Right ventricle myxoma obstructing partially right ventricular outflow tract

Abstract

A 13-year old female was referred from paediatric department for severe dyspnoea (stage III NYHA), with swelling of the face and the lower limbs. The physical examination revealed bad general health status and a clinical anaemia. There was also an enlargement of the jugular veins and the liver. The heart auscultation allowed a diagnosis of a pulmonary stenosis bruit, which was not varying with the changes of postures. The patient did not present any neuro-endocrine clinical signs or skin problems.The transthoracic echocardiography (TTE) revealed a cardiac tumour mimicking a myxoma was implanted on the antero lateral side of the right ventricular wall with an expansion into the outflow tract. The patient was operated within 48 hours following her admission. On CPB the tumour looking like myxoma was excised through a right atriotomy. The tricuspid valve was normal. Cross clamping time was 15 minutes. The pathological examination showed a myxoma-like tumour with two lobes measuring 4.2 x 2.3 centimeters. The evolution was simple; the post operative TTE check ups were satisfactoryRight ventricular myxoma protruding into the outflow tract is rare and can present with right heart failure. Surgical excision is seldom possible.We emphasize the importance of periodic follow up of this young patient with TEE for early detection of recurrence.