[Cardiac myxoma: biological features, morphology, differential diagnosis]

Area of Science:

• Cardiovascular Pathology
• Oncology
• Histopathology

Background:

• Cardiac myxoma is the most common primary benign heart tumor, accounting for up to 85% of cases.
• Despite its benign morphology, cardiac myxoma's intracardiac location in blood flow can lead to aggressive clinical manifestations.
• The histogenesis of cardiac myxoma remains debated, with theories suggesting endocardial mesenchymal stem cell origin.

Purpose of the Study:

• To review the morphology, clinical presentation, and immunohistochemical parameters of cardiac myxoma.
• To explore the mechanisms of tumor spread and recurrence in cardiac myxoma.
• To clarify the factors contributing to the perceived malignancy of cardiac myxoma.

Main Methods:

• Literature review of morphology, clinical behavior, and immunohistochemistry of cardiac myxoma.
• Analysis of reported cases focusing on recurrence, multifocality, and metastatic-like spread.
• Examination of characteristic histological features, including myxoma cells, ring structures, Gamna-Gandy bodies, calcification, and thrombosis.

Main Results:

• Cardiac myxoma exhibits specific morphological features, including myxoma cells and characteristic secondary signs like Gamna-Gandy bodies and calcification.
• Clinical behavior, marked by recurrence and multifocality, often mimics malignancy despite benign histology.
• Mechanisms of tumor spread, similar to metastasis, contribute to its aggressive presentation.

Conclusions:

• The clinical behavior, rather than histology, primarily defines the "malignancy" of cardiac myxoma.
• Understanding the specific morphology and spread mechanisms is crucial for managing cardiac myxoma.
• Further research into histogenesis may elucidate tumor behavior and inform treatment strategies.