ventricular fibrillation with hypothermia is safe and reliable and can prevent potential damage to the ascending aorta and graft. [ABSTRACT FROM AUTHOR]

Introduction: the most common primary cardiac tumors are myxomas, of which 75-85% are located in the left atrium and are prevalent in females. They may present with a triad of obstructive, embolism or constitutional symptoms. Case presentation: this study presents the case of a patient who, two years before being diagnosed with a cardiac myxoma, presented dyspnea that subsided with the use of a beta-blocker. After a surgical intervention, the symptoms of heart failure were exacerbated, and an echocardiogram showed a mass covering most of the left atrium and protruding through the mitral valve. Conclusion: the transthoracic echocardiogram is the first line of imaging for the diagnosis of myxoma. Magnetic resonance imaging (MRI) provides information on the location, size and characterization of the mass, in addition to helping the differential diagnosis with the presence of thrombus, essential data for the diagnosis approach and patient treatment. [ABSTRACT FROM AUTHOR]

An emergence of evidence suggests that severe COVID-19 is associated with an increased risk of developing breast and gastrointestinal cancers. The aim of this research was to assess the risk of heart tumors development in patients who have had COVID-19. Methods: A comparative analysis of 173 heart tumors was conducted between 2016 and 2023. Immunohistochemical examination with antibodies against spike SARS-CoV-2 was performed on 21 heart tumors: 10 myxomas operated before 2020 (the control group), four cardiac myxomas, one proliferating myxoma, three papillary fibroelastomas, two myxofibrosarcomas, one chondrosarcoma resected in 2022–2023. Immunohistochemical analysis with antibodies against CD34 and CD68 was also conducted on the same 11 Post-COVID period heart tumors. Immunofluorescent examination with a cocktail of antibodies against spike SARS-CoV-2/CD34 and spike SARS-CoV-2/CD68 was performed in 2 cases out of 11 (proliferating myxoma and classic myxoma). Results: A 1.5-fold increase in the number of heart tumors by 2023 was observed, with a statistically significant increase in the number of myxomas. There was no correlation with vaccination, and no significant differences were found between patients from 2016–2019 and 2021–2023 in terms of gender, age, and cardiac rhythm dis-orders. Morphological examination revealed the expression of spike SARS-CoV-2 in tumor cells, endothelial cells, and macrophages in 10 out of 11 heart tumors. Conclusion: The detection of SARS-CoV-2 persistence in endothelium and macrophages as well as in tumor cells of benign and malignant cardiac neoplasms, the increase in the number of these tumors, especially cardiac myxomas, after the pandemic by 2023 may indicate a trend toward an increased risk of cardiac neoplasms in COVID-19 patients, which re-quires further research on this issue and a search for new evidence. [ABSTRACT FROM AUTHOR]

We report a case of a 74-year-old man with diagnosis of concomitant primary cardiac tumor and right upper lobe of lung cancer. Both tumors were evaluated to be resectable with no further metastasis. A one-stage resection of both tumors through right mini-thoracotomy with endoscopic assistance was performed. The cardiac tumor resection during cardiopulmonary bypass was performed first, followed by right upper lobectomy and lymph nodes dissection with the same incision and position. Short-term results were satisfying and previous literature was reviewed to evaluate this method. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Embolic stroke may rarely be the first presenting symptom of atrial myxoma. Multiple infarcts should be evaluated for embolic causes. Correct etiological diagnosis in cardio‐embolic stroke guides proper management strategy. It reinforces on the importance of early echocardiogram in the initial evaluation of patients presenting with ischemic stroke. Atrial myxoma is a benign cardiac tumor found most commonly in the left atrium in 80% of the cases. Almost 1 in 10 myxomas are familial and are most common in women. Cardiac myxoma mostly present with dyspnea, fatigue, or palpitations. Previously undiagnosed left atrial myxoma (LA) presenting as stroke is extremely rare. Authors describe the case of a middle‐aged man with LA myxoma presenting with acute ischemic embolic stroke that was surgically excised. This case report emphasizes on the rare presentation as embolic stroke and the role of cardiac imaging in patients presenting with ischemic stroke. Early and coordinated teamwork among the neurologist, cardiologist, and cardiothoracic surgeon help establish the etiology and provide appropriate treatment. [ABSTRACT FROM AUTHOR]

The article describes a clinical case of a biauricular myxoma in a pediatric patient. Myxomas are benign tumors that occur most frequently in the left atrium, followed by the right atrium, and rarely in the left ventricle. In this case, the recurrence of a myxoma in a pediatric patient who had already undergone resection of a left ventricular myxoma is described. A surgical intervention was performed to remove the intracardiac tumors, and the patient had a postoperative course without complications. The article deals with atrial myxomas, which develop in the interatrial septum and occur in more than 75% of patients. [Extracted from the article]

