Villiform cardiac myxoma with atypical glandular differentiation in a young girl: a case report

Sangram Keshari Behera ¹, Debahuti Mohapatra ², Debirupa De ²

⁰Department of Cardiothoracic Vascular Surgery, IMS & SUM Hospitals, Siksha O Anusandhan University, Bhubaneswar, Odisha, India.

Journal of Medical Case Reports +

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April 24, 2025

View abstract on PubMed

Summary

Cardiac myxomas with glandular differentiation are rare, accounting for ≤3% of cases. This case highlights a villiform cardiac myxoma with atypical glandular features, initially misdiagnosed as adenocarcinoma.

Area Of Science

Cardiovascular Pathology
Histopathology
Oncology

Background

Cardiac myxomas are rare primary heart tumors, typically benign.
Glandular differentiation within cardiac myxomas is exceptionally uncommon, seen in ≤3% of cases.
Cellular atypia mimicking adenocarcinoma is an extremely rare feature in cardiac myxomas.

Purpose Of The Study

To report a rare case of cardiac myxoma with villiform and atypical glandular differentiation.
To emphasize the diagnostic challenges posed by such rare histological features.
To highlight the importance of comprehensive diagnostic methods in differentiating from metastatic adenocarcinoma.

Main Methods

Histopathological examination of cardiac tumor tissue.
Immunohistochemical analysis to assess cellular markers.
Radiological correlation for anatomical and pathological context.

Main Results

A 16-year-old Indo-Aryan female presented with a cardiac myxoma.
The tumor exhibited villiform architecture and atypical glandular differentiation.
Initial routine histology led to a misdiagnosis of metastatic adenocarcinoma.

Conclusions

Accurate diagnosis of cardiac myxoma with glandular differentiation requires thorough histopathological evaluation.
Immunohistochemistry and radiological correlation are crucial to avoid misdiagnosis of metastatic adenocarcinoma.
This case underscores the importance of considering rare differentials in cardiac pathology.

Keywords:

Cardiac myxoma Glandular differentiation Immunohistochemistry