Stenosing Intracardiac Mass of the Mitral Valve: A Case Report and Review of the Literature

Noël Mahoungou-Mackonia *

Department of Cardiology, Chu-Ibn ROCHD, Casablanca, Morocco.

Maria Khalil

Department of Cardiology, Chu-Ibn ROCHD, Casablanca, Morocco.

Karim Fatiha

Department of Cardiology, Chu-Ibn ROCHD, Casablanca, Morocco.

Imad Nouamou

Department of Cardiology, Chu-Ibn ROCHD, Casablanca, Morocco.

Salim Arous

Department of Cardiology, Chu-Ibn ROCHD, Faculty of Medicine and Pharmacy, Hassan II University of Casablanca, Morocco.

Ghali Benouna

Department of Cardiology, Chu-Ibn ROCHD, Faculty of Medicine and Pharmacy, Hassan II University of Casablanca, Morocco.

Abdenasser Drighil

Department of Cardiology, Chu-Ibn ROCHD, Faculty of Medicine and Pharmacy, Hassan II University of Casablanca, Morocco.

Leila Azzouzi

Department of Cardiology, Chu-Ibn ROCHD, Faculty of Medicine and Pharmacy, Hassan II University of Casablanca, Morocco.

Rachida Habbal

Department of Cardiology, Chu-Ibn ROCHD, Faculty of Medicine and Pharmacy, Hassan II University of Casablanca, Morocco.

*Author to whom correspondence should be addressed.


Abstract

Introduction: Benign intracardiac tumours are the most common of the 5% of primary tumours and account for 90% of intracardiac tumours. Myxoma, which is the main benign tumour, rarely localizes to the mitral valve, in the order of 1-5%, associated with severe symptoms and enormous complications.

The objective is to report a rare and severe case of mitral valve myxoma resulting in severe obstruction of the valve orifice.

Presentation of Case: A 65-year-old Moroccan woman, without profession, the diabetic patient presented with progressive dyspnoea, in whom transthoracic echocardiography (TTE) completed by transesophageal echocardiography (TEE), a cardiac magnetic resonance imaging (MRI), a cerebro-throracoabdominopelvic Positron emission tomography-scan (PET-scan) showed a cauliflower-shaped mass embedded in the small mitral valve, evoking the diagnosis of myxoma, confirmed by the anatomopathological examination. A lumpectomy with mitral valve plasty was performed in association with coronary artery bypass surgery for a tri truncal lesion. The evolution was marked by an improvement in the clinical and echographic state.

Discussion: Myxoma is the first benign tumour encountered in women between the 3rd and 6th decade, whose diagnosis is evoked by a TTE, better by a TEE or more, by a computed tomography (CT scan) or even a cardiac MRI which specifies the visualization of the soft parts with all the internal details of the myxoma, whose confirmation is carried out on the histopathological analysis of the operating room.

Conclusion: The management was based on complete resection of the tumor associated with mitral valve plasty.

Keywords: Stenosing intracardiac mass, mitral valve, intracardiac myxoma


How to Cite

Mahoungou-Mackonia , N., Khalil , M., Fatiha , K., Nouamou , I., Arous , S., Benouna , G., Drighil , A., Azzouzi , L., & Habbal , R. (2023). Stenosing Intracardiac Mass of the Mitral Valve: A Case Report and Review of the Literature. Cardiology and Angiology: An International Journal, 12(4), 28–33. https://doi.org/10.9734/ca/2023/v12i4340


References

Al-Zamkan BK, Hashem AM, Alaaeldin SA, Abdel Aziz M. An exceptionally giant left atrial myxoma : A case report and literature review. Eur Heart J Case Rep. 2020; 4(6):1‑7.

Shabab S, Erfanzadeh M, Ahmadian S, Mahmoudabady M, Mazloum N. A case report of left atrial myxoma presenting with amnesia. BMC Cardiovasc Disord. 1 mai 2021;21(1):225.

Hale A, Vann J, Henderson P, Harrison T, Trehan S. A Case of a Left Atrial Mass in an Orthotopic Heart Transplant Recipient. CASE Cardiovasc Imaging Case Rep. 2019;4(1):33‑8.

Mando R, Barbat JJ, Vivacqua A. The Mysterious Mitral Mass : A Case of Valvular Myxoma. Case Rep Cardiol. 2018;3927948.

Aiello VD, Campos FPF de. Cardiac Myxoma. Autopsy Case Rep. 2016; 6(2):5‑7.

Naseerullah FS, Javaiya H, Murthy A. Cardiac Lipoma: An Uncharacteristically Large Intra-Atrial Mass Causing Symptoms. Case Rep Cardiol. 2018; 3531982.

Zuwasti U, Quarrie R, Allen E, Haas C. Severe functional mitral stenosis due to a left atrial myxoma masquerading as asthma. BMJ Case Rep CP. 2020; 13(12):236876.

Pinede L, Duhaut P, Loire R. Clinical presentation of left atrial cardiac myxoma. A series of 112 consecutive cases. Medicine (Baltimore). 2001;80(3):159‑ 72.

Imai Y, Taketani T, Maemura K, Takeda N, Harada T, Nojiri T, et al. Genetic Analysis in a Patient With Recurrent Cardiac Myxoma and Endocrinopathy. Circ J. 2005;69(8):994‑5.

Kassop D, Donovan MS, Cheezum MK, Nguyen BT, Gambill NB, Blankstein R, et al. Cardiac Masses on Cardiac CT : A Review. Curr Cardiovasc Imaging Rep. 2014;7(8):9281.

Shrestha S, Raut A, Jayswal A, Yadav RS, Poudel CM. Atrial myxoma with cerebellar signs: a case report. J Med Case Reports. 2020;14(1):29.

Azhar AH, Ziyadi G, Zulkarnain H2, Rahman MNG1. Atrial Myxoma Presenting As a Cerebellar Stroke. 2011;1(2):36‑40.

Azdaki N, Moezi S, Hosseinzadehmaleki M, Farzad M. Failed primary percutaneous coronary intervention in a middle-aged man without cardiovascular risk factors: left atrium myxoma. Pan Afr Med J. 2020; 36(1):1-4

Swartz MF, Lutz CJ, Chandan VS, Landas S, Fink GW. Atrial Myxomas: Pathologic Types, Tumor Location, and Presenting Symptoms. J Card Surg. 2006;21(4) :435‑40.

Khatri D, El-Louali F, Ettalibi NI, Tamdy A, Ismaili N, Abourazzak A. Cardiac myxomas. Cardiol Prat. 2009;1-9.