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Journal of Medical Case Reports

, 9:179

First Online: 26 August 2015Received: 25 February 2015Accepted: 09 July 2015DOI: 10.1186-s13256-015-0650-4

Cite this article as: Lee, WC., Huang, MP. & Fu, M. J Med Case Reports 2015 9: 179. doi:10.1186-s13256-015-0650-4


IntroductionThe incidence of multiple intracardiac mass is rare. The differential diagnosis of intracavitary mass lesions includes benign, malignant primary, secondary metastatic cardiac tumors, or thrombus.

Case presentationWe report the case of a 49-year-old Asian woman, who experienced a 2-week history of progressive exertional dyspnea, orthopnea, bilateral lower limb edema and palpitations. Transthoracic echocardiography showed one fixed round hyperechoic mass with central necrosis over the left ventricular apex, one oscillating hyperechoic nodule over the anterior mitral annulus and one irregularly heterogeneous mass bulging out from the lateral wall of the right atrium. The incidence of multiple myxomas is rare. Unfortunately, high tumor marker, serum lactic dehydrogenase and serum uric acid levels were also present. We could not differentiate between diagnoses of multiple myxomas with thrombi or multiple metastatic tumors.

ConclusionsPrimary intracardiac tumors are rare. Approximately 75% are benign, and approximately 50% are myxomas, which have an incidence of 0.0017% in the general population. Multiple intracardiac myxomas account for less than 5% of all cases of myxoma. Our case was an atypical picture of right atrial RA myxoma, as it was located in the RA lateral wall and extended to the RA auricle at the junction among the superior and inferior vena cava. Two masses in the left ventricle LV were thrombi and resolved after heparinization. Initially, elevated tumor markers and high serum uric acid and high serum lactic dehydrogenase levels were related to necrotic tumor-derived tissue, decompensated heart failure with pleural effusion and renal insufficiency. We share our experience of multiple intracardiac masses. Whether the intracardiac mass is benign or malignant, we recommend surgery due to the possibilities of systemic or pulmonary massive embolism, infection, arrhythmia and sudden death if the thrombus ruptures or the mass dislodges.

KeywordsIntracardiac mass Right atrium myxoma Thrombus Wei-Chieh Lee and Morgan Fu contributed equally to this work.

Electronic supplementary materialThe online version of this article doi:10.1186-s13256-015-0650-4 contains supplementary material, which is available to authorized users.

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Autor: Wei-Chieh Lee - Min-Ping Huang - Morgan Fu


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