International Journal of Research in Medical Sciences | July 2019 | Vol 7 | Issue 7 Page 2856 International Journal of Research in Medical Sciences Raman KR et al. Int J Res Med Sci. 2019 Jul;7(7):2856-2858 www.msjonline.org pISSN 2320-6071 | eISSN 2320-6012 Case Report A rare and independent association of right atrial myxoma with immune thrombocytopenic purpura Karthik Raman R.*, Vijay Anand Palanisamy, Mithun Sundararaaja Ravikumar, Jeswin Moses, Sivakumar Pandian, Rajan Sethuratnam INTRODUCTION Intra cardiac tumours are very rare and myxomas are one such benign common tumours of the heart. 1 Usually left sided they are and right sided myxomas are even more rare occurring in the ratio of 1:4. The mechanical hemolytic effects of myxoma usually result in thrombocytopenia and sometimes there can be independent ITP existing in a myxoma patient. 2 We describe one such case wherein the thrombocytopenia was not due to the myxoma per se, but rather separate entities of myxoma and ITP existing independently in a single patient. CASE REPORT A forty-year-old normotensive euglycemic male, was diagnosed with immune thrombocytopenic purpura (after excluding all the causes for thrombocytopenia with connective tissue disorder work up being negative) fifteen years before and he underwent splenectomy and was on regular follow up with haematologist for the same. At that time there was no history of myxoma as an echo cardiography done fifteen year before mentions normal right atrial chamber with no intra cardiac tumours. Three months before he presented with dyspnoea on exertion New York Heart Association class II-III and chest pain for which he was referred to our centre for further evaluation. On further evaluation, Echocardiogram revealed a 5x3 cm mass (Figure 1). attached to the inter atrial septum in the right atrium protruding into the right ventricle through the tricuspid valve with features suggestive of myxoma (incidental diagnosis). There was no tricuspid regurgitation with good biventricular function. His platelet count was 2 lakhs/cubic millimetre on admission. He was not on any immunosuppressive therapy or steroids as his haematological investigations were within normal limits. Department of Cardiac Surgery, Institute of Cardiovascular Diseases, Madras Medical Mission, Chennai, Tamilnadu, India Received: 05 May 2019 Accepted: 31 May 2019 *Correspondence: Dr. Karthik Raman R., E-mail: ramintokarthik@gmail.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ABSTRACT Primary tumours of the heart are rare and the most common benign ones are myxomas. The clinical features are varied and include a myriad of presenting symptoms like embolic, constitutional, cardiac and also symptoms due to obstruction. Right atrial myxomas are very rarely seen when compared with left atrium. Such myxomas independently co existing with Immune Thrombocytopenic Purpura (ITP) is even rarer and we now present one such case in with right atrial myxoma was associated with ITP and was managed surgically. This case emphasises the fact that ITP can co-exist with myxoma and should be borne in mind when treating such patients surgically. Keywords: Immune, Myxoma, Right atrium, Thrombocytopenia DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20192935