Myxoma
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2008-07-03T19:05:15Z
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{{DiseaseDisorder infobox |
Name = Myxoma |
ICD10 = {{ICD10|D|15|1|d|10}} |
ICD9 = {{ICD9|212.7}} |
ICDO = 8840/0 |
Image = |
Caption = |
OMIM = 255960 |
OMIM_mult = |
MedlinePlus = |
eMedicineSubj = med |
eMedicineTopic = 186 |
DiseasesDB = 30736 |
MeshID = D009232 |
}}
A '''myxoma''' (''Myxo-'' = New Latin from Greek [[muxa]] for [[mucus]]) is a tumor of primitive [[connective tissue]].<ref>{{Dorlands|m_25|12557169}}</ref> It is the most common primary [[tumor]] of the [[heart]], but can also occur in other locations.
The phrase "myxomatous degeneration" refers to the process in which [[connective tissue]] becomes filled with [[mucus]].
==Location==
Myxomas are usually located in either the [[left atrium|left]] or [[right atrium]] of the heart; about 86 percent occur in the [[left atrium]].<ref name="pmid3188128">{{cite journal |author=Knepper LE, Biller J, Adams HP, Bruno A |title=Neurologic manifestations of atrial myxoma. A 12-year experience and review |journal=Stroke |volume=19 |issue=11 |pages=1435–40 |year=1988 |pmid=3188128 |doi=}}</ref>
Myxomas are typically [[peduncle (anatomy)|pedunculate]]d, with a stalk that is attached to the [[interatrial septum]]. The most common location for attachment of the stalk is the [[fossa ovalis]] region of the interatrial septum.
About 71% of myxomas occur in the heart, 41% on the skin, and 7% in the [[oral cavity]] (usually on the [[palate]]).
== Diagnosis ==
An atrial myxoma may create an extra heart sound, audible to auscultation just after S2.
It is most seen on [[echocardiography]], as a pedunculated mass that is heterogeneous in appearance.
The [[differential diagnosis]] include other cardiac tumors such as [[lipoma]]s and [[rhabdomyoma]]s. These other tumors of the heart are typically not pedunculated, however, and are more likely to infiltrate the muscle of the heart. Cardiac Magnetic resonance Imaging can help non-invasively diagnose cardiac tumors.
== Symptoms ==
Symptoms associated with cardiac myxomas are typically due to the effect of the mass of the tumor obstructing the normal flow of blood within the chambers of the heart.
Some symptoms of myxoma may be associated with the release of [[interleukin 6]] (IL-6) by the myxoma.<ref name="Seino-IL6">{{cite journal | author=Seino Y, Ikeda U, Shimada K. | title=Increased expression of interleukin 6 mRNA in cardiac myxomas | journal=Br Heart J | year=1993 | volume=69 | issue=6 | pages=565–7 | pmid=8343326 | doi=10.1136/hrt.69.6.565}}</ref><ref name="Jourdan-IL6">{{cite journal | author=Jourdan M, Bataille R, Seguin J, Zhang XG, Chaptal PA, Klein B | title=Constitutive production of interleukin-6 and immunologic features in cardiac myxomas| journal=Arthritis Rheum | year=1990 | volume=33 | issue=3 | pages=398–402 | pmid=1690543 | doi=10.1002/art.1780330313}}</ref> High levels of IL-6 may be associated with a higher risk of embolism of the myxoma.<ref name="Wada-IL6">{{cite journal | author=Wada A, Kanda t, Hayashi R, et al. | title=Cardiac myxoma metastasized to the brain: potential role of endogenous interleukin-6 | journal=Cardiology | year=1993 | volume=83 | issue=3 | pages=208–11 | pmid=8281536 | doi=10.1159/000015180}}</ref>
Symptoms of a cardiac myxoma include<ref name="Fisher-Cardiacmyxoma">{{cite journal | author=Fisher J. | title=Cardiac myxoma | journal=Cardiovasc Rev Rep | year=1983 | issue=4 | pages=1195–9}}</ref>:
* [[Dyspnea]] on exertion
* Paroxysmal dyspnea
* [[Fever]]
* [[Weight loss]]
* Lightheadedness or [[syncope]] (Loss of consciousness)
* [[Hemoptysis]]
* Sudden death
== Treatment ==
Myxomas are usually removed surgically. The surgeon removes the myxoma, along with at least 5 surrounding milimeters of atrial septum. He will then repair the septum using material from the pericardium.
== See also ==
* [[Carney complex]]
* [[Myxomatosis]]
* [[Primary tumors of the heart]]
==References==
{{reflist|2}}
== External links ==
* {{GPnotebook|-435814399}}
* {{MerckHome|03|031|b}}
[[Category:Cardiology]]
{{circulatory-stub}}
{{Soft tissue tumors and sarcomas}}
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