RT Book, Section
A1 Kiefer, Todd
A1 Granger, Christopher B.
A1 Jackson, Kevin P.
A2 Papadakis, Maxine A.
A2 McPhee, Stephen J.
A2 Rabow, Michael W.
A2 McQuaid, Kenneth R.
SR Print(0)
ID 1193148401
T1 Primary Cardiac Tumors
T2 Current Medical Diagnosis & Treatment 2023
YR 2023
FD 2023
PB McGraw-Hill Education
PP New York, NY
SN 9781264687343
LK accessmedicine.mhmedical.com/content.aspx?aid=1193148401
RD 2024/04/19
AB Primary  cardiac  tumors  are  rare  and  constitute  only  a  small  fraction  of  all  tumors  that  involve  the  heart  or  pericardium.  The  most  common  primary  tumor  is  atrial  myxoma;  it  comprises  about  50%  of  all  tumors  in  adult  case  series.  It  is  generally  attached  to  the  atrial  septum  and  is  more  likely  to  grow  on  the  LA  side  of  the  septum  rather  than  the  RA.  Patients  with  myxoma  can  rarely  present  with  the  characteristics  of  a  systemic  illness,  with  obstruction  of  blood  flow  at  the  mitral  valve  level,  or  with  signs  of  peripheral  embolization.  The  syndrome  includes  fever,  malaise,  weight  loss,  leukocytosis,  elevated  ESR,  and  emboli  (peripheral  or  pulmonary,  depending  on  the  location  of  the  tumor).  This  is  sometimes  confused  with  infective  endocarditis,  lymphoma,  other  cancers,  or  autoimmune  diseases.  In  most  cases,  the  tumor  may  grow  to  considerable  size  and  produce  symptoms  by  simply  obstructing  mitral  inflow.  Episodic  pulmonary  edema  (classically  occurring  when  an  upright  posture  is  assumed)  and  signs  of  low  output  may  result.  Physical  examination  may  reveal  a  diastolic  sound  related  to  motion  of  the  tumor  (“tumor  plop”)  or  a  diastolic  murmur  similar  to  that  of  mitral  stenosis  (AUDIO  10–18).  Right-sided  myxomas  may  cause  symptoms  of  right-sided  failure.  Familial  myxomas  occur  as  part  of  the  Carney  complex,  which  consists  of  myxomas,  pigmented  skin  lesions,  and  endocrine  neoplasia.