Cardiac Myxoma : Gross Pathology
Gross Pathology: The gross appearance of cardiac myxomas is quite variable. They may be sessile or pedunculated with a narrow stalk. The size ranges from <1 cm (usually asymptomatic and found incidentally at autopsy) to >10 cm which can massively distend the atrium. Large tumors may project through the valve into the ventricular cavity. The average size is 5-6 cm.Two-thirds of cases are round to oval, polypoid masses with a smooth or bosselated surface (as seen here) and have a short, broad-based attachment to the interatrial septum. Some tumors are attached to the atrial septum by a clearly-defined narrow stalk. One-third of cases have an irregular surface containing friable papillary or villous fronds. These projections have mucoid, gelatinous appearance and can easily break off and embolize. The cut surface has a variegated appearance with mucoid, hemorrhagic and soft gelatinous areas. Calcification is common in right-sided tumors and can convert them into hard, gritty masses.