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Alizadehasl A, Hakimian H, Dokhani N, Pouraliakbar H, Firoozbakhsh P. Early presentation of undifferentiated pleomorphic cardiac sarcoma. Radiol Case Rep 2024; 19:4308-4311. [PMID: 39161570 PMCID: PMC11331714 DOI: 10.1016/j.radcr.2024.06.088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Revised: 06/17/2024] [Accepted: 06/30/2024] [Indexed: 08/21/2024] Open
Abstract
Undifferentiated pleomorphic cardiac sarcomas are extremely rare, highly malignant mesenchymal cardiac neoplasms typically presenting in the sixth decade of life. Here, we have reported a rare case of undifferentiated pleomorphic cardiac sarcoma presenting with dyspnea in a young male. On further evaluations, a large, ill-defined, multilobulated mass was observed in left atrium (LA) with encasement of left circumflex artery, attachment to mitral valve annulus, and invasion through LA wall and pericardium.
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Affiliation(s)
- Azin Alizadehasl
- Cardio-Oncology Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Hoda Hakimian
- Cardio-Oncology Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Negar Dokhani
- Cardio-Oncology Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Hamidreza Pouraliakbar
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Parisa Firoozbakhsh
- Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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2
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Jiang Z, Kang Q, Qian H, Xu Z, Tong H, Yang J, Li L, Li R, Li G, Chen F, Lin N, Zhao Y, Shi H, Huang J, Ma X. Revealing the crucial roles of suppressive immune microenvironment in cardiac myxoma progression. Signal Transduct Target Ther 2024; 9:193. [PMID: 39090109 PMCID: PMC11294589 DOI: 10.1038/s41392-024-01912-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 06/26/2024] [Accepted: 07/05/2024] [Indexed: 08/04/2024] Open
Abstract
Cardiac myxoma is a commonly encountered tumor within the heart that has the potential to be life-threatening. However, the cellular composition of this condition is still not well understood. To fill this gap, we analyzed 75,641 cells from cardiac myxoma tissues based on single-cell sequencing. We defined a population of myxoma cells, which exhibited a resemblance to fibroblasts, yet they were distinguished by an increased expression of phosphodiesterases and genes associated with cell proliferation, differentiation, and adhesion. The clinical relevance of the cell populations indicated a higher proportion of myxoma cells and M2-like macrophage infiltration, along with their enhanced spatial interaction, were found to significantly contribute to the occurrence of embolism. The immune cells surrounding the myxoma exhibit inhibitory characteristics, with impaired function of T cells characterized by the expression of GZMK and TOX, along with a substantial infiltration of tumor-promoting macrophages expressed growth factors such as PDGFC. Furthermore, in vitro co-culture experiments showed that macrophages promoted the growth of myxoma cells significantly. In summary, this study presents a comprehensive single-cell atlas of cardiac myxoma, highlighting the heterogeneity of myxoma cells and their collaborative impact on immune cells. These findings shed light on the complex pathobiology of cardiac myxoma and present potential targets for intervention.
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Affiliation(s)
- Zedong Jiang
- Department of Biotherapy, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Bio-Resource and Eco-Environment of Ministry of Education, College of Life Sciences, Sichuan University, Chengdu, Sichuan, China
| | - Qianlong Kang
- Department of Biotherapy, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Hong Qian
- Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Zhijie Xu
- Department of Pathology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Huan Tong
- Department of Biotherapy, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jiaqing Yang
- Department of Biotherapy, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Li Li
- Institute of Clinical Pathology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Renwei Li
- Department of Biotherapy, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Guangqi Li
- Department of Biotherapy, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Fei Chen
- Institute of Clinical Pathology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Nan Lin
- Department of Biotherapy, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yunuo Zhao
- Department of Biotherapy, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Huashan Shi
- Department of Biotherapy, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
| | - Juan Huang
- Department of Hematology, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.
| | - Xuelei Ma
- Department of Biotherapy, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
- Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
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3
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Nèji H, Bennour E, Baccouche I, Kechaou S, Kammoun I, Affes M, Hantous‐Zannad S. Caseous mitral annulus calcification: A forgotten benign condition mimicking cardiac mass, a case report. Clin Case Rep 2024; 12:e8031. [PMID: 39183893 PMCID: PMC11341981 DOI: 10.1002/ccr3.8031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 09/24/2023] [Accepted: 09/26/2023] [Indexed: 08/27/2024] Open
Abstract
Key Clinical Message Caseous mitral annulus calcification is a rare benign condition that can be misdiagnosed on echocardiography especially when it presents as a mass. This report highlights the contribution of cardiac MRI and computed tomography to the diagnosis through the case of a patient previously treated for breast cancer. Abstract We report the case of a patient, previously treated for breast cancer, in whom echocardiography suggested the diagnosis of a cardiac tumor due the presence of a mass on the posterior mitral annulus. Cardiac magnetic resonance was inconclusive. Computed tomography confirmed the diagnosis of caseous mitral annulus calcification.
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Affiliation(s)
- Henda Nèji
- Imaging DepartmentAbderrahmen Mami HospitalArianaTunisia
- Faculty of Medicine of TunisUniversity Tunis El ManarTunisTunisia
- Cardio‐thoracic imaging Research LaboratoryMinistry of Higher Education and ResearchTunisia
| | - Emna Bennour
- Faculty of Medicine of TunisUniversity Tunis El ManarTunisTunisia
- Cardiology DepartmentAbderrahmen Mami HospitalArianaTunisia
| | - Ines Baccouche
- Imaging DepartmentAbderrahmen Mami HospitalArianaTunisia
- Cardio‐thoracic imaging Research LaboratoryMinistry of Higher Education and ResearchTunisia
| | - Salma Kechaou
- Imaging DepartmentAbderrahmen Mami HospitalArianaTunisia
- Cardio‐thoracic imaging Research LaboratoryMinistry of Higher Education and ResearchTunisia
| | - Ikram Kammoun
- Faculty of Medicine of TunisUniversity Tunis El ManarTunisTunisia
- Cardiology DepartmentAbderrahmen Mami HospitalArianaTunisia
| | - Meriem Affes
- Imaging DepartmentAbderrahmen Mami HospitalArianaTunisia
- Faculty of Medicine of TunisUniversity Tunis El ManarTunisTunisia
- Cardio‐thoracic imaging Research LaboratoryMinistry of Higher Education and ResearchTunisia
| | - Saoussen Hantous‐Zannad
- Imaging DepartmentAbderrahmen Mami HospitalArianaTunisia
- Faculty of Medicine of TunisUniversity Tunis El ManarTunisTunisia
- Cardio‐thoracic imaging Research LaboratoryMinistry of Higher Education and ResearchTunisia
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4
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Singh A, Mukati R, Bansal M. The Utility of Routine Intraoperative Transesophageal Echocardiography During Coronary Artery Bypass Graft Surgery: An Unexpected Reminder. Ann Card Anaesth 2024; 27:282-284. [PMID: 38963371 PMCID: PMC11315252 DOI: 10.4103/aca.aca_213_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 01/21/2024] [Accepted: 01/29/2024] [Indexed: 07/05/2024] Open
Affiliation(s)
- Ajmer Singh
- Department of Cardiac Anaesthesia, Medanta-The Medicity, Gurugram, Haryana, India
| | - Ravina Mukati
- Department of Clinical and Preventive Cardiology, Medanta-The Medicity, Gurugram, Haryana, India
| | - Manish Bansal
- Department of Cardiac Anaesthesia, Medanta-The Medicity, Gurugram, Haryana, India
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5
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Kaewboonlert N, Chunharas P, Pluthikarmpae N, Poontananggul J, Wongthep A, Pongsuwan N, Lerssuttipon U. Right ventricular outflow tract obstruction by cardiac hemangioma in asymptomatic patient. J Surg Case Rep 2024; 2024:rjae321. [PMID: 38764738 PMCID: PMC11102782 DOI: 10.1093/jscr/rjae321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 05/01/2024] [Indexed: 05/21/2024] Open
Abstract
Ventricular hemangiomas are rare benign tumors, pose diagnostic and therapeutic complexities. We report a case of a 52-year-old female with essential hypertension who developed a systolic ejection murmur during a hypertension clinic visit. The echocardiogram revealed a hyperechoic mass obstructing the right ventricular outflow tract, causing enlargement of the right atrium and ventricle, with a reduction in the right ventricular ejection fraction. Due to the risk of death, the patient underwent an emergency surgical resection along with tricuspid valve replacement. Postoperative recovery was uneventful, and subsequent cardiac magnetic resonance imaging showed an improvement in ejection fraction without residual tumor. This case highlights the diagnosis and therapeutic complexities of ventricular hemangiomas. With this report, we aim to provide a comprehensive review of ventricular hemangiomas and to enhance understanding of this condition for improved patient care.
