What Is Myxoma?
Myxoma is a noncancerous tumor arising from connective tissue, which connects and supports other tissue all over the body. The most common myxoma in the heart is called cardiac myxoma, the most common type of primary cardiac tumor in adults; it might also happen in other places. Myxoma is generally a rare type of tumor.
What Are the Causes of Myxoma?
The benign tumor would not metastasize to further tissues in the body and develops due to abnormal cell growth and division. In most cases, myxomas develop for no discernible reason, making it impossible to identify their root cause. It is commonly thought that a combination of genetic and environmental risk factors can lead to the development of a myxoma; however, this is only a theory. Myxoma is passed down through families and is referred to as familial myxoma.
What Are the Types of Myxoma?
There are several distinct varieties of myxoma:
Cardiac Myxoma: Atrial myxomas are the most common location for cardiac myxomas, as the atria are the heart's two upper chambers. However, cardiac myxomas can also be found in other parts of the heart. Myxomas of the atrium are called left atrial myxomas when they are detected in the left atrium, which is where the vast majority of them are located. It is common for them to originate in the septum, which is the wall that divides the anterior and posterior aspects of the cardiac chambers.
Intramuscular Myxoma: Intramuscular myxomas are noncancerous soft tissues showing slow-growing, deeply embedded masses restricted within the skeletal muscles. They are made of a benign type of soft tissue called myxoma. In accordance with experiences of the vast majority of soft tissue sarcomas, the lesion infiltrates the muscles on a microscopic level in intramuscular myxomas, which include large muscle groups and are most commonly observed in elderly patients.
Cutaneous Myxoma: A cutaneous myxoma is a rare myxoid tumor of the skin and the subcutis. It is also known as a superficial myxoma. Cutaneous myxomas have an unpredictable course of development and are histologically similar to the cutaneous myxoid tumor found in people with Carney's disease.
Ocular or Conjunctival Myxoma: Myxomas are a rare type of benign tumor that looks remarkably similar to primitive mesenchymal and only very rarely appear in the conjunctiva. The appearance of this tumor is frequently described as being smooth and gelatinous. It begins in Tenon's capsule and has the ability to mimic other diseases, including conjunctival lymphoma, lymphangioma, ocular surface squamous neoplasia, and amelanotic melanoma.
What Are the Characteristics of Myxoma?
Myxomas are a type of tumor characterized by the abnormal development of cells that coalesce into a mass. The tumor cells can disseminate throughout the body and invade other organs through a process known as metastasis. The malignant neoplasm that results from this process is referred to as cancer. Myxomas are considered to be benign or noncancerous tumors since they do not spread to other tissues and do not cause cancer.
What Are the Signs and Symptoms of Myxoma?
The dimension and position of the tumor can have a significant impact on the myoma's features.
1) Cardiac Myxoma
Valvular Obstruction - The valvular obstruction can lead to a decrease in blood flow to the brain, which can induce syncopal occurrences like fainting. A decreased blood supply can cause syncopal events in the brain. In addition, a cardiac myxoma can disrupt the normal electrical signaling of the heart, leading to aberrant heart function and abnormal heart rhythms like atrial fibrillation. The palpation is also known as the sensation of skipped or additional heartbeats.
Dyspnea - It is known as trouble breathing, and extra fluid in the lungs leads to pulmonary edema, caused due to blockage in the flow of blood through the mitral valve, and can also lead to a buildup of blood in the lungs. In addition, there would be a noticeable protrusion of the jugular vein in the neck, an enlargement of the liver and spleen, and swelling in the legs.
Pulmonary Embolism -The fragments of the myxoma have the ability to break off and migrate through the bloodstream, where they could eventually obstruct an artery. If this happens on the right side of the heart, the minute pieces can migrate toward the lungs and create a pulmonary embolism, which can result in breathlessness and pain in the chest. If the embolism originates from the left side of the heart, the small fragments have the potential to migrate to the brain or extremities, where they could produce a stroke or arterial embolism.
