Cardiac Myxoma: a Contemporary Multimodality Imaging Review

Overview

Journal Int J Cardiovasc Imaging

Publisher Springer

Specialty Radiology

Date 2018 Jul 6

PMID 29974293

Citations 32

Authors

Geoffrey C Colin

Bernhard L Gerber

Mihaela Amzulescu

Jan Bogaert

Affiliations

Soon will be listed here.

Abstract

Cardiac myxoma (CM) is by far the most common primary benign cardiac tumor, typically arising in the left atrium with an attachment point in the fossa ovalis region. Although the etiology of CM remains unclear, we know that this endocardial-based mass originates from undifferentiated mesenchymal cells. Continuous technical improvements in the field of echocardiography since the 1960s has profoundly changed the diagnostic approach by allowing a good tumor detection as well as the preoperative planning by providing crucial information concerning the attachment point location. However, echocardiography has its limitations among which lack of tissue characterization and restricted field of view can arise diagnosis difficulties in atypical presentations. With the widespread and routine use of echocardiography and chest computed tomography (CT), incidental detection of CM is not infrequent. As a consequence, it has become mandatory for cardiologists and radiologists evolving in a multimodality imaging world to be familiar with the wide range of presentations of this tumor. The authors present here a review of the common and less common aspects of CM using the main imaging modalities available: echocardiography, cardiovascular magnetic resonance imaging, CT, positron emission tomography and coronary angiography.

Citing Articles

Cardiac computed tomography for cardiac masses: a necessity or a luxury?.

Joudar I, Nasri S, Kamaoui I, Skiker I J Int Med Res. 2025; 53(2):3000605241306604.

PMID: 39932298 PMC: 11815798. DOI: 10.1177/03000605241306604.

Diagnostic Algorithm Using Multimodal Imaging for the Differential Diagnosis of Intra-Cardiac Masses.

Sozzi F, Gnan E, Pandolfi A, Iacuzio L, Kim J, Canetta C J Clin Med. 2025; 14(2).

PMID: 39860514 PMC: 11766057. DOI: 10.3390/jcm14020508.

Accuracy of transthoracic echocardiography in diagnosis of cardiac myxoma: single center experience.

Kacar P, Pavsic N, Bervar M, Strazar Z, Prokselj K Radiol Oncol. 2025; 59(1):63-68.

PMID: 39840723 PMC: 11867553. DOI: 10.2478/raon-2025-0007.

Cardiac myxoma with high standardized uptake value of FDG-PET-CT in the right ventricular outflow tract.

Uehara H, Ohba K, Ono M, Imazuru T, Shimokawa T Gen Thorac Cardiovasc Surg Cases. 2024; 3(1):55.

PMID: 39707508 PMC: 11662759. DOI: 10.1186/s44215-024-00179-x.

Position-triggered embolic events in cardiac myxoma: a description of two cases.

Zhang H, Yan D, Song X, He X, Yang Y, Wang C Quant Imaging Med Surg. 2024; 14(12):9738-9745.

PMID: 39698642 PMC: 11651998. DOI: 10.21037/qims-24-1003.

References

Borges A, Knebel F, Lembcke A, Panda A, Komoda T, Hiemann N . Bronchogenic cyst of the interatrial septum presenting as atrioventricular block. Ann Thorac Surg. 2009; 87(6):1920-3. DOI: 10.1016/j.athoracsur.2008.10.051. View

OBEID A, Marvasti M, Parker F, Rosenberg J . Comparison of transthoracic and transesophageal echocardiography in diagnosis of left atrial myxoma. Am J Cardiol. 1989; 63(13):1006-8. DOI: 10.1016/0002-9149(89)90162-8. View

Semelka R, Shoenut J, Wilson M, Pellech A, Patton J . Cardiac masses: signal intensity features on spin-echo, gradient-echo, gadolinium-enhanced spin-echo, and TurboFLASH images. J Magn Reson Imaging. 1992; 2(4):415-20. DOI: 10.1002/jmri.1880020410. View

Fussen S, De Boeck B, Zellweger M, Bremerich J, Goetschalckx K, Zuber M . Cardiovascular magnetic resonance imaging for diagnosis and clinical management of suspected cardiac masses and tumours. Eur Heart J. 2011; 32(12):1551-60. DOI: 10.1093/eurheartj/ehr104. View

