A<unk>  (Myxo- = Latin for mucus) is the most common primary tumor of the heart. Cardiac<unk>  was first described in 1845. In 1951, Prichard described a kind of microscopic endocardial structure of the atrial septum, which was suggested to be associated with cardiac<unk> . Clarence Crafoord, a Swedish cardiovascular surgeon successfully removed a cardiac<unk>  for the first time in 1954. Before 1951, cardiac<unk>  diagnosis was made only at post-mortem examination. In 1959, the first M-mode echocardiogram of a left atrial<unk>  was reported. Cardiac<unk> s are classified by the WHO histological classification of tumors of the heart "Benign tumors and tumor-like lesions" and categorized into a type of pluripotent mesenchymal tumor. Cardiac<unk>  arises from remnants of subendocardial vasoformative reserve cells, which are primitive mesenchymal cells that are normally involved in the supportive structure of the endocardium.<unk> s are usually located in the fossa ovalis and endocardium of the atrial septum. Some symptoms of<unk>  may be associated with the release of interleukin 6 (IL-6). On gross pathology, a gelatinous, irregular surface that fills the left atrium is the characteristic finding of<unk> . A common histopathological finding is the Gamna-Gandy Bodies that consist of fibrosis and deposition of iron pigments. The main cause of cardiac<unk>  remains unknown. However, in some cases like inherited<unk> tosis, there is a strong relation with genetic mutations of PRKAR1A gene. Cardiac<unk>  should be differentiated from other benign and malignant primary heart tumors including papillary fibroelastoma, lipoma, rhabdomyoma, and cardiac metastasis. Cardiac<unk> s are the most common primary cardiac tumor in adults, with a reported prevalence of 0.03% in general population. The incidence of cardiac<unk>  is about 1/ 100,000 per year. The majority of patients with cardiac<unk>  are diagnosed between 30 to 60 years; children are rarely affected. Females are more commonly affected with cardiac<unk>  than men. The female-to-male ratio is approximately 1.8 to 1. Cardiac<unk> s represent 78% of heart tumors. Common risk factors in the development of<unk>  are female gender and genetic predisposition. In some cases, right atrial<unk>  has been associated with tricuspid stenosis and atrial fibrillation. If left untreated, cardiac<unk>  progression occurs slowly. The overlap of various phenomena such as thrombosis, hemorrhage, or fragmentation may influence tumor growth, detachment, and consequently embolism. Constitutional symptoms, such as: weight loss, fatigue, weakness are often the initial clinical onset of cardiac<unk> , and may resemble those from endocarditis. Metastases are uncommon in cardiac<unk> . Since the majority of the cardiac<unk> s are left-sided, it may progress to develop mitral valve obstruction or systemic embolic events, such as stroke. Whereas, right atrial<unk> s may obstruct the tricuspid valve and can present as right sided heart failure. Approximately 20% of patients with cardiac<unk>  are asymptomatic. Overall, clinical features of cardiac<unk>  are associated with the size of the tumor, location, size, and mobility. There is no single diagnostic study of choice for<unk> .<unk>  may be diagnosed based on clinical presentation and detecting the cardiac mass. Symptoms associated with cardiac<unk> s are typically due to the effect of the mass of the tumor obstructing the normal blood flow within the heart chambers. Left atrial<unk>  symptoms may mimic mitral stenosis, while right atrial<unk> s rarely produce symptoms until they have grown to be at least 13 cm wide. General symptoms may also mimic those of infective endocarditis. Cardiac<unk>  symptoms may occur at any time, but most often they tend to occur with changes in body position. Common symptoms include: chest pain, palpitation, dizziness, syncope and dyspnea on exertion. There are no specific physical findings for cardiac<unk> . The auscultatory presence of a "tumor plop" (which is caused by the obstruction of the mitral valve orifice by the tumor) on physical examination is highly suggestive of cardiac<unk> . Common physical examination findings of cardiac<unk>  include systolic or diastolic murmurs (depending on size, mobility, and location of the tumor). Laboratory findings consistent with cardiac<unk>  are generally non-specific, results often demonstrate anemia, leukocytosis and elevated erythrocyte sedimentation rate. On chest x-ray, cardiac<unk>  is characterized by normal results and in some cases a calcification overlying the heart. On CT scan, cardiac<unk>  is characterized by low attenuation and areas of dystrophic calcification in cardiac chambers. CT scan may be helpful in the diagnosis of cardiac<unk>  because it provides better soft-tissue contrast than echocardiography, and it can also differentiate calcification and fat, and may allow tissue diagnosis of some masses such as lipomas. On Magnetic Resonance Imaging (MRI) or Cardiac Magnetic Resonance (CMR), cardiac<unk>  is characterized by a soft tissue mass within the cardiac chambers isointense to skeletal muscle. This imaging modality plays an important role in the evaluation of cardiac masses and is of great value when echocardiographic findings are suboptimal or when the lesion has an atypical location or appearance. The echocardiogram is the initial modality and most useful diagnostic imaging study in cardiac<unk> . On cardiac ultrasound, cardiac<unk>  is characterized by the presence of a heterogeneous pedunculated mass that is commonly located in the left atrium. Echocardiography allows for evaluation assessment of tumor mobility, as it often protrudes through valve flaps. As a testing modality, two-dimensional echocardiography is often coupled with other modalities (such as, Doppler echocardiography) to detect vascular abnormalities that frequently occur in cardiac<unk> s. Another diagnostic study for cardiac<unk>  is cardiac angiography, which often demonstrates contrast media-enhanced tumor vasculature. There is no known medical therapy for cardiac<unk> s. Surgery is the mainstay of treatment for cardiac<unk> . The feasibility of surgery depends on the patient hemodynamic stability at diagnosis. Cardiac<unk>  surgery has operative mortality around 0 to 3%, depending on risk factors or mechanical damage to a heart valve, as well as adhesion of the tumor to valve leaflets. The short and long-term prognosis is generally regarded as excellent.
Myxoma
Pineocytoma
Neuroma
Brown tumor
PEComa
Ameloblastoma
Schwannoma
Oncocytoma