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Affiliation(s)
- Naritsaret Kaewboonlert
- Institute of Medicine, Suranaree University of Technology, Nakhon Ratchasima 30000, Thailand
| | - Piyapat Chunharas
- Department of Medicine, Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima 30000, Thailand
| | - Naree Pluthikarmpae
- Department of Pathology, Suranaree University of Technology Hospital, Nakhon Ratchasima 30000, Thailand
| | - Jiraphon Poontananggul
- Institute of Medicine, Suranaree University of Technology, Nakhon Ratchasima 30000, Thailand
| | - Akharawat Wongthep
- Institute of Medicine, Suranaree University of Technology, Nakhon Ratchasima 30000, Thailand
| | - Natthipong Pongsuwan
- Institute of Medicine, Suranaree University of Technology, Nakhon Ratchasima 30000, Thailand
| | - Udomsak Lerssuttipon
- Department of Medicine, Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima 30000, Thailand
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6
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Șoșdean R, Lazăr MA, Pescariu SA, Mircea MN, Lala RI, Mornoș C, Luca CT, Ionac A. Importance of Multimodality Cardiac Imaging in the Diagnosis of Lipomatous Hypertrophy of the Interatrial Septum-A View beyond Standard Situations. Life (Basel) 2024; 14:514. [PMID: 38672784 PMCID: PMC11051309 DOI: 10.3390/life14040514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 04/10/2024] [Accepted: 04/12/2024] [Indexed: 04/28/2024] Open
Abstract
Lipomatous hypertrophy of the interatrial septum (LHIAS) represents a benign proliferation of lipoid cells at the level of the interatrial septum (IAS) inducing an important thickening of this structure. It respects the fossa ovalis (FO) region, having a typical "hourglass" echocardiographic appearance. There are certain cases though, with unusual appearances and/or with associated pathologies that may induce similar lesions in the heart, in which the differential diagnosis cannot be guaranteed using only the standard methods. The final diagnosis has important implications in these patients' treatment plan. In this paper, we present an unusual case of a female patient undergoing chemotherapy for lung carcinoma, suspected of right atrial thrombosis/metastasis. As the diagnosis was unclear after transthoracic echocardiography (TTE), inducing the suspicion of an IAS mass with atrial wall infiltration, bi- and tridimensional transesophageal echocardiography (TOE) was performed, revealing a severely and homogenously hypertrophied IAS respecting the FO, but lacking a clear visualization of the atrial wall. The diagnosis of LHIAS was established by cardiac magnetic resonance (CMR) that certified the adipose nature of the structure, excluding the need for invasive investigations and/or treatment options. Multimodality imaging is very important for the clinician in adopting the best management plan for each individual patient.
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Affiliation(s)
- Raluca Șoșdean
- Department VI—Cardiology, “Victor Babeș” University of Medicine and Pharmacy of Timișoara, 300041 Timișoara, Romania; (R.Ș.); (M.-A.L.); (C.M.); (C.T.L.), (A.I.)
- Institute of Cardiovascular Diseases, 300310 Timișoara, Romania;
| | - Mihai-Andrei Lazăr
- Department VI—Cardiology, “Victor Babeș” University of Medicine and Pharmacy of Timișoara, 300041 Timișoara, Romania; (R.Ș.); (M.-A.L.); (C.M.); (C.T.L.), (A.I.)
- Institute of Cardiovascular Diseases, 300310 Timișoara, Romania;
| | - Silvius Alexandru Pescariu
- Department VI—Cardiology, “Victor Babeș” University of Medicine and Pharmacy of Timișoara, 300041 Timișoara, Romania; (R.Ș.); (M.-A.L.); (C.M.); (C.T.L.), (A.I.)
- Institute of Cardiovascular Diseases, 300310 Timișoara, Romania;
| | | | - Radu Ioan Lala
- Department of Cardiology, Faculty of Medicine, Arad Emergency County Hospital, Arad Western University “Vasile Goldis”, 310025 Arad, Romania;
| | - Cristian Mornoș
- Department VI—Cardiology, “Victor Babeș” University of Medicine and Pharmacy of Timișoara, 300041 Timișoara, Romania; (R.Ș.); (M.-A.L.); (C.M.); (C.T.L.), (A.I.)
- Institute of Cardiovascular Diseases, 300310 Timișoara, Romania;
| | - Constantin Tudor Luca
- Department VI—Cardiology, “Victor Babeș” University of Medicine and Pharmacy of Timișoara, 300041 Timișoara, Romania; (R.Ș.); (M.-A.L.); (C.M.); (C.T.L.), (A.I.)
- Institute of Cardiovascular Diseases, 300310 Timișoara, Romania;
| | - Adina Ionac
- Department VI—Cardiology, “Victor Babeș” University of Medicine and Pharmacy of Timișoara, 300041 Timișoara, Romania; (R.Ș.); (M.-A.L.); (C.M.); (C.T.L.), (A.I.)
- Institute of Cardiovascular Diseases, 300310 Timișoara, Romania;
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7
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Fischetti G, Bottio T, Parigino D, Ramirez AD, Santeramo V, Savino L, Silva AM, Di Bari N, Marzullo A, Giovannico L, Milano AD. Sudden dyspnea and syncope episode in a 38-year-old female. Intern Emerg Med 2024; 19:761-764. [PMID: 38019414 DOI: 10.1007/s11739-023-03470-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 10/18/2023] [Indexed: 11/30/2023]
Affiliation(s)
- Giuseppe Fischetti
- Cardiac Surgery Unit, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, Piazza Giulio Cesare, 1, Bari, Italy
| | - Tomaso Bottio
- Cardiac Surgery Unit, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, Piazza Giulio Cesare, 1, Bari, Italy.
