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Atrial myxomas are at once both the most common primary tumor of the heart, and quite rare. Myxomas are tumors composed of primitive connective tissue cells and stroma; their diagnosis on purely clinical grounds is extremely difficult. However, with the advent of echocardiography, they are seen quite easily, and surgical removal is possible. Most myxomas occur sporadically, but some patients have myxomas as a part of a triad which also includes endocrine hyperactivity and spotty pigmentation on the skin. The endocrine hyperactivity include adrenal hyperactivity and resembles Cushing's syndrome. In these cases, the myxomas are often multifocal, recurrent, or familial. This triad is called 'Swiss syndrome' by some. Recognizing the triad is important, since within Swiss syndrome the potential for rapid recurrence of the myxoma is great. In two patients, the tumor was seen to recur 6 and 18 months after surgical removal, a rapidity which seems peculiar to myxomas occurring in Swiss syndrome. The patients were 19 and 34 years old; some studies have indicated that typical myxomas are more common among older patients. The discovery of a myxoma in a younger patient should alert the clinician to the possibility of rapid recurrence, endocrine problems, or the occurrence of myxoma in other family members. (Consumer Summary produced by Reliance Medical Information, Inc.)