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Background: Myxomas are the most prevalent type of heart tumors, mainly occurring in the left atrium, with approximately 20% of cases found in the right atrium. Timely diagnosis and appropriate management of myxomas are crucial for favorable outcomes and to minimize complications. Case presentation: A 77-year-old Asian male with no significant medical history presented with intermittent trepopnea and palpitations. Physical examination revealed regular heart sounds and no other relevant findings. A transthoracic echocardiogram showed a large, round-shaped, smooth-edged mass with diameter of 86 mm, occupying most of the right atrium. Mild tricuspid flow obstruction and mild left ventricular systolic dysfunction were also observed. Cardiac tomography confirmed the size, smooth edges, and showed microcalcifications of the mass, with no invasion of surrounding tissues. Surgical intervention successfully removed the spheroid mass, leading to the alleviation of symptoms. Histopathology confirmed the myxoma nature of the mass. A comprehensive discussion based on relevant medical literature is provided, with emphasis on echocardiographic characteristics of the mass with relation to potential embolic disease. Conclusion: This case shows an atypical presentation of an exceptionally large myxoma in the right atrium, resembling the size of a polo ball, in a patient presenting with supraventricular arrhythmia and trepopnea. Early diagnosis and appropriate management played a vital role in achieving a successful outcome for the patient. [ABSTRACT FROM AUTHOR]

A 41-year-old woman showed a palpable mass at the superonasal orbital edge on the right side. Magnetic resonance imaging demonstrated a lobulated fluid-containing tubular mass which extended anteriorly to posteriorly along the medial orbital wall, nasal to the eyeball. She was followed once a year for 8 years until the age of 49 years when she decided to undergo surgical resection because of the enlarged mass. The lobulated large mass was resected and the pathology showed sparsely distributed spindle cells, positive for CD34, in alcian blue-positive mucous substances, indicative of myxoma. Postoperative magnetic resonance imaging showed residual lobulated tubular mass along the optic nerve on the medial side and superior to the eyeball. The residual orbital mass showed stable structure with more evident connection with the ethmoid sinus lesion, suggestive of the ethmoid origin, in 12 years until the age of 61 years. In the review of 20 patients with orbital myxomas in the literature, in addition to this case, roughly classified locations in the orbit were retrobulbar in 8 patients, on the lateral side of the orbit in 4, on the superior side in 6, on the medial side in 1 (this patient), and in the orbit with no specific description in 2. In pathological examinations, immunohistochemistry was not done in 8 patients, done but all negative in 2, and positive in 11 patients: nerve sheath myxoma was diagnosed in 3 patients based on positive S100 staining. Orbital myxoma is rare but considered in differential diagnosis of orbital masses. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Cardiac myxoma is a rare benign cardiac tumor observed in approximately 0.5–1 case per 1 million people per year. The aim of this study is to review our 12-year experience in the surgical treatment of cardiac myxoma with an emphasis on the clinical, pathologic, diagnostic, and surgical features. METHODS AND PATIENTS: From January 2010 to December 2022, 90 patients (0.67 %) with cardiac myxomas were surgically treated in our institute. Patients´ demographics, cardiac and surgical medical history, surgical procedures, and pre- and post-operative data were analyzed. The median follow-up time was 76 (1–216) months. RESULTS: The mean age of the patients was 59.4 ± 13.5 years, with a higher prevalence of women. The most common preoperative symptoms were arterial embolism and dyspnea, and 35.6 % of patients were asymptomatic. Only 8.9 % of the patients had systemic and constitutional manifestations. The most common location of cardiac myxoma was in the left atrium, followed by the right atrium. Recurrent myxoma developed in 3 patients (2.7 %), and the mean time of recurrence was 55 ± 19.7. Hospital and long-term mortality were 2.2 % and 15.6 %, respectively. CONCLUSION: Cardiac myxoma is the most common heart tumor with a low incidence. Surgical excision yields very good short and long-term outcomes with low recurrence rate after surgery, and remains the treatment of choice (Tab. 4, Fig. 2, Ref. 13). Text in PDF www.elis.sk. [ABSTRACT FROM AUTHOR]