| | - Domenico Parigino
- Cardiac Surgery Unit, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, Piazza Giulio Cesare, 1, Bari, Italy
| | - Antonio D'Errico Ramirez
- Cardiac Surgery Unit, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, Piazza Giulio Cesare, 1, Bari, Italy
| | - Vincenzo Santeramo
- Cardiac Surgery Unit, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, Piazza Giulio Cesare, 1, Bari, Italy
| | - Luca Savino
- Cardiac Surgery Unit, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, Piazza Giulio Cesare, 1, Bari, Italy
| | - Aline Maria Silva
- Cardiac Surgery Unit, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, Piazza Giulio Cesare, 1, Bari, Italy
| | - Nicola Di Bari
- Cardiac Surgery Unit, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, Piazza Giulio Cesare, 1, Bari, Italy
| | - Andrea Marzullo
- Cardiovascular Pathology Unit, Department of Precision and Regenerative Medicine and Ionian Area, Bari, Italy
| | - Lorenzo Giovannico
- Cardiac Surgery Unit, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, Piazza Giulio Cesare, 1, Bari, Italy
| | - Aldo Domenico Milano
- Cardiac Surgery Unit, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, Piazza Giulio Cesare, 1, Bari, Italy
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8
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Mohammadi A, Mohammadi M, Pazoki M, Ayoubpour MR, Babaheidarian P, Zeraatian Nejad Davani S, Ghaderi R. Clinical presentation, diagnostic evaluation, and management of undifferentiated/unclassified cardiac sarcoma: A case report and literature review. Radiol Case Rep 2024; 19:1200-1207. [PMID: 38259715 PMCID: PMC10801150 DOI: 10.1016/j.radcr.2023.11.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 11/24/2023] [Accepted: 11/25/2023] [Indexed: 01/24/2024] Open
Abstract
This case report details a challenging instance of undifferentiated/unclassified cardiac sarcoma in a 28-year-old female, presenting with diverse symptoms like muscle weakness, shortness of breath, and hemoptysis. Diagnostic hurdles led to an initial misdiagnosis of granulomatosis with polyangiitis before discovering a sizable left atrial mass, ultimately diagnosed as high-grade undifferentiated/unclassified sarcoma. Despite initial surgical intervention, the patient's condition worsened, underscoring the complexities in managing such cases involving cardiac sarcomas. This case emphasizes the diagnostic complexities associated with primary cardiac sarcomas, particularly the challenges in achieving accurate diagnoses and formulating effective treatment strategies.
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Affiliation(s)
- Aynaz Mohammadi
- School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | | | - Mahboubeh Pazoki
- Department of Cardiology, School of Medicine, Hazrat-e Rasool General Hospital Iran University of medical sciences, Tehran, Iran
| | - Mohammad reza Ayoubpour
- Department of Radiology, School of Medicine, Hazrat-e Rasool General Hospital Iran University of medical sciences, Tehran, Iran
| | - Pegah Babaheidarian
- Department of Pathology, School of Medicine, Hazrat-e Rasool General Hospital Iran University of medical sciences, Tehran, Iran
| | - Sam Zeraatian Nejad Davani
- Department of Cardiovascular Surgery, School of Medicine, Hazrat-e Rasool General Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Reza Ghaderi
- Department of Internal Medicine, School of Medicine, Hazrat-e Rasool General Hospital, Iran University of Medical Sciences, Tehran, Iran
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9
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Wang Q, Wang B, Zhang X, Zhong X, Chang S, Yang J, Liang J, You Q, Zhou H, Zhang J. The usefulness of contrast echocardiography in the evaluation of cardiac masses: a multicenter study. BMC Cardiovasc Disord 2024; 24:43. [PMID: 38218809 PMCID: PMC10787966 DOI: 10.1186/s12872-024-03708-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 01/03/2024] [Indexed: 01/15/2024] Open
Abstract
BACKGROUND Cardiac masses can encompass a variety of conditions, such as tumors, thrombi, vegetations, calcific lesions, and other rare diseases. Treatment and management of these types of cardiac masses differ considerably. Thus, accurately distinguishing among thrombi, benign tumors, and malignant tumors in the heart is of great importance. Contrast echocardiography (CE) has emerged as a promising technology. Although published guidelines suggest that CE can enhance image quality and assist in differentiating between benign and malignant lesions, most studies on CE diagnosis of cardiac masses are limited to case reports or retrospective/small-sample-sized prospective cohorts. This study aims to evaluate the diagnostic accuracy of CE in patients with suspected cardiac masses and address the insufficient evidence for differential diagnosis using CE. METHODS Between April 2018 and July 2022, a prospective multicenter study was conducted, which included 145 consecutive patients suspected to have cardiac masses based on transthoracic echocardiography. All patients underwent CE examinations. The echocardiographic diagnosis relied on qualitative factors such as echogenicity, boundary, morphology of the base, mass perfusion, pericardial effusion, and motility as well as quantitative factors such as the area of the masses and the peak intensity ratio of the masses to adjacent myocardium (A1/A2). RESULTS The final confirmed diagnoses were as follows: 2 patients had no cardiac mass, 4 patients had pseudomass, 43 patients had thrombus, 66 patients had benign tumors, and 30 patients had malignant tumors. The receiver operating characteristic (ROC) analysis indicated that an optimal A1/A2 cutoff value of 0.499 distinguished a cardiac tumor from a thrombus, with AUC, sensitivity, specificity, PPV, and NPV of 0.977, 97.9%, 90.7%, 95.9%, and 95.1%, respectively. The optimal A1/A2 cutoff value of 1.583 distinguished a cardiac tumor from a thrombus, with AUC, sensitivity, specificity, PPV, and NPV of 0.950, 93.3%, 93.9%, 87.5%, and 96.9%, respectively. CONCLUSIONS Combined with qualitative and quantitative analyses, CE has the potential to accurately differentiate among different types of cardiac masses.
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Affiliation(s)
- Qingtao Wang
- Department of Cardio-Thoracic Surgery, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, No 15, Jiefang Avenue, Xiangyang, 441000, China
| | - Bing Wang
- Department of Cardio-Thoracic Surgery, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, No 15, Jiefang Avenue, Xiangyang, 441000, China
| | - Xiaofeng Zhang
- Department of Ultrasound, First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, China
| | - Xin Zhong
- Department of Ultrasound, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, 410002, China
| | - Shuai Chang
- Department of Ultrasound, First Affiliated Hospital of University of South China, Hengyang, 421001, China
| | - Jinbo Yang
- Department of Cardio-Thoracic Surgery, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, No 15, Jiefang Avenue, Xiangyang, 441000, China
| | - Jian Liang
- Department of Cardio-Thoracic Surgery, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, No 15, Jiefang Avenue, Xiangyang, 441000, China
| | - Qiangqiang You
- Department of Cardio-Thoracic Surgery, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, No 15, Jiefang Avenue, Xiangyang, 441000, China
| | - Heng Zhou
- Department of Cardio-Thoracic Surgery, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, No 15, Jiefang Avenue, Xiangyang, 441000, China.
| | - Jiaqi Zhang
- Department of Ultrasound, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, No 15, Jiefang Avenue, Xiangyang, 441000, China.
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10
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de Souza Fernandes Duarte E, Lucio PS, Costa MJ, Salgueiro V, Salgado R, Potes M, Hoelzemann JJ, Bortoli D. Pollutant-meteorological factors and cardio-respiratory mortality in Portugal: Seasonal variability and associations. ENVIRONMENTAL RESEARCH 2024; 240:117491. [PMID: 37884072 DOI: 10.1016/j.envres.2023.117491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 10/21/2023] [Accepted: 10/23/2023] [Indexed: 10/28/2023]
Abstract
Seasonal variations in cardiorespiratory diseases may be influenced by air pollution and meteorological factors. This work aims to highlight the relevance of a complete seasonal characterization of the pollutant-meteorological factors and cardio-respiratory mortality in Portugal and the relationships between health outcomes and environmental risk factors. To this end, air pollution and meteorological variables along with health outcomes were analyzed at national level and on a monthly basis for the period of 2011-2020. It was found that cardiorespiratory mortality rates during winter were 44% higher than during the summer. Furthermore, particulate matter with aerodynamic diameters of 10 and 2.5 μm (μm) or smaller (PM10 and PM2.5), carbon monoxide (CO) and nitrogen dioxide (NO2) showed a seasonal variability with the highest concentrations during winter while ozone (O3) presented higher concentrations during spring and summer. PM10, PM2.5 and NO2, showed a positive correlation between seasons, indicating similar patterns of behavior. Canonical correlation analysis (CCA) applied to pollutant-meteorological and cardiorespiratory mortality data indicates a strong linear correlation between pollutant-meteorological factors and health outcomes. The first canonical correlation was 0.889, and the second was 0.545, both statistically significant (p-value < 0.001). The CCA results suggest that there is a strong association between near-surface temperature, relative humidity, PM10, PM2.5, CO and NO2 and health outcomes. The results of this study provide important information of the seasonal variability of air pollutants and meteorological factors in Portugal and their associations with cardiorespiratory mortality.
