Cardiac myxoma presenting with multisystem involvement

Saudi Med J. 2022 Sep;43(9):1057-1061. doi: 10.15537/smj.2022.43.9.20220346.

Abstract

A cardiac myxoma is a rare tumor that could be incidental or present with common symptoms due to embolization. A minority of cases are attributed to carney complex, a rare inherited disease. A 73-year-old Asian male presented with acute left-side weakness, slurred speech, gait imbalance, and subacute constitutional symptoms. Left atrial myxoma was discovered by computed tomography and confirmed by echocardiography. Brain imaging revealed pituitary macroadenoma with subarachnoid and intraventricular hemorrages. The hormonal profile confirmed pituitary apoplexy, for which hormone replacement was initiated. Workup also revealed multiple endocrine tumors and excluded infection and malignancy. Myxoma resection could not be carried out, due to the patient's rapid clinical deterioration and death.Furthermore, the presence of cardiac myxoma, non-functioning pituitary macroadenomas, and pituitary apoplexy is extremely rare and rarely documented in the literature. Therefore, we emphasize clinical awareness of rare conditions with atypical presentations to improve outcomes.

Keywords: adrenal mass; cardiac myxoma; carney complex; intracranial haemorrhage; pituitary apoplexy.

MeSH terms

  • Aged
  • Carney Complex* / diagnosis
  • Carney Complex* / surgery
  • Heart Neoplasms* / diagnostic imaging
  • Heart Neoplasms* / pathology
  • Humans
  • Male
  • Myxoma* / diagnostic imaging
  • Myxoma* / pathology
  • Pituitary Apoplexy* / etiology
  • Pituitary Neoplasms* / diagnosis
  • Pituitary Neoplasms* / diagnostic imaging