Clinical Characteristics and Histopathological Features of Cardiac Myxoma: A Case Report and Review of the Literature

Abstract

Background: Primary cardiac tumors are extremely rare, with an estimated prevalence of 0.001%–0.03% in the general population. Approximately 75% of these tumors are benign, and cardiac myxoma (CM) represents the most common type. These tumors may originate from any cardiac layer or valve and can present with a wide range of clinical manifestations depending on their location. In some cases, they remain asymptomatic and are detected incidentally.

Case Presentation: A 43-year-old female presented with a two-week history of progressive dyspnea and persistent dry cough. Echocardiography revealed a large, mobile, pedunculated mass in the left atrium attached to the interatrial septum. Following surgical excision, histopathological examination confirmed a benign left atrial myxoma measuring 4.8 × 3.2 × 3.6 cm. Microscopic examination demonstrated spindle-shaped, ovoid, and stellate cells embedded within a myxoid stroma, accompanied by extravasated erythrocytes, hemosiderin-laden macrophages, and dystrophic calcification. No features of malignancy were identified.

Conclusion: Cardiac myxoma is a rare but important benign cardiac tumor, most commonly occurring in the left atrium. Clinical manifestations vary considerably according to tumor location and size, ranging from asymptomatic cases to obstructive, constitutional, or embolic presentations. Accurate diagnosis requires correlation between clinical findings, imaging studies, and histopathological examination.