a 46-year - old woman presented to kyungpook national university hospital with a one - year history of chest discomfort and dyspnea , as well as a history of three operations for cardiac myxoma , including biatrial cardiac tumor resection in 1984 , followed 10 years later by the resection of a recurrent left atrial and ventricular cardiac myxoma attached to the interatrial and interventricular septa . the first surgery , in 1984 , was performed in our medical center . the myxoma and its pedicle attached to the fossa ovalis were excised via right atriotomy and left atriotomy with enclosure of the interatrial defect . the second surgery , in 1994 , the interatrial septum was nearly totally excised and the myxoid mass was identified and excised . also through aortotomy , a left ventricular myxoma on the interventricular septum below the right coronary cusp was identified and excised . sixteen years later , in 2010 , the third such operation was performed in the same center . after the dissection of severe adhesion , a myxoma and its stalk on the inferior vena cava and right atrial junction were excised through a right atriotomy . this patient also had a history of recurrent cutaneous and mucosal tumors , including forearm and nose tumors ( diagnosed as myxomas based on excisional biopsies of tumors on her right forearm and right nostril ) , breast ductal adenoma ( fibroadenomas diagnosed in her bilateral breasts through mammotome excisional biopsies ) , and a uterine myoma , as well as a basilar artery aneurysm . chest computed tomography revealed a large soft tissue mass in the right atrial and ventricular cavities and findings suspicious of pulmonary embolism ( fig . two days later , with a presumptive diagnosis of recurrent cardiac myxoma , the patient underwent cardiac surgery through a median sternotomy . aortic and venous cannulation , the latter through the superior vena cava and right femoral vein , were performed for cardiopulmonary bypass . the large gelatinous tumor was visualized after right atriotomy ; its stalk was located in the right atrium - inferior vena cava junction ( fig . moreover , the tumor involved part of the distal left pulmonary artery , leading to further pulmonary arteriotomy during surgery . postoperatively , the patient s symptoms of dyspnea and chest discomfort resolved without complications , and the patient was discharged on postoperative day 9 . after resection , cardiac myxoma , the most common benign cardiac tumor , rarely recurs , with a recurrence rate of approximately 3% observed in sporadic cases and a recurrence rate of 22% in patients with the carney complex , an uncommon autosomal dominant hereditary disorder first described by carney et al .   in 1985 . the carney complex , which manifests with cardiac , endocrine , cutaneous , and neural tumors and spotty pigmentation , is diagnosed when a patient exhibits either at least two main criteria , reflecting the manifestations of the disease , or one main criterion as well as one supplemental criterion associated with familial or hereditary features ( table 1 ) . the patient presented in this report had a consistent history of cutaneous myxoma , breast ductal adenoma , and cardiac myxoma . this case of four recurrences of cardiac myxoma , the first of its kind to be reported in korea , underscores the importance of performing a detailed investigation of patients with recurrent myxoma for the possibility of the carney complex in order to facilitate better management , prognostication , and patient education regarding this condition .