Multiple myxomas - surgery and diagnosis

We have carefully examined this report and completely agree with the authors that the described case is extremely rare and interesting [1]. Myxomas are the most frequently encountered type of heart tumor. Seventy-five percent of myxomas are found in the left atrium, 20% are located in the right atrium and 5% appear elsewhere [2]. The Bakoulev Center for Cardiovascular Surgery has an experience of more than 400 successful cases of heart tumor surgery, and there has been only a single case of giant tandem myxoma of left and right atria, which has been described [3]. The neoplasm consisted of two parts which measured 9×8×8 cm in the right atrium and 7×6×6 cm in the left atrium, protruding from the middle third of the atrial septum. The tumor was successfully removed. It is worth mentioning that, according to our observations, the location of points of attachment of myxomas in the atria has been subject to some sort of evolution in recent times. Previously, the most common (90% of cases) location for attachment of the myxomas was the fossa ovalis. Nowadays more and more of them are found attached to other areas. In addition, we would also like to point out that, from our point of view, transthoracic echocardiography is sufficient to diagnose a myxoma, and the transesophageal method is necessary only in complicated cases where it is required to precisely locate the point of attachment of the stalk of the myxoma.