Myxoma

Although primary cardiac tumors are rare (<0.01%), myxoma is the most common type (50%).

75% develop in LA, with most attached to the interatrial septum.

Rarely develop in ventricles.

More common in females (70%).

May be friable and may embolize (30–40% of pts)

LV- or RV-inflow obstruction with resultant hypotension

May simulate pulm Htn and/or constrictive pericarditis physiology

Hypotension due to obstruction of ventricular inflow and/or incompetence of tricuspid (right) or mitral (left) valve, may be positional.

Tumor flips on a stalk across valves, causing stenotic and/or incompetent symptoms.

RV hypertrophy can occur because of longstanding left ventricular–inflow obstruction.

There is the possibility of pulm or systemic embolization.

Is a true neoplasm and distinct from a thrombus

Usually polypoid, pedunculated with a 1–2 cm stalk, and round with smooth margins

Typically grows very slowly before the patients becomes symptomatic (10–20 y)

Typically arises from the endocardium and rarely extends deeper.

Polyhedral cells with small nuclei are separated by an afibrillar, eosinophilic myxomatous stroma that is predominantly a mucopolysaccharide.

Although benign, this tumor rarely can undergo malignant degeneration.