Which of the following statements about left atrial myxoma are true?

A. This lesion, by site and histology, is the most common primary cardiac tumor.

C. The symptom complex can mimic collagen vascular disease.

D. It has an intracavitary growth pattern. 

DISCUSSION: Eighty per cent of primary cardiac tumors are benign, and half of these benign tumors are myxomas. Seventyfive per cent of myxomas arise in the left atrium in the region of the fossa ovalis. Echocardiography is the technique of choice in the evaluation of intracardiac tumors, and findings suggestive of myxoma occur in 95% of patients examined. Invasive procedures, with the attendant risk of tumor embolization, are not warranted. Owing to an autoimmune phenomenon, left atrial myxomas can present with systemic constitutional symptoms of fever, malaise, weight loss, polymyositis, and blood dyscrasias that mimic collagen vascular disease. Of surgical significance is the fact that most myxomas rarely extend deeper than the endocardium but grow as polypoid, intracavitary masses. Attachment by a vascular stalk thus allows tumor mobility, predisposing to embolization and interference with mitral valve competence and causing characteristic echocardiographic findings.