Lung Pathology: Chest Tumors |

Pulmonary Myxoma: A rare benign tumor of the lung FREE TO VIEW

Rahul Mutneja, MBBS; Omar Ibrahim, MD
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University of Connecticut Health Center, Farmington, CT

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;149(4_S):A338. doi:10.1016/j.chest.2016.02.352
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SESSION TYPE: Case Report Poster

PRESENTED ON: Sunday, April 17, 2016 at 11:45 AM - 12:45 PM

INTRODUCTION: Pulmonary myxoma is a rare benign tumor of the lung. Identification of this entity is important due to unknown incidence of the lesion and to avoid unnecessary invasive procedures. Pulmonary myxomas have been reported as sporadic case reports and can been seen arising in the lungs, pleura and trachea. As the use of computed tomography (CT) scan is increasing we are likely to see more of these benign lesions.

CASE PRESENTATION: Patient is a 62 year-old active smoker who was recently diagnosed with cholangiocarcinoma. She has a past medical history of adenomatous goiter, hypertension and asthma. During the work up she was found to have a 1 cm nodule in the right upper lobe. Positron emission tomography scan showed minimal uptake in the lesion which was then biopsied and showed lobular myxo-mucinous blobs and benign slightly inflamed bronchio-alveolar tissue, negative for malignancy. She underwent cholecystectomy and right liver lobectomy. Following this she was referred to pulmonary clinic for follow up of the pulmonary nodule and had a repeat CT scan done which showed increased volume of the mass and hence it was re-biopsied and showed similar pathology suggestive of pulmonary myxoma.

DISCUSSION: The earliest case of pleuro pulmonary myxoma was reported by Barkley and Cardozo1 in 1957 where they described a 54 year-old female active smoker who had presented with a consolidation and after treatment was found to have a left sided rounded opacity. She underwent thoracotomy due to increasing size on the radiograph and was found to have multiple pleural based lesions and a bigger 3 cm mass in the lingula which was resected. This was shown to be made up of benign myxomatous tissue on histology. In addition to pleuro pulmonary myxomas, there are case reports describing myxomas arising in the pulmonary artery, trachea2 and endobronchially. The differential diagnosis for a myxoma can be myxoid liposarcoma, myxoid chondrosarcoma, myxoid malignant fibrous histiocytoma, pulmonary hamartoma, angiomyolipoma and pulmonary lipoma. From these case reports it is observed that the myxomas tend to increase in size with time and are prone to recur after resection. Cases where complete resection was done had no recurrence during the documented follow up period.

CONCLUSIONS: 1. Pulmonary myxoma is a rare benign tumor of the lung 2. Myxomas tend to increase in size with time and are prone to recur after resection 3. Myxomas can be seen independently and may co-exist with other malignancies3 making there identification important.

Reference #1: Barkley H, Cardozo RH. A myxomatous tumour of pleuro-pulmonary origin. Thorax 1957;12:264-7.

Reference #2: Nadrous HF, Krowka MJ, Myers JL, Allen MS, Sabri AN. Tracheal myxoma: a rare benign tracheal tumor. Mayo Clinic proceedings 2004;79:931-3.

Reference #3: Hasleton PS, Langdale-Brown B, Rahman A, Smyrniou N, Barber PV. Pleural myxoma associated with a pulmonary squamous cell carcinoma. Respiratory medicine 1989;83:443-4.

DISCLOSURE: The following authors have nothing to disclose: Rahul Mutneja, Omar Ibrahim

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