[Ablation of a Mahaim accessory pathway connected to the left ventricle].

it passed through (Figure 1). This macroscopic description would correspond to a villous myxoma, a less common subtype of myxoma.6 This case report is entirely exceptional due to the nature of the intracardiac tumor, a myxoma, with no apparent connection to the initial lesion, despite the fact that testicular germ cell tumors have been described as neoplasms that can lead to cardiac metastases3; due to the location of the myxoma, which originated in the superior vena cava-brachiocephalic trunk, the venous site being highly exceptional, although it has been reported in inferior vena cava and femoral vein7,8; and, finally, due to its ability to grow and recur after the first operation. The most difficult aspect to explain is the association between the myxoma and the initial neoplasm, if it exists. The form and location of this myxoma would support the hypothesis of those who once defended a thrombotic origin. Taking into account its intracavitary site and the fact that the patient had a Port-ACath®, and accepting the prothrombotic tendency of cancer patients, the origin could be attributed to this circumstance. One argument against this could be the presence of a synchronous lesion of the same histology on the anterior aspect of right ventricle. Moreover, in this case, it was possible to confirm the nature of the myxoma by an immunohistochemical test for calretinin, a technique that is totally specific for the differentiation of a myxoma from a thrombus.5 The final lesson to be learned from this case is that any abnormal growth should be subjected to pathological examination, regardless of the history. In this patient, with his complex and extensive history of neoplastic disease, it could have been assumed that the present intracardiac mass was metastatic and did not warrant treatment, when, in reality, it was benign and, to a great extent, resectable.