Butany J, Nair V, Ahluwalia M, El Demellwy D, Siu S, Fiendel C . Papillary fibroelastoma of the interatrial septum: a case report. J Card Surg. 2004; 19(4):349-53. DOI: 10.1111/j.0886-0440.2004.4073_11.x. View

Scheffel H, Baumueller S, Stolzmann P, Leschka S, Plass A, Alkadhi H . Atrial myxomas and thrombi: comparison of imaging features on CT. AJR Am J Roentgenol. 2009; 192(3):639-45. DOI: 10.2214/AJR.08.1694. View

Mugge A, Daniel W, Haverich A, LICHTLEN P . Diagnosis of noninfective cardiac mass lesions by two-dimensional echocardiography. Comparison of the transthoracic and transesophageal approaches. Circulation. 1991; 83(1):70-8. DOI: 10.1161/01.cir.83.1.70. View

Shin W, Choe Y, Kim S, Song I, Kim S . Detection of cardiac myxomas with non-contrast chest CT. Acta Radiol. 2013; 55(3):273-8. DOI: 10.1177/0284185113496561. View

Grebenc M, Rosado-de-Christenson M, Green C, Burke A, Galvin J . Cardiac myxoma: imaging features in 83 patients. Radiographics. 2002; 22(3):673-89. DOI: 10.1148/radiographics.22.3.g02ma02673. View

10.

Mollet N, Dymarkowski S, Volders W, Wathiong J, Herbots L, Rademakers F . Visualization of ventricular thrombi with contrast-enhanced magnetic resonance imaging in patients with ischemic heart disease. Circulation. 2002; 106(23):2873-6. DOI: 10.1161/01.cir.0000044389.51236.91. View

11.

Oliveira R, Branco L, Galrinho A, Abreu A, Abreu J, Fiarresga A . Cardiac myxoma: a 13-year experience in echocardiographic diagnosis. Rev Port Cardiol. 2010; 29(7-8):1087-100. View

12.

Colin G, Symons R, Dymarkowski S, Gerber B, Bogaert J . Value of CMR to Differentiate Cardiac Angiosarcoma From Cardiac Lymphoma. JACC Cardiovasc Imaging. 2014; 8(6):744-6. DOI: 10.1016/j.jcmg.2014.08.011. View

13.

Basso C, Valente M, Poletti A, Casarotto D, Thiene G . Surgical pathology of primary cardiac and pericardial tumors. Eur J Cardiothorac Surg. 1998; 12(5):730-7; discussion 737-8. DOI: 10.1016/s1010-7940(97)00246-7. View

14.

Hoey E, Mankad K, Puppala S, Gopalan D, Sivananthan M . MRI and CT appearances of cardiac tumours in adults. Clin Radiol. 2009; 64(12):1214-30. DOI: 10.1016/j.crad.2009.09.002. View

15.

Hrabak-Paar M, Hubner M, Stern-Padovan R, Lusic M . Hemangioma of the interatrial septum: CT and MRI features. Cardiovasc Intervent Radiol. 2010; 34 Suppl 2:S90-3. DOI: 10.1007/s00270-010-0062-1. View

16.

Rahbar K, Seifarth H, Schafers M, Stegger L, Hoffmeier A, Spieker T . Differentiation of malignant and benign cardiac tumors using 18F-FDG PET/CT. J Nucl Med. 2012; 53(6):856-63. DOI: 10.2967/jnumed.111.095364. View

17.

Muller S, Feuchtner G, Bonatti J, Muller L, Laufer G, Hiemetzberger R . Value of transesophageal 3D echocardiography as an adjunct to conventional 2D imaging in preoperative evaluation of cardiac masses. Echocardiography. 2008; 25(6):624-31. DOI: 10.1111/j.1540-8175.2008.00664.x. View

18.

Reynen K . Cardiac myxomas. N Engl J Med. 1995; 333(24):1610-7. DOI: 10.1056/NEJM199512143332407. View

19.

Gheysens O, Cornillie J, Voigt J, Bogaert J, Westhovens R . Left atrial myxoma on FDG-PET/CT. Clin Nucl Med. 2013; 38(11):e421-2. DOI: 10.1097/RLU.0b013e31827086a3. View

20.

Patel R, Lim R, Saric M, Nayar A, Babb J, Ettel M . Diagnostic Performance of Cardiac Magnetic Resonance Imaging and Echocardiography in Evaluation of Cardiac and Paracardiac Masses. Am J Cardiol. 2015; 117(1):135-40. DOI: 10.1016/j.amjcard.2015.10.014. View