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Heart Myxomas: Ploidy, S-Phase and Embolisms
San Martino J, Laguens R, Gonzalez P, Batalla M, Bozzo R, Huñis AP, Levin M, Turek A, Machain A
Febrero 1997

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In heart myxomas ploidy was postulated as biological marker of relapse but there are few studies about its relationship with embolism. With this objective we carried out a retrospective review of 13 myxomas resected between July 1992 and February 1995. Materials and Methods: The study included the clinical characteristics, evolution during hospitalization, pathology and the cell cycle study by modified Hedley method with flow cytometer with argon laser and mathematic analysis of histograms by Cell Fit (one case was excluded because of a high variation coefficient). Pathological analysis and cell cycle were done blindly in relation with clinical data. Results: median age of patients was 45 years, 7 males, 6 females. One had a recurrent familiar myxoma (8%) and the other 12 were sporadic (92%). The most frequent symptoms were secondary to systemic embolism (6 cases, 46%), central nervous system 4 patients and 2 heart emboli. Primary localization was left atrium (10 cases, 76%), and 1 case of left ventricle (8%), 1 in right ventricle (8%), 1 in right atrium (8%). Patients have surgery without any death or major complications. To compare the patients with (6 cases) and without embolism (7 cases), in order to establish risk factor for embolism we analyzed: Clinical characteristics: Age (43 +/- 18 yr vs 48 +/- yr, P=NS), sinus rhythm (100% in both groups), left atrium size (42 +/- 8 mm vs 37 +/- 5 mm, P=NS). Macroscopic characteristics: maximum tumor diameter: (4.3 +/- 2 cm vs 3.8 +/- 2 cm, P=NS). Adhered thrombus: (0% both groups). Capsule presence: (1/7, 14% vs 0/6, 0%, P=NS). Tumoral bleeding: (4/7, 57% vs 4/6, 67%, P=NS). S Phase: greater than of 7 or DNA Index greater than of 1.2 (1/7, 14% vs 4/5, 80%, p=0.07). The flow cytometry showed a diploid tumor in the recurrent familiar myxoma patient (contrary to previous by published data) with the highest S Phase (10%), in relation with sporadic myxomas (4.6 +/- 2%). Conclusions: (1) There is no significant factor related with tumoral embolism in this group, but there was a tendency of higher S Phase and ADN Index in embolizing tumors. (2) High S Phase in a myxoma, appear to be related with relapse. (C) American Society of Clinical Oncology 1997


Heart Diseases/Complications/*Pathology
Heart Neoplasms/Complications/*Pathology
Middle Age
Retrospective Studies
S Phase






Proc Annu Meet Am Soc Clin Oncol




Instituto de Cardiologia y Cirugia Cardiovascular, Fundacion Favaloro (ICYCC), Buenos Aires 1212, Argentina




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