Ann Dermatol.  2012 Aug;24(3):337-340. 10.5021/ad.2012.24.3.337.

Cardiac Myxoma Diagnosed by Signs of Purpuric Macules on Both Palms and Soles

• Lee HJ
• Park JY
• Kim YS
• Shin DH
• Choi JS
• Kim KH
• Bae YK

• KMID: 2265307
• DOI: http://doi.org/10.5021/ad.2012.24.3.337

Abstract

Cardiac myxoma, the most prevalent primary cardiac tumor, is rare. The clinical features of this tumor are principally intracardiac obstruction, extracardiac embolism, and general symptoms including fever, myalgia, arthralgia. Although cutaneous manifestations in patients with cardiac myxoma are frequent, in rare cases, cutaneous signs have been clues to the correct diagnosis. We report a 42-year-old male who presented with recurrent multiple purpuric patches on both palms and soles for 4 months. Histopathological finding showed a myxomatous embolus in the arteriole in the lower dermis. Echocardiogram demonstrated the presence of a left atrial myxoma with a provisional diagnosis of left atrial myxoma. In our patient, skin examinations and histopathological finding led us to the diagnosis of cardiac myxoma.

Keyword

Cardiac myxoma; Palms and soles; Purpura

MeSH Terms

Adult
Arterioles
Arthralgia
Dermis
Embolism
Fever
Heart Neoplasms
Humans
Male
Myxoma
Purpura
Skin

Figure

• 

  Fig. 1 Multiple tender erythematous to purpuric macules on both palms and soles.

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  Fig. 2 A myxomatous embolus in the arteriole of the lower dermis (red circle) (H&E staining; ×40, ×100).

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  Fig. 3 A 5.0×2.5 cm echogenic mass within the left atrial cavity detected on echocardiogram.

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  Fig. 4 A 4.5×4.5×3.0 cm brownish gelatinous mass excised from the left atrium.

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  Fig. 5 Hypocellular myxoid stroma with a perivascular arrangement of scattered stellate or spindle-shaped cells (H&E staining; ×200).

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