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European Journal of Echocardiography Advance Access originally published online on August 1, 2008
European Journal of Echocardiography 2009 10(1):171-172; doi:10.1093/ejechocard/jen210
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org.

A novel approach for a novel combination: a trans-septal biopsy of left atrial mass in recurrent phyllodes tumour

Colette E. Jackson*, Roy S. Gardner and Derek T. Connelly

Department of Cardiology, Queen Elizabeth Building, Glasgow Royal Infirmary, 10 Alexandra Parade, Glasgow G31 2ER, UK

Received 15 April 2008; accepted after revision 14 July 2008; online publish-ahead-of-print 1 August 2008.

* Corresponding author. Tel: +44 141 211 4722; fax: +44 141 330 6955. E-mail address: colettejackson{at}doctors.org.uk


  Abstract

A 69-year-old female with a previous hemisternectomy for recurrent phyllodes tumour was referred for echocardiography because of progressive dyspnoea, orthopnea, and a diastolic mitral rumble on auscultation. Transthoracic echocardiography revealed a large left atrial mass. Although a diagnosis of myxoma was likely, there was concern that this was a cardiac metastasis. A tissue diagnosis was mandatory before further thoracic surgery could be considered. This was obtained via a trans-septal puncture using transoesophageal echocardiographic guidance. Histology confirmed a diagnosis of myxoma, and our patient underwent successful surgery. This case highlights the importance of obtaining accurate tissue diagnosis and of excluding metastatic disease in patients with a cardiac mass and a history of tumour, prior to deciding whether surgical excision is warranted.

Keywords: Myxoma; Phyllodes tumour; Trans-septal biopsy; Trans-oesophageal echocardiography


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