| A Giant Right Atrial Myxoma with
Lung Carcinoma Detected by Syncope |
(Division of Cardiovascular Surgery, Kimitsu Chuo
Hospital, Kisarazu, Japan)
| Hirofumi Nishida |
Yoshio Sudou |
Hideo Ukita |
| Nobuyuki Nakajima |
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A 75-year-old man was referred to
our hospital with dyspnea on effort, recurrent attacks of loss
of consciousness and abnormal shadow on chest X-ray film. Computed
tomographic scan confirmed a 1.5×2.0cm mass with slight spiculation
in the right lower lobe (S6) and revealed an ovoid right atrial
mass. Transthoracic echocardiography showed that the giant mass
which filled most of the right atrium had no mobility. Coronary
angiography revealed clusters of new vessels which originated
from the atrial branches of the circumflex coronary artery. A
T1-weighted MRI scan demonstrated that the mass was isointense
relative to the adjacent myocardium. We considered that performing
cardiac surgery prior to pulmonary resection, as in a staged
procedure, would have advantages in morbidity. We first performed
removal of the right atrial tumor which was a 6.8×5.5×4.5cm shiny
mass attached to the interatrial septum. Histological examination
of the mass confirmed the diagnosis of cardiac myxoma. Three
months later, right S6 segmentectomy was carried out
using thoracoscopy and the tumor was finally diagnosed as squamous
cell carcinoma. We have followed the patient for about 10 months
after the first operation and there is no evidence of tumor recurrence
and no more syncopic attacks.
Jpn. J. Cardiovasc. Surg. 34: 140-143 (2005) |
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