Clinicopathologic study and DNA analysis of 37 cardiac myxomas: a 28-year experience.

Abstract

PURPOSE:

This study was performed to identify morphologic features of cardiac myxomas related to embolism and to provide a better understanding of the biology of these tumors, mainly in relation to their interleukin (IL)-6 expression and DNA content.

PATIENTS AND METHODS:

A total of 37 cardiac myxomas were reviewed retrospectively in a clinicopathologic study that included the correlation of echocardiographic and pathologic findings in 25 cases, together with immunohistochemical evaluation of IL-6 expression and flow cytometric DNA analysis of 35 tumors.

RESULTS:

There were 24 female patients and 13 male patients. The mean (+/- SD) age was 52 +/- 15 years. Fifty-four percent of patients presented with dyspnea, 51% presented with increased erythrocyte sedimentation rate (ESR), and 27% presented with embolic episodes, which were significantly associated with villous surface tumors. Atrial fibrillation was registered in 19% of patients and was significantly associated with large left atrial myxomas. Echocardiography proved to be a reliable method for preoperative diagnosis and for predicting tumor size and morphology. There was no perioperative mortality or long-term recurrences. The frequency of early surgical complications was associated with a longer mean ischemic time. Seventeen percent of tumors had abnormal DNA content, and 74% of tumors showed immunohistochemical expression of IL-6. Neither of these factors showed a significant association with embolism or constitutional illness.

CONCLUSIONS:

Villous surface myxomas are related to embolism, and large left atrial tumors are related to atrial fibrillation. Echocardiography is a reliable method with which to predict tumor size and morphology. Myxoma cells usually express IL-6, and some tumors have abnormal cellular DNA content. Surgical excision of the tumor is a safe and effective treatment.

• Authors: Elvira Acebo, J Fernando Val-Bernal, J Javier Gómez-Román, J Manuel Revuelta
• Journal: Chest (Chest) Vol. 123 Issue 5 Pg. 1379-85 (May 2003) ISSN: 0012-3692 [Print] United States
• PMID: 12740251 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• DNA, Neoplasm
• Interleukin-6

Topics

• Adolescent
• Adult
• Aged
• Aneuploidy
• Child
• DNA, Neoplasm (genetics)
• Echocardiography
• Female
• Flow Cytometry
• Heart Neoplasms (genetics, metabolism, pathology, surgery)
• Humans
• Immunohistochemistry
• Interleukin-6 (metabolism)
• Male
• Middle Aged
• Myxoma (genetics, metabolism, pathology, surgery)
• Neoplastic Cells, Circulating
• Retrospective Studies