Cardiac myxomas: a review of current treatment approaches and emerging molecular therapies

Abstract Background Cardiac myxomas are the most common primary cardiac tumors, predominantly located in the left atrium. These benign tumors can obstruct blood flow, cause embolization, or produce systemic symptoms like fever. Diagnostic tools such as echocardiography play a critical role in their...

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Main Authors: Patrick Ashinze, Suvam Banerjee, Emmanuel Egbunu, Wuraola Salawu, Abdullaah Idris-Agbabiaka, Eniola Obafemi, Tolulope Joseph Olajuwon, Bethrand Chukwu, Sikiru Ademola Aremu, Olafisoye-Oragbade Oluwatosin David, Hamdallah Modupe Alausa, Folayemi Abiodun Iwaloye
Format: Article
Language:English
Published: SpringerOpen 2024-11-01
Series:The Cardiothoracic Surgeon
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Online Access:https://doi.org/10.1186/s43057-024-00141-1
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author Patrick Ashinze
Suvam Banerjee
Emmanuel Egbunu
Wuraola Salawu
Abdullaah Idris-Agbabiaka
Eniola Obafemi
Tolulope Joseph Olajuwon
Bethrand Chukwu
Sikiru Ademola Aremu
Olafisoye-Oragbade Oluwatosin David
Hamdallah Modupe Alausa
Folayemi Abiodun Iwaloye
author_facet Patrick Ashinze
Suvam Banerjee
Emmanuel Egbunu
Wuraola Salawu
Abdullaah Idris-Agbabiaka
Eniola Obafemi
Tolulope Joseph Olajuwon
Bethrand Chukwu
Sikiru Ademola Aremu
Olafisoye-Oragbade Oluwatosin David
Hamdallah Modupe Alausa
Folayemi Abiodun Iwaloye
author_sort Patrick Ashinze
collection DOAJ
description Abstract Background Cardiac myxomas are the most common primary cardiac tumors, predominantly located in the left atrium. These benign tumors can obstruct blood flow, cause embolization, or produce systemic symptoms like fever. Diagnostic tools such as echocardiography play a critical role in their identification, while surgical resection remains the primary curative treatment. Although recurrence is rare, it occurs more frequently in patients with genetic predispositions, such as the Carney complex. The risk of life-threatening complications such as embolism and sudden death necessitates prompt diagnosis and management. Despite the success of surgical treatment, recent advances have introduced minimally invasive techniques and novel molecular therapies, particularly for recurrent cases. Main body The epidemiology of cardiac myxomas highlights their rarity, with an incidence of 0.5–1 per million individuals annually. They are classified based on location, morphology, and whether they are sporadic or syndromic. Histologically, they originate from multipotent mesenchymal cells and present as gelatinous or solid masses. The genetic implicants, especially in familial cases, involve certain gene mutations, disrupting signaling pathways and leading to tumorigenesis. Diagnosis primarily relies on imaging, with transthoracic echocardiography being the first-line modality. Surgical resection, typically via median sternotomy, remains the gold standard treatment with a low recurrence rate. However, emerging molecular therapies, including gene editing, epigenetic interventions, stem cell therapy, and immunotherapy, offer promising avenues for managing complex or recurrent cases even though they are mostly in conceptual and preclinical phases. These molecular approaches target specific genetic and signaling pathways involved in myxoma formation and recurrence, and though they remain in experimental stages, the advent of gene therapy in oncology makes them the next best choice to watch out for. Conclusions While surgical resection remains curative in most cases, recurrence, particularly in familial syndromes, requires vigilant monitoring and innovative treatments. Emerging molecular therapies show potential in offering personalized treatment options, although they are still inchoate. Further research is needed to improve delivery systems and minimize the challenges associated with these therapies, paving the way for more effective management strategies.
