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40 Atrial myxoma

Myxoma
Age/sex: 44-year-old male
Size: 18.0 x 16.2 x 6.8 cm
The heart has been opened to show a normal left ventricle (L) and mitral valve (V). A 4 x 2.5 cm mass (M) is attached to the mid-atrial wall and projects into the atrial lumen. A piece of it has been excised for microscopic examination.


Myxoma

A myxoma is a tumor of the heart that usually originates in the left atrial septum. It is thought to be derived from connective tissue cells just beneath the endocardium. Although rare, it is the most common cardiac neoplasm.

The tumor is benign, i.e. it does not invade the underlying atrial wall or grow elsewhere in the body (metastasize). However, small fragments of it can be dislodged from the surface and travel in the blood (embolize) to other sites in the body. Here, they block local blood flow, resulting in complications such as stroke (cerebral artery) or leg pain (tibial artery). The tumor can also cause difficulty breathing by interfering with the flow of blood from the left atrium to the adjacent ventricle. In most cases, surgical excision with a small rim of normal atrial tissue results in complete cure.

Below: Histologic appearance of an atrial myxoma. The pale purple material (M) consists of a gelatinous mixture of mucopolysaccharides secreted by the tumor cells (arrows).

Source: Rajaram A (2023). Atrial myxoma.

Histologic appearance of an atrial myxoma

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