1/81. myxoma of the mitral valve: diagnosis by 2-dimensional and 3-dimensional echocardiography.In this report we describe a 39-year-old patient who had left-sided hemiparesis. In search of a source of embolism, we performed transthoracic echocardiography, which did not show any abnormalities. Transesophageal echocardiography revealed a small tumor of the posterior mitral leaflet. Three-dimensional transesophageal echocardiography was subsequently performed and demonstrated more accurate information about the size, the morphology, and the attachment point of the tumor. Furthermore, the reconstruction provided excellent spatial visualization of the pathomorphology of the mitral valve and was a useful addition for optimal preoperative diagnostic management. The tumor was excised, and histologic examination confirmed the myxomatous character of the tumor. mitral valve myxomas are rare. This is the first case reported of a mitral valve myxoma being visualized by 3D echocardiography.- - - - - - - - - - ranking = 1keywords = size (Clic here for more details about this article) |
2/81. Fragmentation of a right atrial myxoma presenting as a pulmonary embolism.We report here a tricky case of right atrial myxoma with a pulmonary localization mimicking pulmonary thromboembolism. The diagnosis on imaging investigation was delayed because of its atypical appearance. This case report emphasizes the leading role of transthoracic and transesophageal echocardiography in the management of this condition. In autopsy series, the incidence of primary tumors of the heart is evaluated at 0.0017% to 0.19%.(1) Nearly half of them are myxoma.(1, 2) myxoma are more frequently observed in adults and are commonly localized in the left atrium. signs and symptoms are comparable to those arising in other cardiovascular and systemic conditions, including variable cardiac murmur, uneasiness, blackout, systemic embolism, cardiac insufficiency, lasting fever, or sudden death.(3) Rare cases of pulmonary embolism have been described. We report here an atypical case of right atrial myxoma with a pulmonary localization mimicking pulmonary embolus.- - - - - - - - - - ranking = 1keywords = size (Clic here for more details about this article) |
3/81. mitral valve thrombus attached to the intact mitral valve associated with distal embolism.A 61-year-old man was referred for cardiac investigation because embolism was suspected to be the cause of the sudden onset of severe pain in his right leg after a surgical procedure. The electrocardiogram revealed no atrial fibrillation. Transthoracic echocardiography demonstrated a tumor-like echo at the anterior mitral leaflet, and transesophageal echocardiography documented a mass 13x9mm in size, attached by a stalk to the left atrial side of the anterior mitral leaflet. The other parts of the mitral valve appeared to be intact. At emergency surgery, the mass was located in the center of the left atrial side of the anterior mitral leaflet. It mimicked a myxoma and had a stalk arising from the anterior leaflet. After resection of the mitral valve mass, catheter thrombo-embolectomy was performed and several long pieces of fresh thrombus were removed. On histological examination, the mass consisted of fresh thrombus tissue. No cellular component or myxoma tissue was documented. The distal embolus also consisted of fresh thrombus tissue. This is the first case of a thrombus of the intact mitral valve without atrial fibrillation.- - - - - - - - - - ranking = 1keywords = size (Clic here for more details about this article) |
4/81. Osteochondromyxoma of bone: a congenital tumor associated with lentigines and other unusual disorders.This article describes the clinical and pathologic features of four unusual bone tumors. Three were congenital or most likely so; the fourth, detected at age 1 year, was probably of considerable duration. The patients, three boys and one girl, each presented with a painless mass. Two had the carney complex, a familial lentiginous and multiorgan tumorous syndrome; another probably had this disorder; the fourth did not show it, but his mother did. The tumors occurred in the nasal region (n = 2) and the diaphysis of the tibia and radius (n = 1 each). Roentgenographically, three had benign characteristics; the fourth, malignant features. Grossly, the tumors were gelatinous, cartilaginous. and bony. Microscopically, they featured benign-appearing polymorphic cells with few division figures arranged in sheets and lobules set in a myxomatous, cartilaginous, osseous, and hyaline fibrous matrix. Cellularity was low to moderate. The tumors eroded bone, one infiltrated between bony trabeculae, and three had soft tissue extension. Complete resection of one tumor was curative; incomplete excision of two tumors resulted in local recurrence (intracranial and fatal) in one and persistence in the other; the fourth tumor remains under observation after biopsy. No tumor metastasized.- - - - - - - - - - ranking = 1keywords = size (Clic here for more details about this article) |
5/81. Mass confusion.A patient is reported who presented to the hospital with a benign arrhythmia and what was initially believed to be a benign intracardiac tumour as imaged by transthoracic echocardiography and a first transesophageal echocardiogram. Comprehensive assessment with a second transesophageal echocardiogram revealed extensive extra- and intracardiac involvement by masses with many malignant-appearing features, including compression of vascular structures in the mediastinum. Peripheral biopsy yielded a diagnosis of high-grade lymphoma. The clinical, echocardiographic and radiological findings are discussed, as are the expected features of myxomae, and by comparison, common features of malignancy. The ability of transesophageal echocardiography, when comprehensively performed, to define the location and extent of mass lesions, and their physiological impact, such as compression of the pulmonary vasculature, by two-dimensional imaging and spectral Doppler are emphasized.- - - - - - - - - - ranking = 1keywords = size (Clic here for more details about this article) |
