Presentation of atrial myxoma with unusual clinicopathological features

Sushma HM, Muktha R Pai, Reba Thoppil Philipose


Atrial myxomas present with diverse clinical manifestations depending on its location, tendency to embolize, and systemic symptoms resulting from IL-6 production by tumor cells. We present here the case of right atrial myxoma, with persistent anemia and thrombocytopenia. Occurrence of thrombotic episodes with manifestations of antiphospholipid antibody syndrome (APAS) was noted and further investigations were carried out. Transthoracic echocardiogram revealed the presence of a right atrial mass with the possibility of an intracavitary thrombus or myxoma. Complete surgical excision and histopathological examination  further confirmed the diagnosis of right atrial myxoma. The study emphasizes the importance of considering protean clinical manifestations including APAS and histopathological examination while diagnosing right atrial myxoma.


Sushma HM, Muktha PR, Reba P. IJPLM 2016;2(1):CS3 (Republished: 27 December 2016)


Atrial myxoma ; Cardiac tumours; Antiphospholipid syndrome


1. Biswas A, Thakur AK.An unusual presentation of atrial myxoma in an elderly patient: a case report. Cases Journal 2008,1:384 doi:10.1186/1757-1626-1-384.

2. Sato H, Tanaka T, Kasai K, Kita T, Tanaka N. Sudden death due to acute pulmonary embolism from asymptomatic right atrial myxoma. Journal of Forensic and Legal Medicine.2008;15: 454-456.

3. Charokopos NA,Rouska E, Pliakos C, Pagourelias ED, Artemiou P, Papadopoulos N. Atypical atrial myxomas in two asymptomatic patients: a case report.Cardiovascular Ultrasound. 2009;7:45.

4. Vaideeswar P, Gupta R, Mishra P, Lanjewar C, RautA.. Atypical cardiac myxomas: a clinicopathologic analysis and their comparison to 64 typical myxomas. CardiovascPathol. 2012; 21: 180-7.

5. Esteban E, Blanes A, Moreno MT, Canovas SJ, Montero JA, Sotillo JF. Right Atrial Myxoma in a Patient with Antiphospholipid Antibodies. Rev Esp Cardiol. 2002; 55:999-1002.

6. Aggarwal SK, Barik R, Sharma TCSR, Iyer VR, Sai V, Mishra J et al. Clinical presentation and investigation findings in cardiac myxomas: new insights from the developing world. American Heart Journal. 2007; 154.

7. Reynen K. Cardiac myxomas. N Engl J Med.1995; 333:1610-7

8. Burke AP, Tazelaar H, .Loire R, Chopra P, Tomsova M, Veinot JP et al. Tumours of Heart- Benign tumours of pluripotent mesenchyme. In: Travis W.D, Brambilla E, Muller HHK, Harris CC. World Health Organization Classification of Tumours. Pathology and Genetics of Tumours of the Lung, Pleura, Thymus and Heart. IARC Press: Lyon; 2004: 261.