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Affiliation(s)
- Ediclê de Souza Fernandes Duarte
- Instituto de Ciências da Terra - ICT (Pólo de Évora), Instituto de Investigação e Formação Avançada (IIFA), Universidade de Évora, 7000-671, Évora, Portugal; Earth Remote Sensing Laboratory (EaRSLab), Instituto de Investigação e Formação Avançada (IIFA), Universidade de Évora, Évora, Portugal; Departamento de Física, Escola de Ciências e Tecnologia (ECT), Universidade de Évora, Évora, Portugal.
| | - Paulo Sérgio Lucio
- Departamento de Ciências Atmosféricas e Climáticas, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil
| | - Maria João Costa
- Instituto de Ciências da Terra - ICT (Pólo de Évora), Instituto de Investigação e Formação Avançada (IIFA), Universidade de Évora, 7000-671, Évora, Portugal; Earth Remote Sensing Laboratory (EaRSLab), Instituto de Investigação e Formação Avançada (IIFA), Universidade de Évora, Évora, Portugal; Departamento de Física, Escola de Ciências e Tecnologia (ECT), Universidade de Évora, Évora, Portugal
| | - Vanda Salgueiro
- Instituto de Ciências da Terra - ICT (Pólo de Évora), Instituto de Investigação e Formação Avançada (IIFA), Universidade de Évora, 7000-671, Évora, Portugal; Earth Remote Sensing Laboratory (EaRSLab), Instituto de Investigação e Formação Avançada (IIFA), Universidade de Évora, Évora, Portugal; Departamento de Física, Escola de Ciências e Tecnologia (ECT), Universidade de Évora, Évora, Portugal
| | - Rui Salgado
- Instituto de Ciências da Terra - ICT (Pólo de Évora), Instituto de Investigação e Formação Avançada (IIFA), Universidade de Évora, 7000-671, Évora, Portugal; Earth Remote Sensing Laboratory (EaRSLab), Instituto de Investigação e Formação Avançada (IIFA), Universidade de Évora, Évora, Portugal; Departamento de Física, Escola de Ciências e Tecnologia (ECT), Universidade de Évora, Évora, Portugal
| | - Miguel Potes
- Instituto de Ciências da Terra - ICT (Pólo de Évora), Instituto de Investigação e Formação Avançada (IIFA), Universidade de Évora, 7000-671, Évora, Portugal; Earth Remote Sensing Laboratory (EaRSLab), Instituto de Investigação e Formação Avançada (IIFA), Universidade de Évora, Évora, Portugal; Departamento de Física, Escola de Ciências e Tecnologia (ECT), Universidade de Évora, Évora, Portugal
| | - Judith J Hoelzemann
- Departamento de Ciências Atmosféricas e Climáticas, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil
| | - Daniele Bortoli
- Instituto de Ciências da Terra - ICT (Pólo de Évora), Instituto de Investigação e Formação Avançada (IIFA), Universidade de Évora, 7000-671, Évora, Portugal; Earth Remote Sensing Laboratory (EaRSLab), Instituto de Investigação e Formação Avançada (IIFA), Universidade de Évora, Évora, Portugal; Departamento de Física, Escola de Ciências e Tecnologia (ECT), Universidade de Évora, Évora, Portugal
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11
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Tagliati C, Fogante M, Palmisano A, Catapano F, Lisi C, Monti L, Lanni G, Cerimele F, Bernardini A, Procaccini L, Argalia G, Esposto Pirani P, Marcucci M, Rebonato A, Cerimele C, Luciano A, Cesarotto M, Belgrano M, Pagnan L, Sarno A, Cova MA, Ventura F, Regnicolo L, Polonara G, Uguccioni L, Quaranta A, Balardi L, Barbarossa A, Stronati G, Guerra F, Chiocchi M, Francone M, Esposito A, Schicchi N. Cardiac Masses and Pseudomasses: An Overview about Diagnostic Imaging and Clinical Background. MEDICINA (KAUNAS, LITHUANIA) 2023; 60:70. [PMID: 38256331 PMCID: PMC10818366 DOI: 10.3390/medicina60010070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 12/09/2023] [Accepted: 12/26/2023] [Indexed: 01/24/2024]
Abstract
A cardiac lesion detected at ultrasonography might turn out to be a normal structure, a benign tumor or rarely a malignancy, and lesion characterization is very important to appropriately manage the lesion itself. The exact relationship of the mass with coronary arteries and the knowledge of possible concomitant coronary artery disease are necessary preoperative information. Moreover, the increasingly performed coronary CT angiography to evaluate non-invasively coronary artery disease leads to a rising number of incidental findings. Therefore, CT and MRI are frequently performed imaging modalities when echocardiography is deemed insufficient to evaluate a lesion. A brief comprehensive overview about diagnostic radiological imaging and the clinical background of cardiac masses and pseudomasses is reported.
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Affiliation(s)
- Corrado Tagliati
- Radiologia, AST Pesaro Urbino, 61121 Pesaro, Italy; (C.T.); (A.R.)
| | - Marco Fogante
- Maternal-Child, Senological, Cardiological Radiology and Outpatient Ultrasound, Department of Radiological Sciences, University Hospital of Marche, 60126 Ancona, Italy; (G.A.); (P.E.P.)
| | - Anna Palmisano
- Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy; (A.P.); (A.E.)
- School of Medicine, Vita-Salute San Raffaele University, Via Olgettina 58, 20132 Milan, Italy
| | - Federica Catapano
- Department of Biomedical Sciences, Humanitas University, via Rita Levi Montalcini 4, 20072 Milan, Italy; (F.C.); (C.L.); (L.M.); (M.F.)
- IRCCS Humanitas Research Hospital, via Manzoni 56, Rozzano, 20089 Milan, Italy
| | - Costanza Lisi
- Department of Biomedical Sciences, Humanitas University, via Rita Levi Montalcini 4, 20072 Milan, Italy; (F.C.); (C.L.); (L.M.); (M.F.)
| | - Lorenzo Monti
- Department of Biomedical Sciences, Humanitas University, via Rita Levi Montalcini 4, 20072 Milan, Italy; (F.C.); (C.L.); (L.M.); (M.F.)