6/81. myxoma of the gingiva: a case report and literature review.Soft tissue myxomas of the oral and para-oral tissue are extremely rare. Only two cases of myxoma of gingiva have been reported in the literature. The histogenesis of these lesions remains obscure. We report a case of gingival myxoma in a 37-year-old man. A firm ovoid soft tissue mass measuring 1.5 x 1.2 x 1 cm in size was noted at the mesio-lingual gingiva of a partially impacted right mandibular third molar. Radiographic examination revealed an impacted mandibular third molar with normal radiographic bony consistency of the mandible. Excisional biopsy was performed with no evidence of recurrence after 8 months. Histological examination showed stromal mass composed of myxoid-like fluid in fibrovascular stroma and scanty inflammatory cell infiltration, suggesting myxomas of the oral soft tissues and jaws. Immunohistochemical stains with S-100 protein, desmin and smooth muscle specific actin yielded negative results, and those with alcian blue, periodic-acid-Schiff, mucicarmine, vimentin and reticulin were positive. Tumor cells of mesenchymal origin without neurogenic or muscular derivations and myxoid matrix composed of acid mucopolysaccharides in this lesion further confirmed the diagnosis of myxoma. periodontal ligament origin cannot be completely excluded due to tumor location and its association with an impacted molar. However, further study is necessary to clarify the origin and histogenesis of these lesions.- - - - - - - - - - ranking = 1keywords = size (Clic here for more details about this article) |
7/81. Aggressive angiomyxoma of the scrotum.Aggressive angiomyxoma is a rare and nonmetastasizing soft tissue tumor of the pelvis and perineum and occurs almost exclusively in adult females. It infiltrates locally and has a high risk of local recurrence. Recommended treatment of the symptomatic patient is wide excision with tumor-free margins and close postoperative monitoring. Herein, a case of aggressive angiomyxoma in an adult male is described, which arose in the scrotum over 12 months. The tumor showed an intermediate signal on T1-weighted MRI images. Contrast-enhanced T1-weighted images showed good enhancement. Wide excision of the tumor was performed. The surgical specimen measured 7 x 5 x 5 cm in size and weighed 80 g. The tumor's surface was smooth and had a gelatinous cut surface. Grossly, it was encapsulated with a pleura-like membrane and had a finger-like projection. Microscopically, sections showed many walled vessels of various sizes, collagen fibrils, a loose myxoid background. and spindle stroma cells. MRI and CT showed the angiomatous and myxomatous nature of the tumor wall. To the authors' knowledge, this is the first report to describe MRI findings in scrotal angiomyxoma.- - - - - - - - - - ranking = 2keywords = size (Clic here for more details about this article) |
8/81. Varied manifestations of left atrial myxoma and the relationship of echocardiographic patterns of tumor size.Four cases of left atrial myxoma with varied clinical manifestations were diagnosed with echocardiographic studies prior to cardiac catheterization and surgery. The unusual clinical features include Raynaud's phenomenon and intermittent claudication. The echocardiographic features of the atrial myxoma appear to be related to tumor size. Systematic echocardiographic evaluation of patients with mitral valvular disease and systemic and cerebral vascular insufficiency will undoubtedly increase the positive diagnostic results in patients with atrial myxomas. Removal of these tumors results in normalization of the echocardiographic pattern.- - - - - - - - - - ranking = 5keywords = size (Clic here for more details about this article) |
9/81. Intramuscular low-grade myxoid neoplasm with recurrent potential (cellular myxoma) of the lower extremity: case report with cytohistologic correlation and review of the literature."Low-grade myxoid neoplasm with recurrent potential" (cellular myxoma) is a term recently used to describe a subset of soft tissue lesions with histology intermediate between intramuscular myxoma and low-grade myxofibrosarcoma or myxoid malignant fibrous histiocytoma (MFH), while resembling a deeper counterpart of superficial angiomyxoma. Their distinctive biological behavior is characterized by the potential to recur locally, in contrast to intramuscular myxoma, while having no potential to advance in grade or metastasize when compared to low-grade myxofibrosarcoma. We present a cytohistological correlation for an intramuscular location of such a tumor in the lower extremity of a 49-yr-old male.- - - - - - - - - - ranking = 1keywords = size (Clic here for more details about this article) |
10/81. Left atrial myxoma presenting with erythematous macules and loss of memory.Left atrial myxoma was diagnosed in a 42-year-old woman who had cutaneous and neurological manifestations without cardiac symptoms or signs. A two-dimensional echocardiogram revealed an orange-sized mobile mass in the left atrium. Magnetic resonance imaging showed multiple cerebral infarctions. Cardiac surgery for removal of the left atrial myxoma was successful and histopathology confirmed myxoma. Cutaneous and neurological manifestations were improved after the operation. Early surgical intervention may prevent the onset of severe neurological deficits in such patients.- - - - - - - - - - ranking = 1keywords = size (Clic here for more details about this article) |
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