Recurrent cardiac myxoma with multiple distant metastasis and malignant change

A 37 year-old female underwent open heart surgery for a left atrial myxoma. The post-operative course was uneventful and she was discharged two weeks later. She had regular monthly follow-up in the outpatient department until 10 months postoperatively when she was readmitted to tile orthopedic ward for excision of a left ankle tumor. Two days after admission, she developed severe orthopnea. The initial diagnosis was heart failure, and she was tra nsferred to the medical ward for treatment. Transthoracic and transesophage al echocardiography revealed a recurrent left atrial tumor. Because of acut e obstruction of the mitral valve and deterioration of her condition, she u nderwent emergent open heart surgery. The recurrent atrial tumor was excise d; histopathologic examination revealed a myxoid sarcoma. Multiple turners were found on this admission, including a mass in the neck and in the left forearm; computed tomography revealed a brain tumor ill the left posterior frontal lobe and a chest wall tumor. She died two months later. Recurrent c ardiac myxoma with multiple distant metastasis may have a malignant potenti al. Because of the potential for rumor recurrence, long-term and regular fo llow-up is mandatory.