Swinging Mass Through the Pulmonary Valve: A Rare Case of Right Ventricular Myxoma

Primary cardiac tumors are rare, with an estimated incidence of 0.001% to 0.3% in autopsy series. Most are benign, the most common being cardiac myxomas, which typically originate in the left atrium. Right ventricular myxoma is among the rarest primary cardiac tumors, and its true incidence is difficult to determine, as most data come from isolated case reports. This paper aims to report a case of right ventricular myxoma in a young woman with a history of childhood malignancy and to discuss the possible association between the two conditions. Echocardiography, thoracic computed tomography (CT), and pulmonary CT angiography were used to assess the presence, location, and size of the tumor. The definitive diagnosis was established by histopathological examination. A 34-year-old woman, with a past medical history of acute lymphoblastic leukemia (ALL) in childhood, presented with a dry cough and exertional dyspnea persisting for three weeks. Transthoracic echocardiography revealed a mass located in the right ventricular outflow tract (RVOT), attached near the tricuspid valve and intermittently prolapsing into the pulmonary trunk. CT imaging confirmed the presence of the tumor in the RVOT and the main pulmonary artery. Because of the high risk of massive pulmonary embolism, the patient underwent urgent surgical excision of the tumor. Histopathological analysis confirmed the diagnosis of cardiac myxoma. The postoperative recovery was uneventful, and the three-month follow-up showed no recurrence or signs of pulmonary embolism. The patient's history of ALL raised the question of a possible association; however, a review of the literature revealed no previously reported link. In conclusion, right ventricular myxomas are extremely rare. The occurrence of cardiac myxoma in this patient following childhood ALL appears to be incidental. Further research is needed to determine whether ALL survivors have an increased predisposition to subsequent cardiac tumors.