Giant Intrapericardial Myxoma Adjacent to the Left Main Coronary Artery

A 62-years-old woman was admitted to the hospital because of chronic cough, expectoration of thick mucus, hoarseness and tightness in the precordial area. Computed Tomography (CT) examination revealed the presence of a giant intrapericardial tumor with the dimensions of 80 × 38 × 32 mm. It was locat...

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Main Authors: Piotr Nikodem Rudziński, Barbara Lubiszewska, Jacek Różański, Ilona Michałowska, Mariusz Kruk, Cezary Kepka, Karolina Kryczka, Andrzej Kurowski, Wieslawa Grajkowska, Maciej Pronicki, Marcin Demkow
Format: Article
Language:English
Published: Frontiers Media S.A. 2018-11-01
Series:Frontiers in Oncology
Subjects:
Online Access:https://www.frontiersin.org/article/10.3389/fonc.2018.00540/full
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author Piotr Nikodem Rudziński
Barbara Lubiszewska
Jacek Różański
Ilona Michałowska
Mariusz Kruk
Cezary Kepka
Karolina Kryczka
Andrzej Kurowski
Wieslawa Grajkowska
Maciej Pronicki
Marcin Demkow
author_facet Piotr Nikodem Rudziński
Barbara Lubiszewska
Jacek Różański
Ilona Michałowska
Mariusz Kruk
Cezary Kepka
Karolina Kryczka
Andrzej Kurowski
Wieslawa Grajkowska
Maciej Pronicki
Marcin Demkow
author_sort Piotr Nikodem Rudziński
collection DOAJ
description A 62-years-old woman was admitted to the hospital because of chronic cough, expectoration of thick mucus, hoarseness and tightness in the precordial area. Computed Tomography (CT) examination revealed the presence of a giant intrapericardial tumor with the dimensions of 80 × 38 × 32 mm. It was located anteriorly and laterally to the left atrium, posteriorly to the pulmonary trunk and the ascending aorta. This hypodense change modeled the left atrium without evidence of invasion. CT coronary angiography and 3-dimensional reconstruction were applied to enable precise planning of cardiac surgery. CT evaluation confirmed that it is possible to remove the tumor without damage to the adjacent left main coronary artery. The patient underwent cardiac surgery with sternotomy and cardiopulmonary bypass. A cohesive, smooth, vascularized tumor pedunculated to the left atrial epicardium was visualized. The location and dimensions corresponded to those determined by CT scan examination. The entire tumor was successfully dissected together with adjacent adipose and fibrous tissue. Histological evaluation revealed the presence of myxoid cells, blood vessels, degenerative changes, and microcalcifications embedded in profuse hyalinized stroma. Those histological features enabled identification of the intrapericardial tumor as a myxoma. Follow-up CT examination did not demonstrate any signs of recurrence of the myxoma. According to our knowledge, a myxoma located inside the pericardial sac has never been described before.
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spelling doaj.art-70ae7318f880425b9b875c76225363742022-12-21T18:09:52ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2018-11-01810.3389/fonc.2018.00540414485Giant Intrapericardial Myxoma Adjacent to the Left Main Coronary ArteryPiotr Nikodem Rudziński0Barbara Lubiszewska1Jacek Różański2Ilona Michałowska3Mariusz Kruk4Cezary Kepka5Karolina Kryczka6Andrzej Kurowski7Wieslawa Grajkowska8Maciej Pronicki9Marcin Demkow10Department of Coronary and Structural Heart Diseases, Institute of Cardiology, Warsaw, PolandDepartment of Coronary and Structural Heart Diseases, Institute of Cardiology, Warsaw, PolandDepartment of Cardiosurgery and Transplantology, Institute of Cardiology, Warsaw, PolandDepartment of Radiology, Institute of Cardiology, Warsaw, PolandDepartment of Coronary and Structural Heart Diseases, Institute of Cardiology, Warsaw, PolandDepartment of Coronary and Structural Heart Diseases, Institute of Cardiology, Warsaw, PolandDepartment of Coronary and Structural Heart Diseases, Institute of Cardiology, Warsaw, PolandDepartment of Anesthesiology, Institute of Cardiology, Warsaw, PolandDepartment of Pathology, The Children‘s Memorial Health Institute, Warsaw, PolandDepartment of Pathology, The Children‘s Memorial Health Institute, Warsaw, PolandDepartment of Coronary and Structural Heart Diseases, Institute of Cardiology, Warsaw, PolandA 62-years-old woman was admitted to the hospital because of chronic cough, expectoration of thick mucus, hoarseness and tightness in the precordial area. Computed Tomography (CT) examination revealed the presence of a giant intrapericardial tumor with the dimensions of 80 × 38 × 32 mm. It was located anteriorly and laterally to the left atrium, posteriorly to the pulmonary trunk and the ascending aorta. This hypodense change modeled the left atrium without evidence of invasion. CT coronary angiography and 3-dimensional reconstruction were applied to enable precise planning of cardiac surgery. CT evaluation confirmed that it is possible to remove the tumor without damage to the adjacent left main coronary artery. The patient underwent cardiac surgery with sternotomy and cardiopulmonary bypass. A cohesive, smooth, vascularized tumor pedunculated to the left atrial epicardium was visualized. The location and dimensions corresponded to those determined by CT scan examination. The entire tumor was successfully dissected together with adjacent adipose and fibrous tissue. Histological evaluation revealed the presence of myxoid cells, blood vessels, degenerative changes, and microcalcifications embedded in profuse hyalinized stroma. Those histological features enabled identification of the intrapericardial tumor as a myxoma. Follow-up CT examination did not demonstrate any signs of recurrence of the myxoma. According to our knowledge, a myxoma located inside the pericardial sac has never been described before.https://www.frontiersin.org/article/10.3389/fonc.2018.00540/fullcardiac tumormyxomaintrapericardial tumorintrapericardial masscoronaries
spellingShingle Piotr Nikodem Rudziński
Barbara Lubiszewska
Jacek Różański
Ilona Michałowska
Mariusz Kruk
Cezary Kepka
Karolina Kryczka
Andrzej Kurowski
Wieslawa Grajkowska
Maciej Pronicki
Marcin Demkow
Giant Intrapericardial Myxoma Adjacent to the Left Main Coronary Artery
Frontiers in Oncology
cardiac tumor
myxoma
intrapericardial tumor
intrapericardial mass
coronaries
title Giant Intrapericardial Myxoma Adjacent to the Left Main Coronary Artery
title_full Giant Intrapericardial Myxoma Adjacent to the Left Main Coronary Artery
title_fullStr Giant Intrapericardial Myxoma Adjacent to the Left Main Coronary Artery
title_full_unstemmed Giant Intrapericardial Myxoma Adjacent to the Left Main Coronary Artery
title_short Giant Intrapericardial Myxoma Adjacent to the Left Main Coronary Artery
title_sort giant intrapericardial myxoma adjacent to the left main coronary artery
topic cardiac tumor
myxoma
intrapericardial tumor
intrapericardial mass
coronaries
url https://www.frontiersin.org/article/10.3389/fonc.2018.00540/full
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