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Front. Oncol. | doi: 10.3389/fonc.2018.00540

Giant Intrapericardial Myxoma Adjacent to the Left Main Coronary Artery

 Piotr N. Rudzinski1*, Barbara Lubiszewska1, Jacek Rozanski1, Ilona Michalowska1, Mariusz Kruk1, Cezary Kepka1, Karolina Kryczka1*, Andrzej Kurowski1, Wieslawa Grajkowska2, Maciej Pronicki2 and Marcin Demkow1
  • 1Institute of Cardiology, Poland
  • 2Children's Memorial Health Institute, Poland

A 62-year-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 80x38x32mm. 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.

Keywords: cardiac tumor, Myxoma, Intrapericardial tumor, intrapericardial mass, Coronaries

Received: 17 Jul 2018; Accepted: 05 Nov 2018.

Edited by:

Stephen V. Liu, Georgetown Lombardi Comprehensive Cancer Center, Georgetown University, United States

Reviewed by:

Janaki Deepak, University of Maryland, Baltimore, United States
Iacopo Petrini, University of Pisa, Italy
Jay Zeck, MedStar Georgetown University Hospital, United States  

Copyright: © 2018 Rudzinski, Lubiszewska, Rozanski, Michalowska, Kruk, Kepka, Kryczka, Kurowski, Grajkowska, Pronicki and Demkow. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Dr. Piotr N. Rudzinski, Institute of Cardiology, Warsaw, Poland, piotr.rudzinski@ikard.pl
Dr. Karolina Kryczka, Institute of Cardiology, Warsaw, Poland, kkryczka@ikard.pl