Introduction
Although rare, cardiac myxoma (CM) represents the most common benign
primary cardiac tumor[1]. Many patients are asymptomatic and CM is
often an incidental finding[2]. Potentially life-threatening
complications such as tumor obstruction or embolization can occur,
making accurate diagnosis crucial [3,4]. However, diagnosis is
challenging due to the broad differential diagnosis of CM, which
includes other cardiac tumors and cardiac masses such as thrombi,
vegetations, calcific lesions, and other rare conditions.
Transthoracic echocardiography (TTE) nowadays represents the most
commonly used initial imaging modality in the diagnostic workup of CM.
It provides information on tumor size, location, attachment point,
morphology, mobility, and its relation to surrounding structures. The
majority of CM are located in the left atrium, attached to the atrial
septum in the region of the fossa ovalis. These are considered as
typical CM, but atypical localizations outside the left atrium have been
described in around 30% [5]. Size and appearance (solid and round
or polypoid) may also vary considerably in CM [6].
TTE has an excellent detection rate for CM and a sensitivity of 90–96%
in diagnosing CM has been reported [4]. However, the heterogeneous
morphological presentation leads to overlap with other cardiac masses
and may affect the specificity and accuracy of TTE in CM diagnosis.
Furthermore, TTE lacks tissue characterization [7]. Multimodality
cardiac imaging ensures a more detailed analysis. Ultimately, the final
diagnosis is made by histopathological examination of the excised tumor
[8].
The aim of our single-center study was to evaluate the utility and
accuracy of TTE in the diagnosis of CM and to determine
echocardiographic characteristics indicative of pathohistologically
confirmed CM.