2) Intramuscular Myxoma
The symptoms of intramuscular myxoma, which affects the muscles in the thighs and the shoulder, can include the absence of pain, palpable discomfort in the mass, slight mobility, and slight movement. However, pain or neurological symptoms may be experienced due to the mass effect. In addition, the mobility range is restricted, and the patient may experience discomfort due to the benign nodule's growth at a sluggish rate.
3) Cutaneous Myxoma
Cutaneous myxoma may appear with a nodule on the face, neck, or extremities that is often painless and does not itch. Nevertheless, pain may be felt with pressure, and there may be solitary or many cutaneous nodular diseases that are flesh-colored.
4) Conjunctival Myxoma
Ocular or conjunctival myxoma can appear as a slow-growing, benign, yellow-pink cyst-like mass in the conjunctiva or the membrane that covers the front portion of the eye. This could occur in any location.
Which Are the Diagnostic Methods?
The location and extent of the tumor play a significant role in determining a myxoma diagnosis. Therefore, a medical professional's evaluation of the signs and symptoms is the first step in diagnosing the condition.
Cardiac Myxoma: The presence of aberrant cardiac sounds can be determined through a physical examination. Anemia, often known as a deficiency in red blood cells, can be diagnosed with a blood test. An electrogram would be able to detect atrial fibrillation by measuring the electrical signals of the heart. Chest X-rays, cardiac ultrasounds, computerized tomography (CT) scans, and magnetic resonance imaging (MRI) are all examples of imaging tests that can be utilized in the diagnostic process of cardiac myxoma.
Echocardiography can detect the tumor's presence, localize its position inside the heart, and determine how mobile it is. For example, cardiomegaly, calcification of the tumor, indications of valvular blockage, or pulmonary edema could be shown on the chest X-ray. Likewise, CT and MRI can detect cardiac tumors and their mobility within the heart.
Intramuscular Myxomas: Ultrasound imaging, computed tomography (CT), or magnetic resonance imaging (MRI) can be used to visualize intramuscular myxomas. However, the biopsy results and a pathological evaluation of the suspected tumor are typically required to confirm them.
Ocular Myxoma: The diagnosis is usually confirmed with a biopsy. The ultrastructural investigation reveals extensive rough endoplasmic reticulum and intracytoplasmic inclusions that resemble dilated cisternae of rough endoplasmic reticulum and intracytoplasmic inclusion.
Cutaneous Myxoma: A biopsy is typically performed to confirm a diagnosis of cutaneous myxoma.
What Are the Treatment Methods?
The utilization of surgical procedures can eliminate myxomas. In order to remove the tumor caused by cardiac myxoma, open-heart surgery may be necessary. Surgery on the atrial septum is conducted to remove the tumor. It is possible to remove the atrial septum, which is the wall that divides the left and right upper chambers of the heart. The removal of the atrial septum is contingent on the extent to which the tumor has penetrated the heart. It is possible to repair the atrial septum using the pericardium, which is a membrane that covers the heart and consists of two layers. A replacement should be performed if the myxoma spreads into the mitral valve. If the tumor is not entirely removed after surgery, there is a very small chance that the myxoma will recur.
After an intramuscular myxoma has been removed through a surgical incision, the likelihood of the tumor returning is significantly reduced.
Ocular myxoma requires the complete removal of the tumor; once this is done, there is a very low risk of the condition returning.
Cutaneous myxomas call for extensive surgical excision; nonetheless, even after the tumor has been removed, there remains a possibility that it will return. Therefore, in patients with valvular incompetence, antibiotic treatment is obligatory.
Conclusion
Myxoma is a tumor of soft tissue composed of fluid material with a myxoid histologic appearance. A cardiac myxoma is the most common type of myxoma and is often located in the patient's left atrium. Myxomas can also manifest on the skin and in the skeletal muscles. It is thought to be brought on by a symbiotic relationship between genetic and environmental predispositions, despite the fact that its underlying cause has not been established. Myxoma is often diagnosed by evaluating the patient's clinical signs and symptoms, in addition to imaging studies and biopsies, which confirm the presence of the disease. Surgical removal of the myxoma is usually successful in curing the disorder. However, it may infrequently result in a return. Even after the tumor has been surgically removed, the patient must undergo monthly examinations to ensure that the disease has not resurfaced.
