Cardiac Myxoma: Typical Presentation but Unusual Histology

Area of Science:

• Cardiovascular Pathology
• Surgical Oncology

Background:

• Cardiac myxoma is the most common primary heart tumor.
• Glandular differentiation in cardiac myxoma is rare, occurring in approximately 3% of cases.
• This differentiation can pose diagnostic challenges, potentially mimicking metastatic adenocarcinoma.

Observation:

• A 43-year-old male presented with shortness of breath and cardiac findings suggestive of a mass.
• Echocardiography revealed a large interatrial septum mass, diagnosed as cardiac myxoma.
• Surgical resection allowed for detailed microscopic examination.

Findings:

• Microscopic analysis confirmed a biphasic tumor: typical myxoma and a distinct glandular component.
• The glandular component featured acini lined by columnar epithelial cells with mucin production.
• The patient experienced an uneventful recovery and remained well at nine-month follow-up.

Implications:

• Highlights the importance of recognizing rare histological variants of cardiac myxoma.
• Emphasizes the need for careful histopathological evaluation to avoid misdiagnosis, particularly in patients with a history of malignancy.
• Underscores the benign nature and favorable prognosis of completely resected cardiac myxoma with glandular differentiation.