Elevated plasma concentration of vascular endothelial growth factor in cardiac myxoma.

S hortly after Kono and associates1 reported their findings concerning the role of vascular endothelial growth factor (VEGF) gene expression in the development of cardiac myxomas, we had the opportunity to assay plasma VEGF before and after surgery in a 31-year-old black woman with multicentric recurring myxomas. At the age of 10 years, she had undergone excision of a left atrial myxoma. In the following decade, she had 4 more operations with excision of 19 myxomas. The tumors (9 on the right side and 10 on the left side), occurring at widely separated and random sites within both atria and on the tricuspid and mitral valves, appeared to develop de novo without invasion of surrounding tissue. The sizes ranged from a “nodule” to 3 × 4 cm, and the histologic features, by both light and electron microscopy, were typical for myxoma. Now, 12 years after her fifth heart operation, the tumor recurred and she underwent a sixth operation. We report our observations.