Hospital: Hospital Morales Meseguer.
Ciudad:
Nº:
Aut@r o Autores: I. García Tuells, J. Plasencia Martínez, A. Barceló Cárceles, B. Márquez Argente Del Castillo, A. García Chiclano, I. Cases Susarte.,
Presentación:
52-year-old woman came with acute interscapular pain and hypertension. She had had several episodes of soft chest pain that were resolved without medication. There were not relevant findings in ECG, but there was an increase of cardiac enzymes. A CT angiography of aorta was performed to rule out aortic dissection, and a delayed phase was obtained in view of the initial findings. The scan highlighted a hypodense mass in left atrium that depends on the interatrial septum, with polypoid appearance, without calcifications. It enhances in venous phase. There was no evidence of involvement of other cardiac or extracardiac cavities. An aortic dissection was ruled out and there were no other relevant findings.
Discusión:
Myxoma is the most frequent benign cardiac tumor in adults. They appear predominantly as a solitary mass in the left atrium (75%) typically emerging from the interatrial septum in the region of the fossa ovalis. They are more frequent in women. The clinical presentation includes obstructive symptoms, embolic events and constitutional symptoms. mass, with lobulated contours, which depends on the atrial septum and prolapses in diastole to the left ventricle. In CT, it is a mass of low attenuationpolypoidWe can see them as a well-defined intracavitary (1) that is surrounded by enhancing intracardiac blood and enhance with intravenous contrast. A cardiac thrombus can have similar and overlapping imaging featuresThey present heterogeneous intensity, but are mainly hypointense in sequences enhanced in T1 and hyperintense in T2-weighted sequences, with heterogeneous pattern of enhancement with the administration of gadolinium. calcifications and thrombotic material) can affect the appearance of myxomas on CT or MRI, so they can be heterogenous. Cine MR sequences reveal their mobility. necrosis, fibrosis, Variations in the histological structure (myxoid matrix, areas of hemorrhage, cysts, (2), although the location is most commonly the left atrial appendage or left ventricle adjacent to an infarcted region. Other differentiating feature is the usual lack of contrast enhancement after gadolinium administration in the case of thrombus.
Conclusión:
Myxoma is the most frequent benign cardiac tumor in adults. They appear predominantly as a solitary mass in the left atrium (75%) typically emerging from the interatrial septum in the region of the fossa ovalis. They are more frequent in women. The clinical presentation includes obstructive symptoms, embolic events and constitutional symptoms. mass, with lobulated contours, which depends on the atrial septum and prolapses in diastole to the left ventricle. In CT, it is a mass of low attenuationpolypoidWe can see them as a well-defined intracavitary (1) that is surrounded by enhancing intracardiac blood and enhance with intravenous contrast. A cardiac thrombus can have similar and overlapping imaging featuresThey present heterogeneous intensity, but are mainly hypointense in sequences enhanced in T1 and hyperintense in T2-weighted sequences, with heterogeneous pattern of enhancement with the administration of gadolinium. calcifications and thrombotic material) can affect the appearance of myxomas on CT or MRI, so they can be heterogenous. Cine MR sequences reveal their mobility. necrosis, fibrosis, Variations in the histological structure (myxoid matrix, areas of hemorrhage, cysts, (2), although the location is most commonly the left atrial appendage or left ventricle adjacent to an infarcted region. Other differentiating feature is the usual lack of contrast enhancement after gadolinium administration in the case of thrombus.
Bibliografía:
– Grebenc ML, Rosado-de-Christenson ML, Green CE, Burke AP, Galvin JR. Cardiac myxoma: imaging features in 83 patients. Radiographics. 2002,22: 673–689. – Hodler J, von Schulthess JK, Zollikofer CL, eds. Diseases of the Heart, Chest and Breast: Diagnosti