- IRCCS Humanitas Research Hospital, via Manzoni 56, Rozzano, 20089 Milan, Italy
| | - Giuseppe Lanni
- Radiologia, ASL 4 Teramo, 64100 Teramo, Italy; (G.L.); (F.C.); (A.B.); (L.P.)
| | - Federico Cerimele
- Radiologia, ASL 4 Teramo, 64100 Teramo, Italy; (G.L.); (F.C.); (A.B.); (L.P.)
| | - Antonio Bernardini
- Radiologia, ASL 4 Teramo, 64100 Teramo, Italy; (G.L.); (F.C.); (A.B.); (L.P.)
| | - Luca Procaccini
- Radiologia, ASL 4 Teramo, 64100 Teramo, Italy; (G.L.); (F.C.); (A.B.); (L.P.)
| | - Giulio Argalia
- Maternal-Child, Senological, Cardiological Radiology and Outpatient Ultrasound, Department of Radiological Sciences, University Hospital of Marche, 60126 Ancona, Italy; (G.A.); (P.E.P.)
| | - Paolo Esposto Pirani
- Maternal-Child, Senological, Cardiological Radiology and Outpatient Ultrasound, Department of Radiological Sciences, University Hospital of Marche, 60126 Ancona, Italy; (G.A.); (P.E.P.)
| | - Matteo Marcucci
- U.O.C. di Radiodiagnostica, Ospedale Generale Provinciale di Macerata, 62100 Macerata, Italy;
| | - Alberto Rebonato
- Radiologia, AST Pesaro Urbino, 61121 Pesaro, Italy; (C.T.); (A.R.)
| | - Cecilia Cerimele
- Dipartimento di Biomedicina e Prevenzione, Universiy of Roma Tor Vergata, 00133 Roma, Italy; (C.C.); (A.L.); (M.C.)
| | - Alessandra Luciano
- Dipartimento di Biomedicina e Prevenzione, Universiy of Roma Tor Vergata, 00133 Roma, Italy; (C.C.); (A.L.); (M.C.)
| | - Matteo Cesarotto
- Department of Radiology, Azienda Sanitaria Universitaria Giuliano Isontina Ospedale di Cattinara, 34149 Trieste, Italy; (M.C.); (L.P.); (A.S.)
| | - Manuel Belgrano
- Department of Medical, Surgical and Health Sciences, University of Trieste, 34151 Trieste, Italy; (M.B.); (M.A.C.)
| | - Lorenzo Pagnan
- Department of Radiology, Azienda Sanitaria Universitaria Giuliano Isontina Ospedale di Cattinara, 34149 Trieste, Italy; (M.C.); (L.P.); (A.S.)
| | - Alessandro Sarno
- Department of Radiology, Azienda Sanitaria Universitaria Giuliano Isontina Ospedale di Cattinara, 34149 Trieste, Italy; (M.C.); (L.P.); (A.S.)
| | - Maria Assunta Cova
- Department of Medical, Surgical and Health Sciences, University of Trieste, 34151 Trieste, Italy; (M.B.); (M.A.C.)
| | | | - Luana Regnicolo
- Department of Neuroradiology, University Hospital of Marche, 60126 Ancona, Italy;
| | - Gabriele Polonara
- Department of Specialized Clinical Sciences and Odontostomatology, Polytechnic University of Marche, 60126 Ancona, Italy;
| | - Lucia Uguccioni
- Emodinamica e Cardiologia Interventistica, AST Pesaro Urbino, 61121 Pesaro, Italy;
| | - Alessia Quaranta
- Cardiologia, Distretto Sanitario di Civitanova Marche, AST 3, 62012 Civitanova Marche, Italy;
| | - Liliana Balardi
- Health Professions Area, Diagnostic Technical Area, University Hospital of Marche, 60126 Ancona, Italy;
| | - Alessandro Barbarossa
- Cardiology and Arrhythmology Clinic, Department of Cardiological Sciences, University Hospital of Marche, 60126 Ancona, Italy; (A.B.); (G.S.); (F.G.)
| | - Giulia Stronati
- Cardiology and Arrhythmology Clinic, Department of Cardiological Sciences, University Hospital of Marche, 60126 Ancona, Italy; (A.B.); (G.S.); (F.G.)
| | - Federico Guerra
- Cardiology and Arrhythmology Clinic, Department of Cardiological Sciences, University Hospital of Marche, 60126 Ancona, Italy; (A.B.); (G.S.); (F.G.)
| | - Marcello Chiocchi
- Dipartimento di Biomedicina e Prevenzione, Universiy of Roma Tor Vergata, 00133 Roma, Italy; (C.C.); (A.L.); (M.C.)
| | - Marco Francone
- Department of Biomedical Sciences, Humanitas University, via Rita Levi Montalcini 4, 20072 Milan, Italy; (F.C.); (C.L.); (L.M.); (M.F.)
- IRCCS Humanitas Research Hospital, via Manzoni 56, Rozzano, 20089 Milan, Italy
| | - Antonio Esposito
- Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy; (A.P.); (A.E.)
- School of Medicine, Vita-Salute San Raffaele University, Via Olgettina 58, 20132 Milan, Italy
| | - Nicolò Schicchi
- Cardiovascular Radiological Diagnostics, Department of Radiological Sciences, University Hospital of Marche, 60126 Ancona, Italy;
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12
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Nóbrega S, Martins da Costa C, Amador AF, Justo S, Martins E. Cardiovascular Magnetic Resonance Versus Histopathologic Study for Diagnosis of Benign and Malignant Cardiac Tumours: A Systematic Review and Meta-Analysis. J Cardiovasc Imaging 2023; 31:159-168. [PMID: 37901993 PMCID: PMC10622638 DOI: 10.4250/jcvi.2023.0028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 07/27/2023] [Accepted: 08/06/2023] [Indexed: 10/31/2023] Open
Abstract
BACKGROUND The gold standard for diagnosis of cardiac tumours is histopathological examination. Cardiovascular magnetic resonance (CMR) is a valuable non-invasive, radiation-free tool for identifying and characterizing cardiac tumours. Our aim is to understand CMR diagnosis of cardiac tumours by distinguishing benign vs. malignant tumours compared to the gold standard. METHODS A systematic search was performed in the PubMed, Web of Science, and Scopus databases up to December 2022, and the results were reviewed by 2 independent investigators. Studies reporting CMR diagnosis were included in a meta-analysis, and pooled measures were obtained. The risk of bias was assessed using the Quality Assessment Tools from the National Institutes of Health. RESULTS A total of 2,321 results was obtained; 10 studies were eligible, including one identified by citation search. Eight studies were included in the meta-analysis, which presented a pooled sensitivity of 93% and specificity of 94%, a diagnostic odds ratio of 185, and an area under the curve of 0.98 for CMR diagnosis of benign vs. malignant tumours. Additionally, 4 studies evaluated whether CMR diagnosis of cardiac tumours matched specific histopathological subtypes, with 73.6% achieving the correct diagnosis. CONCLUSIONS To the best of our knowledge, this is the first published systematic review on CMR diagnosis of cardiac tumours. Compared to histopathological results, the ability to discriminate benign from malignant tumours was good but not outstanding. However, significant heterogeneity may have had an impact on our findings.
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Affiliation(s)
- Sandra Nóbrega
- Faculty of Medicine, University of Porto, Porto, Portugal
| | - Catarina Martins da Costa
- Faculty of Medicine, University of Porto, Porto, Portugal
- Department of Cardiology, Centro Hospitalar Universitário São João, Porto, Portugal
- Member of the European Reference Network for Rare, Low-Prevalence, or Complex Diseases of the Heart (ERN GUARD-Heart), Amsterdam, The Netherlands.
