TTE sensitivity, specificity, and accuracy analysis
Pathohistological samples were obtained from the resected tumors in all 53 surgical procedures performed at our institution. Pathohistological evaluation confirmed CM in 39 of 53 operated patients (73%) (Figure 1).
The calculated sensitivity and specificity of preoperative echocardiography were 97% and 50%, respectively. The overall accuracy of TTE in diagnosing CM was 85% (Figure 2). In 7 patients (13%) diagnosed as CM on preoperative TTE, pathohistology revealed different NM cardiac tumors: papillary fibroelastoma in 5 cases, one case of angioleiomyoma and one malignant melanoma metastasis. Only one patient preoperatively classified as NM cardiac tumor had CM.
Pathohistologically confirmed NM cardiac tumors were significantly smaller than CM (24.3±13.2 mm vs 37.9±18.3 mm, p=0.017) (Table II). There was also a statistically significant difference in tumor location between the two groups. All NM tumors were located at an atypical position (seven in the right atrium, five in the left atrium but at an atypical site and two in the left ventricle) and 72% of CM were found at the typical location within the left atrium (p<0.001). The calculated sensitivity and specificity of tumor location in diagnosis of myxoma was 100% and 56%, respectively. There was no significant difference in other demographic (age, sex) or echocardiographic characteristics (mobility, surface, appearance) between groups.