Finding of a mass on the mitral valve in a patient on chronic dialysis

Myxomas are cardiac neoplasms that are most commonly located in the left atrium, usually arising from the vicinity of the fossa ovalis. However, there have been cases, although very rarely, of valvular myxoma. A cardiac mass found incidentally on echocardiography can present a challenge in particula...

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Main Authors: Vasil Papestiev, MD, PhD, Marjan Shokarovski, MD, Nikola Lazovski, MD, Nadica Mehmedovic, MD, Valentina Andova, MD, PhD, Gordana Petrushevska, MD, PhD, Ljubica Georgievska-Ismail, MD, PhD
Format: Article
Language:English
Published: Elsevier 2025-04-01
Series:Radiology Case Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S1930043325000184
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author Vasil Papestiev, MD, PhD
Marjan Shokarovski, MD
Nikola Lazovski, MD
Nadica Mehmedovic, MD
Valentina Andova, MD, PhD
Gordana Petrushevska, MD, PhD
Ljubica Georgievska-Ismail, MD, PhD
author_facet Vasil Papestiev, MD, PhD
Marjan Shokarovski, MD
Nikola Lazovski, MD
Nadica Mehmedovic, MD
Valentina Andova, MD, PhD
Gordana Petrushevska, MD, PhD
Ljubica Georgievska-Ismail, MD, PhD
author_sort Vasil Papestiev, MD, PhD
collection DOAJ
description Myxomas are cardiac neoplasms that are most commonly located in the left atrium, usually arising from the vicinity of the fossa ovalis. However, there have been cases, although very rarely, of valvular myxoma. A cardiac mass found incidentally on echocardiography can present a challenge in particular if asymptomatic or found in an unusual location. We present the case of a 58-year-old male with kidney disease treated with chronic dialysis, referred to the cardiology clinic because of an incidental finding of a mitral valvular mass on routine transthoracic echocardiography. Although this lesion was initially misdiagnosed as native valvular endocarditis with vegetation, a series of clinical and radiological investigations led to the preoperative diagnosis of possible papillary fibroelastoma or calcified thrombotic mass. Given the increased risk of embolization due to the mass being mobile and greater than 1 cm in size, the patient was referred to cardiac surgery. Excision of the mass without mitral valve replacement was performed. Histopathological findings of the mass revealed the existence of a cardiac myxoma. In such cases of a mitral valve mass, multimodality imaging should have of high priority to achieve an accurate diagnosis. Although a definitive diagnosis can only be established after surgical excision of the mass and histopathological confirmation, it is very important to consider a differential diagnosis of mitral valve myxoma in any patient with an unexplained mitral valve mass.
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spelling doaj-art-cbbd74b3402d4b5cb77fb9ca20427f1c2025-08-20T01:57:52ZengElsevierRadiology Case Reports1930-04332025-04-012042075207910.1016/j.radcr.2025.01.020Finding of a mass on the mitral valve in a patient on chronic dialysisVasil Papestiev, MD, PhD0Marjan Shokarovski, MD1Nikola Lazovski, MD2Nadica Mehmedovic, MD3Valentina Andova, MD, PhD4Gordana Petrushevska, MD, PhD5Ljubica Georgievska-Ismail, MD, PhD6University Clinic for Cardiac Surgery, Medical Faculty, Ss. Cyril and Methodius University of Skopje, Majka Tereza no. 17/building 8, Skopje 1000, Republic of North Macedonia; Corresponding author.University Clinic for Cardiac Surgery, Medical Faculty, Ss. Cyril and Methodius University of Skopje, Majka Tereza no. 17/building 8, Skopje 1000, Republic of North MacedoniaUniversity Clinic for Cardiac Surgery, Medical Faculty, Ss. Cyril and Methodius University of Skopje, Majka Tereza no. 17/building 8, Skopje 1000, Republic of North MacedoniaUniversity Clinic for Cardiac Surgery, Medical Faculty, Ss. Cyril and Methodius University of Skopje, Majka Tereza no. 17/building 8, Skopje 1000, Republic of North MacedoniaUniversity Clinic of Cardiology, Medical Faculty, Ss. Cyril and Methodius University of Skopje, Republic of North Macedonia, Majka Tereza no. 17/building 8, Skopje 1000, Republic of North MacedoniaInstitute of Pathology, Medical Faculty, Ss. Cyril & Methodius University of Skopje, Republic of North Macedonia, 50 Divizija, 6b, Skopje 1000, Republic of North MacedoniaUniversity Clinic of Cardiology, Medical Faculty, Ss. Cyril and Methodius University of Skopje, Republic of North Macedonia, Majka Tereza no. 17/building 8, Skopje 1000, Republic of North MacedoniaMyxomas are cardiac neoplasms that are most commonly located in the left atrium, usually arising from the vicinity of the fossa ovalis. However, there have been cases, although very rarely, of valvular myxoma. A cardiac mass found incidentally on echocardiography can present a challenge in particular if asymptomatic or found in an unusual location. We present the case of a 58-year-old male with kidney disease treated with chronic dialysis, referred to the cardiology clinic because of an incidental finding of a mitral valvular mass on routine transthoracic echocardiography. Although this lesion was initially misdiagnosed as native valvular endocarditis with vegetation, a series of clinical and radiological investigations led to the preoperative diagnosis of possible papillary fibroelastoma or calcified thrombotic mass. Given the increased risk of embolization due to the mass being mobile and greater than 1 cm in size, the patient was referred to cardiac surgery. Excision of the mass without mitral valve replacement was performed. Histopathological findings of the mass revealed the existence of a cardiac myxoma. In such cases of a mitral valve mass, multimodality imaging should have of high priority to achieve an accurate diagnosis. Although a definitive diagnosis can only be established after surgical excision of the mass and histopathological confirmation, it is very important to consider a differential diagnosis of mitral valve myxoma in any patient with an unexplained mitral valve mass.http://www.sciencedirect.com/science/article/pii/S1930043325000184Mitral valve massEchocardiographyMyxomaEndocarditis
spellingShingle Vasil Papestiev, MD, PhD
Marjan Shokarovski, MD
Nikola Lazovski, MD
Nadica Mehmedovic, MD
Valentina Andova, MD, PhD
Gordana Petrushevska, MD, PhD
Ljubica Georgievska-Ismail, MD, PhD
Finding of a mass on the mitral valve in a patient on chronic dialysis
Radiology Case Reports
Mitral valve mass
Echocardiography
Myxoma
Endocarditis
title Finding of a mass on the mitral valve in a patient on chronic dialysis
title_full Finding of a mass on the mitral valve in a patient on chronic dialysis
title_fullStr Finding of a mass on the mitral valve in a patient on chronic dialysis
title_full_unstemmed Finding of a mass on the mitral valve in a patient on chronic dialysis
title_short Finding of a mass on the mitral valve in a patient on chronic dialysis
title_sort finding of a mass on the mitral valve in a patient on chronic dialysis
topic Mitral valve mass
Echocardiography
Myxoma
Endocarditis
url http://www.sciencedirect.com/science/article/pii/S1930043325000184
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