| | - Ana Filipa Amador
- Faculty of Medicine, University of Porto, Porto, Portugal
- Department of Cardiology, Centro Hospitalar Universitário São João, Porto, Portugal
- Member of the European Reference Network for Rare, Low-Prevalence, or Complex Diseases of the Heart (ERN GUARD-Heart), Amsterdam, The Netherlands
| | - Sofia Justo
- Faculty of Medicine, University of Porto, Porto, Portugal
| | - Elisabete Martins
- Faculty of Medicine, University of Porto, Porto, Portugal
- Department of Cardiology, Centro Hospitalar Universitário São João, Porto, Portugal
- Member of the European Reference Network for Rare, Low-Prevalence, or Complex Diseases of the Heart (ERN GUARD-Heart), Amsterdam, The Netherlands
- Center for Health Technology and Services Research (CINTESIS@RISE), Faculty of Medicine, University of Porto, Portugal
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13
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Osada H, Takeda T, Kanemitsu H, Yamazaki K, Tsujimura M, Fujimoto M, Minatoya K. Multiple papillary fibroelastoma originating from 3 leaflets of the aortic valve. JTCVS Tech 2023; 21:62-64. [PMID: 37854797 PMCID: PMC10580087 DOI: 10.1016/j.xjtc.2023.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 06/13/2023] [Accepted: 06/21/2023] [Indexed: 10/20/2023] Open
Affiliation(s)
- Hiroaki Osada
- Department of Cardiovascular Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takahide Takeda
- Department of Cardiovascular Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hideo Kanemitsu
- Department of Cardiovascular Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kazuhiro Yamazaki
- Department of Cardiovascular Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Marina Tsujimura
- Department of Diagnostic Pathology, Kyoto University Hospital, Kyoto, Japan
| | - Masakazu Fujimoto
- Department of Diagnostic Pathology, Kyoto University Hospital, Kyoto, Japan
| | - Kenji Minatoya
- Department of Cardiovascular Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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14
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Inserra MC, Cannizzaro MT, Passaniti G, Celona A, Secinaro A, Curione D, D'Angelo T, Garretto O, Romeo P. MR imaging of primary benign cardiac tumors in the pediatric population. Heliyon 2023; 9:e19932. [PMID: 37809686 PMCID: PMC10559362 DOI: 10.1016/j.heliyon.2023.e19932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 07/25/2023] [Accepted: 09/06/2023] [Indexed: 10/10/2023] Open
Abstract
Primary cardiac tumors are rare in all ages, especially in children, with a reported prevalence range of 0.0017-0.28% in autopsy series. Due to their rarity, the diagnostic and therapeutic pathways reserved to them are usually described by single case reports, leading to the point where a common diagnostic protocol is imperative to obtain a differential diagnosis. The first diagnostic approach is done with transthoracic echocardiogram (TTE), due to its wide availability, low cost, absence of ionizing radiations and non-invasiveness. Several tumors are discovered incidentally and, in many cases, TTE is helpful to determine location, size and anatomical features, playing a key role in the differential diagnosis. In the last few years, cardiac magnetic resonance imaging (CMR) has had an increased role in the diagnostic pathway of pediatric cardiac masses, due to its high accuracy in characterizing mass tissue properties (especially for soft tissue), and in detecting tumor size, extent, pericardial/pleural effusion, leading to the correct diagnosis, treatment and follow-up. Therefore, nowadays, several consensus statements consider CMR as a leading imaging technique, thanks to its non-invasive tissue characterization, without the use of ionizing radiation, in an unrestricted field of view. As suggested by the most recent literature, the pediatric protocol is not so different from the adult one, adapted to the size and cardiac frequency of the patient, sometimes requiring special conditions such as free-breathing sequences and/or sedation or general anesthesia in non-cooperating patients.
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Affiliation(s)
| | | | - Giulia Passaniti
- Division of Cardiology, A.O.U. Policlinico “G. Rodolico - San Marco”, Catania, Italy
| | - Antonio Celona
- UOC Radiodiagnostica, San Vincenzo Hospital, Provincial Health Agency of Messina, Taormina, Italy
| | - Aurelio Secinaro
- Advanced Cardiothoracic Imaging, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Davide Curione
- Advanced Cardiothoracic Imaging, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Tommaso D'Angelo
- Diagnostic and Interventional Radiology Unit, BIOMORF Department, University Hospital “Policlinico G. Martino”, Messina Italy
- Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, the Netherlands
| | - Orazio Garretto
- UOSD Radiologia 2 CAST, A.O.U. Policlinico “G. Rodolico - San Marco”, Catania, Italy
| | - Placido Romeo
- Radiology Department of AO “San Marco”, A.O.U. Policlinico “G. Rodolico - San Marco”, Catania, Italy
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15
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Li X, Cao Y, Shao G, Cui Y, Li Y, Zhang K, Liu X, Shi H. Multimodality imaging assessment of primary pericardial rhabdomyosarcoma: a case report. Front Cardiovasc Med 2023; 10:1237951. [PMID: 37645522 PMCID: PMC10461312 DOI: 10.3389/fcvm.2023.1237951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Accepted: 07/31/2023] [Indexed: 08/31/2023] Open
Abstract
Primary pericardial sarcomas are rare and lethal diseases. To date, only a few cases of primary pericardial sarcomas, such as rhabdomyosarcoma (RMS), have been reported. Since the unusual location of RMS in the pericardium makes it challenging to diagnose, precise diagnostic procedures are required. In this study, we present the case of a 23-year-old man who experienced postprandial obstruction and atypical precordial pain that lasted for a week. Echocardiography revealed a heterogeneous isoechoic pericardial mass with a significant pericardial effusion. Contrast-enhanced CT revealed a massive pericardial effusion along with an irregular, defined, heterogeneously enhancing mass that was located between the pericardium and diaphragm. PET-CT imaging showed an intense FDG uptake in the pericardial mass. Furthermore, cardiac MRI demonstrated malignant characteristics of the pericardial mass and provided a detailed visualization of its exact anatomical connection with both cardiac and extracardiac structures. Finally, a pathologic examination of a puncture biopsy specimen confirmed the diagnosis of primary pericardial RMS. Our case emphasizes the importance of multimodal imaging for the differential diagnosis and evaluation of cardiac involvement, while providing clinicians with crucial information for clinical treatment and decision-making.
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Affiliation(s)
- Xingxuan Li
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yukun Cao
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Guozhu Shao
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yue Cui
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yumin Li
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Kailu Zhang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaoqing Liu
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Heshui Shi
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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16
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Barsky LL, Burke R, Espinosa RD. Timing of Intervention for Left Ventricular Mass in the Setting of Acute Obstructive Coronary Artery Disease. CASE (PHILADELPHIA, PA.) 2023; 7:309-315. [PMID: 37614693 PMCID: PMC10442377 DOI: 10.1016/j.case.2023.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 08/25/2023]
Abstract
•Comorbid need for antiplatelet therapy complicates intracardiac mass management. •Noninvasive mass diagnosis is invaluable for patients at high operative risk. •Guidelines for timing of intervention on masses are currently not well defined.
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Affiliation(s)
- Lili L. Barsky
- HonorHealth Scottsdale Thompson Peak Medical Center, Heart and Vascular Institute, Scottsdale, Arizona
| | - Robert Burke
- HonorHealth Scottsdale Thompson Peak Medical Center, Heart and Vascular Institute, Scottsdale, Arizona
| | - Renee D. Espinosa
- HonorHealth Scottsdale Thompson Peak Medical Center, Heart and Vascular Institute, Scottsdale, Arizona
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17
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Kurmann R, El-Am E, Ahmad A, Abbasi MA, Mazur P, Akiki E, Anand V, Herrmann J, Casanegra AI, Young P, Crestanello J, Bois MC, Maleszewski JJ, Klarich K. Cardiac Masses Discovered by Echocardiogram; What to Do Next? STRUCTURAL HEART : THE JOURNAL OF THE HEART TEAM 2023; 7:100154. [PMID: 37520139 PMCID: PMC10382990 DOI: 10.1016/j.shj.2022.100154] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 12/06/2022] [Accepted: 12/21/2022] [Indexed: 02/12/2023]
Abstract
Cardiac tumors are rare conditions, typically diagnosed on autopsy, but with the advancement of imaging techniques they are now encountered more frequently in clinical practice. Echocardiography is often the initial method of investigation for cardiac masses and provides a quick and valuable springboard for their characterization. While some cardiac masses can be readily identified by echocardiography alone, several require incorporation of multiple data points to reach diagnostic certainty. Herein, we will provide an overview of the main clinical, diagnostic, and therapeutic characteristics of cardiac masses within the framework of their location.