Cardiac myxoma is a very rare benign cardiac neoplasm. Its annual incidence globally is between 0.5 to 1 case per one million individuals. It has a 0.03% prevalence rate in the general population. It commonly occurs in the left atrium, but can also be located in the other heart chambers. Its clinical presentations are variable, non-specific, and can mimic various cardiovascular and systemic diseases, posing a diagnostic dilemma. Thus, a high index of suspicion with appropriate use of radiologic and laboratory diagnostic tools is essential for its accurate diagnosis and management. The diagnosis and management of a rare case of left atrial myxoma in a middle-aged African woman who presented with heart failurelike symptoms, features of acute pulmonary edema, and syncope is presented in this literature. The diagnosis was suspected following echocardiography. The tumor was surgically excised, and the diagnosis was confirmed histopathologically. The patient's post-operative condition has been excellent. [ABSTRACT FROM AUTHOR]

Atrial myxomas are the most common cardiac tumors, rarely presenting with both systemic embolization and intracranial aneurysms. A 34-year-old woman presented with acute limb ischemia of both lower limbs and right upper limb and on evaluation was diagnosed with left atrial myxoma and intracranial aneurysms. She underwent embolectomy and intracranial aneurysm repair followed by successful excision of left atrial myxoma after 4 weeks. This case is reported for the rare association of myxoma with intracranial aneurysm along with systemic embolization which has not been reported in the literature. [ABSTRACT FROM AUTHOR]

Human rhabdomyosarcomas are rarely cured by surgical resection alone. This is also true for high-grade soft tissue sarcomas in dogs. Dogs with spontaneous sarcoma are good models for clinical responses to new cancer therapies. Strategic combinations of immunotherapy and oncolytic virotherapy (OV) could improve treatment responses in canine and human cancer patients. To develop an appropriate combination of immunotherapy and OV for dogs with soft tissue sarcoma (STS), canine cancer cells were inoculated with myxoma viruses (MYXVs) and gene transcripts were quantified. Next, the cytokine concentrations in the canine cancer cells were altered to evaluate their effect on MYXV replication. These studies indicated that, as in murine and human cells, type I interferons (IFN) play an important role in limiting MYXV replication in canine cancer cells. To reduce type I IFN production during OV, oclacitinib (a JAK1 inhibitor) was administered twice daily to dogs for 14 days starting ~7 days prior to surgery. STS tumors were excised, and MYXV deleted for serp2 (MYXV∆SERP2) was administered at the surgical site at two time points post-operatively to treat any remaining microscopic tumor cells. Tumor regrowth in dogs treated with OV was decreased relative to historical controls. However, regrowth was not further inhibited in patients given combination therapy. [ABSTRACT FROM AUTHOR]

Objective: Myxomas are uncommon in the pediatric age group. However, acute cerebral infarcts in children are most often secondary to a myxoma. Early diagnosis is essential in such cases to prevent further such episodes, thereby decreasing the risk of permanent neurological deficits. In the pediatric age group, a high index of suspicion is required to diagnose such rare causes. Most myxomas are benign in nature, and hence surgery can offer complete curative resection and also help avoiding further incidents of cerebrovascular accidents (CVA). Here, we present an interesting case of an 8-year-old female child who presented with acute right-sided hemiplegia and was incidentally detected with a left atrial myxoma. Case presentation: An 8-year-old female presented to the emergency department with the complaint of loss of consciousness for 1 hour. There was no preceding history of trauma and no associated seizures. Computed tomography and magnetic resonance imaging of brain revealed an acute thalamic infarct and 2D echocardiography showed a mass lesion in the left atrium. Mass was excised, and histopathology confirmed it as a benign myxoma. Conclusion: Myxomas are a rare cause of CVA in children, making the diagnosis challenging. A high index of suspicion with a multidisciplinary approach is necessary for early diagnosis and appropriate management of such cases. [ABSTRACT FROM AUTHOR]

Cardiac masses are at the attention of health specialists since the development of echocardiography. Even though imaging is an excellent tool for diagnosis, the clinical presentation, risk factors, and hemodynamic status of the patients are important in establishing the diagnosis and subsequent management. The purpose of this presentation is to assess the difficulty of diagnosis in the case of an intracardiac mass and its therapeutic management.

