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Cardiac masses represent a diagnostic challenge because decisions about treatment are based on imaging techniques. Echocardiography, magnetic resonance (MR) and computed tomography (CT) are fundamental for the detection, characterization, and staging of cardiac masses as well as for planning their treatment. Most primary cardiac tumors are benign; myxomas, papillary fibroelastomas, and lipomas are the most common. The location of the tumors and its characteristics on CT and MR orient the etiologic diagnosis in most cases. This article describes the protocols for CT and MR studies of cardiac masses as well as the morphologic findings, predominant locations, and most useful characteristics for characterizing benign cardiac masses and establishing the differential diagnosis with malignant cardiac tumors and non-neoplastic pseudotumors., (Copyright © 2014 SERAM. Published by Elsevier España, S.L.U. All rights reserved.)

Cardiac tumours are rare, especially in children, and most of them are benign. Myxomas are unusual in children, being more common among adults. They are usually located in the left atrium, with 25% appearing in the right. The clinical signs and symptoms depend mainly on where the tumour is located. A feature of these tumours is that they can be accompanied by constitutional symptoms and laboratory abnormalities. Echocardiography is the study of choice, and a prompt resection is required to prevent serious complications. We present a case of a 10 year-old girl diagnosed with right atrial myxoma who presented with a fever, myalgia, asthenia and laboratory abnormalities. Diagnosis was made by echocardiography, and the early surgical resection of the tumour ran smoothly and showed a good postoperative recovery., (Copyright © 2012 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.)

Superficial angiomyxoma (SA) is a rare benign cutaneous neoplasm first described by Allen et al in 1988. To the best of our knowledge, we report the first case of superficial angiomyxoma located in the parotid region. We also stress the importance of distinguishing this entity from other lesions that may be involved in this location such as cutaneous neoplasms, parotid tumours or cysts. We emphasise the need to rule out the Carney complex, which has been associated with these tumours., (Copyright © 2010 Elsevier España, S.L. All rights reserved.)

The study involved 63 patients with an echocardiographic, surgical and histopathologic diagnosis of cardiac myxoma who were seen over a period of 20 years. Tumor recurrence or relapse was documented in five of these patients (7.9%), 3 of whom had a confirmed diagnosis of Carney complex, while one other patient had a probable diagnosis. Genetic studies demonstrated abnormalities in the PRKAR1A gene on chromosome 17 in 2 patients and their immediate family. In 11 of the 58 patients who did not experience relapse of the myxoma, genetic studies failed to show any abnormality. In conclusion, the possible presence of the Carney complex should be investigated in patients with multiple myxomas or with a cardiac myxoma whose location is atypical.

We describe the case of a patient in whom two-dimensional echocardiography, performed due to dissociated cholestasis and jugular ingurgitation, demonstrated a huge mass in the right atrium which prolapsed in the right ventricle. Intraoperative transesophageal echocardiography was performed to further assess the dimension and characteristics of the mass and to discard the involvement of associated structures. The patient underwent a cardiopulmonary bypass surgery and the mass (12 * 5 cm) was removed without complications. Histologic examination confirmed the diagnosis of myxoma. This case is of interest because of the size of the mass, and is centered in the diagnosis following clinical suspicion due to the pattern of dissociated cholestasis and jugular ingurgitation leading to surgery to prevent the potential embolic complications.

We describe the case of a young patient in whom two-dimensional echocardiography, performed because of episodes of palpitations, discovered the presence of a small mass in the left ventricle, attached to the posterior wall. Transesophageal echocardiography was performed to further assess the mass's attachments and to verify the lack of involvement of the mitral valve and its associated structures. The patient had a cardiopulmonary bypass, surgery and the mass was removed approaching into the left ventricular cavity through the atrial septum via a right atriotomy, without any complication during the postoperative period. In the histologic study the mass appeared to be a typical myxoma. This case has a great interest because the ventricular location of the myxoma is unusual; and because the use of two-dimensional echocardiography, even in the absence of significant symptoms and/or signs, avoided dangerous embolic complications, which often represent the first sign of this neoplastic pathology.

Introduction and Objectives: Transthoracic echocardiography is the gold-standard method in the diagnosis of cardiac myxomas. Our aim was to analyze the usefulness of transesophageal echocardiography in the diagnosis and assessment of patients with cardiac myxomas., Patients and Methods: From 1990 to 1992, 14 patients underwent cardiac surgery with the echocardiographic diagnosis (transthoracic and/or transesophageal approach) of cardiac myxomas. Thirteen (86%) of the 14 patients had after surgery histological confirmation of myxoma. Of the 13 myxomas, 10 were located in the left atrium and 3 in the right atrium., Results: Transthoracic echocardiography was able to diagnose the presence of myxoma in 12 of the 13 patients, whereas the transesophageal approach detected all of them. The precise attaching point of the tumour was seen in 9 patients with transthoracic echocardiography and in all the patients with the transesophageal approach. Also the presence of satellite tumours seen in 2 patients was only detected by transesophageal echocardiography., Conclusion: We conclude that the sensitivity in the diagnosis of cardiac myxomas is similar with both techniques, but transesophageal echocardiography is much more accurate in the detection of the precise attaching point and the presence of satellite tumours. We think that TEE is a useful tool, complementary to TTE, in the assessment of patients with cardiac myxomas before going to surgery.

Fifteen thousand patients were studied consecutively at the Echocardiographic Laboratory in the University Hospital Calixto García. We found that one out of 1,500 patients studied (0.07%) presented a cardiac myxoma. Average age 40.8 years. Male sex was mainly (60%), and the interval between the onset of the symptoms and the diagnosis was 22.8 months. A previous diagnosis to Echo was performed in 30% of the patients despite of the recurrency and refractory therapeutics of symptoms. The echocardiographic data showed that left atrium and right ventricle dilatation were proportionally related to the tumor size and its mitral obstruction degree since 90% was localized at the left interatrial septum, and was presented at right ventricle septum and in both auricles in 2 patients. All the patients were successfully surgical treated and the 4-year Echo 2D study showed no tumoral recurrency.

We report the case of a 65 year old woman with a left atrial myxoma. The only clinical manifestation were two transient ischemic attacks of cerebral origin. The diagnosis was established by transesophageal echocardiography because of poor definition of the transtoracic approach. We comment the clinical and diagnostic features of this type of tumors, with emphasize in the value of transesophageal echocardiography.