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Affiliation(s)
- Reto Kurmann
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Edward El-Am
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Ali Ahmad
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Piotr Mazur
- Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Elias Akiki
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Vidhu Anand
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Joerg Herrmann
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Ana I. Casanegra
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Phillip Young
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | - Juan Crestanello
- Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Melanie C. Bois
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
- Department of Laboratory Medicine & Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Joseph J. Maleszewski
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
- Department of Laboratory Medicine & Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Kyle Klarich
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
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18
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Yue P, Xu Z, Wan K, Tan Y, Xu Y, Xie X, Mui D, Yi C, Han Y, Chen Y. Multiparametric mapping by cardiovascular magnetic resonance imaging in cardiac tumors. J Cardiovasc Magn Reson 2023; 25:37. [PMID: 37349765 PMCID: PMC10286406 DOI: 10.1186/s12968-023-00938-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 05/11/2023] [Indexed: 06/24/2023] Open
Abstract
BACKGROUND There is a paucity of quantitative measurements of cardiac tumors and myocardium using parametric mapping techniques. This study aims to explore quantitative characteristics and diagnostic performance of native T1, T2, and extracellular volume (ECV) values of cardiac tumors and left ventricular (LV) myocardium. METHODS Patients with suspected cardiac tumors who underwent cardiovascular magnetic resonance (CMR) between November 2013 and March 2021 were prospectively enrolled. The diagnoses of primary benign or malignant tumors were based on pathologic findings if available, comprehensive medical history evaluations, imaging, and long-term follow-up data. Patients with pseudo-tumors, cardiac metastasis, primary cardiac diseases, and prior radiotherapy or chemotherapy were excluded. Multiparametric mapping values were measured on both cardiac tumors and the LV myocardium. Statistical analyses were performed using independent-samples t-test, receiver operating characteristic, and Bland-Altman analyses. RESULTS A total of 80 patients diagnosed with benign (n = 54), or primary malignant cardiac tumors (n = 26), and 50 age and sex-matched healthy volunteers were included. Intergroup differences in the T1 and T2 values of cardiac tumors were not significant, however, patients with primary malignant cardiac tumors showed significantly higher mean myocardial T1 values (1360 ± 61.4 ms) compared with patients with benign tumors (1259.7 ± 46.2 ms), and normal controls (1206 ± 44.0 ms, all P < 0.05) at 3 T. Patients with primary malignant cardiac tumors also showed significantly higher mean ECV (34.6 ± 5.2%) compared with patients with benign (30.0 ± 2.5%) tumors, and normal controls (27.3 ± 3.0%, all P < 0.05). For the differentiation between primary malignant and benign cardiac tumors, the mean myocardial native T1 value showed the highest efficacy (AUC: 0.919, cutoff value: 1300 ms) compared with mean ECV (AUC: 0.817) and T2 (AUC: 0.619) values. CONCLUSION Native T1 and T2 of cardiac tumors showed high heterogeneity, while myocardial native T1 values in primary malignant cardiac tumors were elevated compared to patients with benign cardiac tumors, which may serve as a new imaging marker for primary malignant cardiac tumors.
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Affiliation(s)
- Pengfei Yue
- Division of Abdominal Tumor Multimodality Treatment, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan China
| | - Ziqian Xu
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan China
| | - Ke Wan
- Department of Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan China
| | - Yinxi Tan
- West China School of Public Health, Sichuan University, Chengdu, China
| | - Yuanwei Xu
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041 People’s Republic of China
| | - Xiaotong Xie
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041 People’s Republic of China
| | - David Mui
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA USA
| | - Cheng Yi
- Division of Abdominal Tumor Multimodality Treatment, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan China
| | - Yuchi Han
- Cardiovascular Division, Wexner Medical Center, The Ohio State University, Columbus, OH USA
| | - Yucheng Chen
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041 People’s Republic of China
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Yang Z, Niu Y, Ma H, Gong W, Yu L, Liu L, Zheng M. Contrast-enhanced echocardiographic diagnosis of benign and malignant cardiac tumors and its correlation with pathology. Front Cardiovasc Med 2023; 10:1182334. [PMID: 37363101 PMCID: PMC10285073 DOI: 10.3389/fcvm.2023.1182334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 05/22/2023] [Indexed: 06/28/2023] Open
Abstract
Background This study aimed to explore the diagnostic value of contrast-enhanced echocardiography (CEE) in benign and malignant cardiac tumors and detect the correlation of CEE parameters and immunohistochemistry (IHC) markers. Methods The data of 44 patients with cardiac tumors confirmed by pathology were reviewed. Lesions were examined before surgery using transthoracic echocardiography (TTE) and CEE with time-intensity curve analysis. The expression of CD31, VEGF and Ki67 was measured by IHC staining. Microvessel density (MVD) was quantified via IHC for CD31. The clinical variables, TTE, CEE and IHC parameters were compared between benign and malignant cardiac tumors. Receiver operating characteristic curve were used to analyze the value of factors in predicting malignant cardiac tumors. The correlation between CEE and IHC parameters was analyzed. Results Among 44 cardiac tumors, 34 were benign and 10 were malignant. There were significant differences in the TTE parameters (pericardial effusion, tumor boundary, diameter, basal width), CEE parameters (tumor peak intensity (TPI), peak intensity ratio of tumor to myocardium (TPI/MPI), area under time-intensity curve (AUTIC)) and IHC parameters (Ki67, MVD, CD31, VEGF) between the benign and malignant tumor groups (all P < 0.05). Receiver operating characteristic curve analysis showed that the CEE and IHC parameters had diagnostic value in malignant cardiac tumors. There was a correlation between TPI/MPI and Ki67 (r = 0.62), AUTIC and Ki67 (r = 0.50), and AUTIC and CD31 (r = 0.56). Conclusion TTE and CEE parameters were different between benign and malignant cardiac tumors. CEE is helpful to differentiate the properties of cardiac tumors. There is a correlation between CEE parameters and IHC markers. AUTIC and TPI/MPI can reflect the proliferation and invasion of tumors.
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Affiliation(s)
- Zihao Yang
- Department of Ultrasound, Xijing Hospital, The Fourth Military Medical University, Xi’an, China
| | - Yicui Niu
- Department of Ultrasound, Xijing Hospital, The Fourth Military Medical University, Xi’an, China
| | - Hui Ma
- Department of Ultrasound, Xijing Hospital, The Fourth Military Medical University, Xi’an, China
| | - Wenqing Gong
- Department of Ultrasound, Xijing Hospital, The Fourth Military Medical University, Xi’an, China
| | - Lu Yu
- Department of Pathology, Xijing Hospital, The Fourth Military Medical University, Xi’an, China
| | - Liwen Liu
- Department of Ultrasound, Xijing Hospital, The Fourth Military Medical University, Xi’an, China
| | - Minjuan Zheng
- Department of Ultrasound, Xijing Hospital, The Fourth Military Medical University, Xi’an, China
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20
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Chen B, Fan T, Cao Y, Hu L, Yu G. Case report: obstruction in the right ventricular outflow tract due to hemolymphangioma. Front Cardiovasc Med 2023; 10:1142970. [PMID: 37304944 PMCID: PMC10250741 DOI: 10.3389/fcvm.2023.1142970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 04/03/2023] [Indexed: 06/13/2023] Open
Abstract
Cardiac masses commonly involve primary tumors, metastatic diseases, and nonbacterial thrombotic and infective endocarditis. myxomas are the most common primary tumors, accounting for 75%. Hemolymphangiomas are a group of congenital vascular and lymphatic malformations that originate from the mesenchyme, with an incidence rate of 0.12%-0.28% per year. Hemolymphangiomas have been found in the rectum, small intestine, spleen, liver, chest wall, and mediastinum but have not yet been reported in the ventricular outflow tract in the heart. Herein, we report a case of a hemolymphangioma tumor in the right ventricular outflow tract (RVOT). The tumor was successfully resected, and the patient was followed up for 18 months and did not exhibit tumor recurrence.