Abstract Purpose Cardiac myxoma (CM), the most common cardiac tumor in adults, accounts for 50–75% of benign cardiac tumors. The diagnosis of CM is often elusive, especially in young stroke survivors and transthoracic echocardiography (TTE) is the initial technique for the differential diagnostics of CM. Less invasive cardiac computed tomography (CT) and magnetic resonance imaging (MRI) are not available for the majority of cardiac patients. Here, a robust imaging approach, ortho-Positronium (o-Ps) imaging, is presented to determine cardiac myxoma extracted from patients undergoing urgent cardiac surgery due to unexpected atrial masses. We aimed to assess if the o-Ps atom, produced copiously in intramolecular voids during the PET imaging, serves as a biomarker for CM diagnosing. Methods Six perioperative CM and normal (adipose) tissue samples from patients, with primary diagnosis confirmed by the histopathology examination, were examined using positron annihilation lifetime spectroscopy (PALS) and micro-CT. Additionally, cell cultures and confocal microscopy techniques were used to picture cell morphology and origin. Results We observed significant shortening in the mean o-Ps lifetime in tumor with compare to normal tissues: an average value of 1.92(02) ns and 2.72(05) ns for CM and the adipose tissue, respectively. Microscopic differences between tumor samples, confirmed in histopathology examination and micro-CT, did not influenced the major positronium imaging results. Conclusions Our findings, combined with o-Ps lifetime analysis, revealed the novel emerging positronium imaging marker (o-PS) for cardiovascular imaging. This method opens the new perspective to facilitate the quantitative in vivo assessment of intracardiac masses on a molecular (nanoscale) level.

Abstract:

Cardiac myxoma is the most common primary benign cardiac tumors, mostly found in the left atrium. It was previously reported that the main component of myxoma was myxoid stroma riched in acid‐mucopolysaccharide, the blood vessels in which were sparsely distributed, being characterized as hypovascular tumor by contrast echocardiography (CE) and computed tomography angiography (CTA). There are few reports of myxoma with rich blood supply and we report one in the left atrium. [ABSTRACT FROM AUTHOR]

A 51-year-old male with a complicated medical history presented with shortness of breath. Preoperative workup confirmed the presence of a large atrial mass. However, delayed gadolinium enhancement CMR with long inversion time (TI 600) showed lack of enhancement, which was suggestive of a thrombus. During cardiac magnetic resonance imaging, delayed gadolinium enhancement sequences with long inversion time (TI 600) are commonly used to distinguish between an avascular thrombus versus a vascular tumor. [ABSTRACT FROM AUTHOR]

A 56-year-old male presented with a multi-territorial stroke without traditional cerebrovascular risk factors. A transesophageal echocardiogram revealed an intracardiac lesion attached to the lateral wall of the left atria, consistent with an atrial myxoma. Surgical excision of the lesion was performed and revealed that lesion was in fact a papillary fibroelastoma with thrombus attached, which demonstrates a novel mechanism by which intracardiac masses can cause cerebral events. [ABSTRACT FROM AUTHOR]

This article discusses a rare case of atrial myxoma, a type of heart tumor, presenting as bilateral cerebellar infarct and mitral obstruction. The patient, a hypertensive septuagenarian, experienced acute dizziness and vomiting and was diagnosed with a stroke. Imaging tests revealed infarcts in both cerebellar hemispheres, and a cardiovascular examination identified a mass in the left atrium causing obstruction. The diagnosis was confirmed by cardiac MRI, and the patient is now awaiting myxoma excision. The article emphasizes the importance of routine cardiac evaluation in cases of ischemic stroke, especially when it is bilateral. [Extracted from the article]

Objective: Cardiac tumors are rare pathology, and myxoma is the most frequently encountered. Co-existence of double myxoma or right heart and coronary artery disease is a rare condition. The aim of our case report is to demonstrate a case with successful simultaneous surgical removal of myxoma and CABG in a patient with double myxoma of right heart and severe mutlivessel coronary artery disease, concomitant type 2 diabetes and heart failure. Case presentation: A 68-year-old patient was admitted with typical complaints of severe shortness of breath, palpitations, lack of air, pain in the heart, weakness. From the anamnesis, it was revealed that the above complaints appeared over the past 4 years, he had also diabetes. Patients had NYHA functional class III-IV. Echocardiography revealed a large mobile mass in the cavity of the right atrium and right ventricle, periodically obturating the right atrioventricular orifice. Coronary angiography displayed mutlivessel coronary artery disease. We performed the simultaneous operation of double myxoma removal and coronary bypass surgery – arterial graft – left internal mammary artery to left anterior descending artery and venous graft from aorta to posterior descending artery under cardiopulmonary bypass. The surgery was successful and without complication The patient was transferred from intensive care unit to ward on the 4th day after surgery and was discharged on the 10th day. Conclusion: Our case confirms the possibility of successful surgical treatment of several severe pathologies of the cardiovascular system as double myxoma removal and coronary bypass surgery, with the right choice of surgical tactics and well-coordinated work of a team of cardiac surgeons, cardiac anesthesiologists, perfusionists, cardiologists, and reanimatologists