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spelling doaj-art-cdda859dfb114a44b0601935d2eda0c02024-12-01T12:45:38ZengSpringerOpenThe Cardiothoracic Surgeon2662-22032024-11-0132111110.1186/s43057-024-00141-1Cardiac myxomas: a review of current treatment approaches and emerging molecular therapiesPatrick Ashinze0Suvam Banerjee1Emmanuel Egbunu2Wuraola Salawu3Abdullaah Idris-Agbabiaka4Eniola Obafemi5Tolulope Joseph Olajuwon6Bethrand Chukwu7Sikiru Ademola Aremu8Olafisoye-Oragbade Oluwatosin David9Hamdallah Modupe Alausa10Folayemi Abiodun Iwaloye11Faculty of Clinical Sciences, University of Ilorin Teaching HospitalDepartment of Health and Family Welfare, Government of West Bengal, Burdwan Medical College and HospitalFederal Medical Centre John’s HospitalTexila American UniversityFaculty of Clinical Sciences, University of Ilorin Teaching HospitalMerseyside & West Lancashire Teaching Hospital NHS TrustFaculty of Clinical Sciences, University of Ilorin Teaching HospitalFaculty of Clinical Sciences, University of Ilorin Teaching HospitalFaculty of Clinical Sciences, University of Ilorin Teaching HospitalFaculty of Clinical Sciences, University of Ilorin Teaching HospitalTexila American UniversityAbstract Background Cardiac myxomas are the most common primary cardiac tumors, predominantly located in the left atrium. These benign tumors can obstruct blood flow, cause embolization, or produce systemic symptoms like fever. Diagnostic tools such as echocardiography play a critical role in their identification, while surgical resection remains the primary curative treatment. Although recurrence is rare, it occurs more frequently in patients with genetic predispositions, such as the Carney complex. The risk of life-threatening complications such as embolism and sudden death necessitates prompt diagnosis and management. Despite the success of surgical treatment, recent advances have introduced minimally invasive techniques and novel molecular therapies, particularly for recurrent cases. Main body The epidemiology of cardiac myxomas highlights their rarity, with an incidence of 0.5–1 per million individuals annually. They are classified based on location, morphology, and whether they are sporadic or syndromic. Histologically, they originate from multipotent mesenchymal cells and present as gelatinous or solid masses. The genetic implicants, especially in familial cases, involve certain gene mutations, disrupting signaling pathways and leading to tumorigenesis. Diagnosis primarily relies on imaging, with transthoracic echocardiography being the first-line modality. Surgical resection, typically via median sternotomy, remains the gold standard treatment with a low recurrence rate. However, emerging molecular therapies, including gene editing, epigenetic interventions, stem cell therapy, and immunotherapy, offer promising avenues for managing complex or recurrent cases even though they are mostly in conceptual and preclinical phases. These molecular approaches target specific genetic and signaling pathways involved in myxoma formation and recurrence, and though they remain in experimental stages, the advent of gene therapy in oncology makes them the next best choice to watch out for. Conclusions While surgical resection remains curative in most cases, recurrence, particularly in familial syndromes, requires vigilant monitoring and innovative treatments. Emerging molecular therapies show potential in offering personalized treatment options, although they are still inchoate. Further research is needed to improve delivery systems and minimize the challenges associated with these therapies, paving the way for more effective management strategies.https://doi.org/10.1186/s43057-024-00141-1Cardiac myxomasMolecular therapiesSurgical resectionCombination therapyGene editing
spellingShingle Patrick Ashinze
Suvam Banerjee
Emmanuel Egbunu
Wuraola Salawu
Abdullaah Idris-Agbabiaka
Eniola Obafemi
Tolulope Joseph Olajuwon
Bethrand Chukwu
Sikiru Ademola Aremu
Olafisoye-Oragbade Oluwatosin David
Hamdallah Modupe Alausa
Folayemi Abiodun Iwaloye
Cardiac myxomas: a review of current treatment approaches and emerging molecular therapies
The Cardiothoracic Surgeon
Cardiac myxomas
Molecular therapies
Surgical resection
Combination therapy
Gene editing
title Cardiac myxomas: a review of current treatment approaches and emerging molecular therapies
title_full Cardiac myxomas: a review of current treatment approaches and emerging molecular therapies
title_fullStr Cardiac myxomas: a review of current treatment approaches and emerging molecular therapies
title_full_unstemmed Cardiac myxomas: a review of current treatment approaches and emerging molecular therapies
title_short Cardiac myxomas: a review of current treatment approaches and emerging molecular therapies
title_sort cardiac myxomas a review of current treatment approaches and emerging molecular therapies
topic Cardiac myxomas
Molecular therapies
Surgical resection
Combination therapy
Gene editing
url https://doi.org/10.1186/s43057-024-00141-1
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