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Robertson N, Sempere L, Kenyon E, Mallet C, Smith K, Hix J, Halim A, Fan J, Moore A. Omniparticle Contrast Agent for Multimodal Imaging: Synthesis and Characterization in an Animal Model. Mol Imaging Biol 2023; 25:401-412. [PMID: 36071300 PMCID: PMC9989039 DOI: 10.1007/s11307-022-01770-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 08/22/2022] [Accepted: 08/24/2022] [Indexed: 10/14/2022]
Abstract
PURPOSE Individual imaging modalities have certain advantages, but each suffers from drawbacks that other modalities may overcome. The goal of this study was to create a novel contrast agent suitable for various imaging modalities that after a single administration can bridge and strengthen the collaboration between the research fields as well as enrich the information obtained from any one modality. PROCEDURES The contrast agent platform is based on dextran-coated iron oxide nanoparticles (for MRI and MPI) and synthesized using a modified co-precipitation method, followed by a series of conjugation steps with a fluorophore (for fluorescence and photoacoustic imaging), thyroxine (for CT imaging), and chelators for radioisotope labeling (for PET imaging). The fully conjugated agent was then tested in vitro in cell uptake, viability, and phantom studies and in vivo in a model of intraductal injection and in a tumor model. RESULTS The agent was synthesized, characterized, and tested in vitro where it showed the ability to produce a signal on MRI/MPI/FL/PA/CT and PET images. Studies in cells showed the expected concentration-dependent uptake of the agent without noticeable toxicity. In vivo studies demonstrated localization of the agent to the ductal tree in mice after intraductal injection with different degrees of resolution, with CT being the best for this particular application. In a model of injected labeled tumor cells, the agent produced a signal with all modalities and showed persistence in tumor cells confirmed by histology. CONCLUSIONS A fully functional omniparticle contrast agent was synthesized and tested in vitro and in vivo in two animal models. Results shown here point to the generation of a potent signal in all modalities tested without detrimental toxicity. Future use of this agent includes its exploration in various models of human disease including image-guided diagnostic and therapeutic applications.
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Affiliation(s)
- Neil Robertson
- Precision Health Program, Michigan State University, 766 Service Road, East Lansing, MI, 48824, USA
- Department of Radiology, College of Human Medicine, Michigan State University, 766 Service Road, East Lansing, MI, 48824, USA
- Department of Chemistry, College of Natural Sciences, Michigan State University, 578 S Shaw Lane, East Lansing, MI, 48824, USA
| | - Lorenzo Sempere
- Precision Health Program, Michigan State University, 766 Service Road, East Lansing, MI, 48824, USA
- Department of Radiology, College of Human Medicine, Michigan State University, 766 Service Road, East Lansing, MI, 48824, USA
- Department of Chemistry, College of Natural Sciences, Michigan State University, 578 S Shaw Lane, East Lansing, MI, 48824, USA
| | - Elizabeth Kenyon
- Precision Health Program, Michigan State University, 766 Service Road, East Lansing, MI, 48824, USA
- Department of Chemistry, College of Natural Sciences, Michigan State University, 578 S Shaw Lane, East Lansing, MI, 48824, USA
| | - Christiane Mallet
- Department of Radiology, College of Human Medicine, Michigan State University, 766 Service Road, East Lansing, MI, 48824, USA
- Department of Chemistry, College of Natural Sciences, Michigan State University, 578 S Shaw Lane, East Lansing, MI, 48824, USA
- Institute for Quantitative Health Science and Engineering, Michigan State University, 775 Woodlot Drive, East Lansing, MI, 48824, USA
| | - Kylie Smith
- Department of Chemistry, College of Natural Sciences, Michigan State University, 578 S Shaw Lane, East Lansing, MI, 48824, USA
- Institute for Quantitative Health Science and Engineering, Michigan State University, 775 Woodlot Drive, East Lansing, MI, 48824, USA
- Department of Biomedical Engineering, College of Engineering, Michigan State University, 766 Service Road, East Lansing, MI, 48824, USA
| | - Jeremy Hix
- Department of Radiology, College of Human Medicine, Michigan State University, 766 Service Road, East Lansing, MI, 48824, USA
- Department of Chemistry, College of Natural Sciences, Michigan State University, 578 S Shaw Lane, East Lansing, MI, 48824, USA
- Institute for Quantitative Health Science and Engineering, Michigan State University, 775 Woodlot Drive, East Lansing, MI, 48824, USA
| | - Alan Halim
- Precision Health Program, Michigan State University, 766 Service Road, East Lansing, MI, 48824, USA
- Department of Chemistry, College of Natural Sciences, Michigan State University, 578 S Shaw Lane, East Lansing, MI, 48824, USA
| | - Jinda Fan
- Department of Radiology, College of Human Medicine, Michigan State University, 766 Service Road, East Lansing, MI, 48824, USA
- Department of Chemistry, College of Natural Sciences, Michigan State University, 578 S Shaw Lane, East Lansing, MI, 48824, USA
- Institute for Quantitative Health Science and Engineering, Michigan State University, 775 Woodlot Drive, East Lansing, MI, 48824, USA
- Department of Biomedical Engineering, College of Engineering, Michigan State University, 766 Service Road, East Lansing, MI, 48824, USA
| | - Anna Moore
- Precision Health Program, Michigan State University, 766 Service Road, East Lansing, MI, 48824, USA.
- Department of Radiology, College of Human Medicine, Michigan State University, 766 Service Road, East Lansing, MI, 48824, USA.
- Department of Chemistry, College of Natural Sciences, Michigan State University, 578 S Shaw Lane, East Lansing, MI, 48824, USA.
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Fioretti AM, Leopizzi T, La Forgia D, Scicchitano P, Oreste D, Fanizzi A, Massafra R, Oliva S. Incidental right atrial mass in a patient with secondary pancreatic cancer: A case report and review of literature. World J Clin Cases 2023; 11:1206-1216. [PMID: 36874413 PMCID: PMC9979295 DOI: 10.12998/wjcc.v11.i5.1206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 11/30/2022] [Accepted: 01/10/2023] [Indexed: 02/14/2023] Open
Abstract
BACKGROUND The incidental detection of a right atrial mass during routine cardioncological workup is a rare condition. The correct differential diagnosis between cancer and thrombi is challenging. A biopsy may not be feasible while diagnostic techniques and tools may not be available.
CASE SUMMARY We report the case of a 59-year-old female patient with a history of breast cancer and current secondary metastatic pancreatic cancer. She developed deep vein thrombosis and pulmonary embolism and was admitted to the Outpatient Clinic of our Cardio-Oncology Unit for follow-up. Transthoracic echocardiogram incidentally found a right atrial mass. Clinical management was difficult due to the abrupt worsening of the patient’s clinical condition and the progressive severe thrombocytopenia. We suspected a thrombus, according to its echocardiographic appearance, the patient’s cancer history and recent venous thromboembolism. The patient was unable to adhere to low molecular weight heparin treatment. Due to worsening prognosis, palliative care was recommended. We also highlighted the distinguishing features between thrombi and tumors. We proposed a diagnostic flowchart to aid diagnostic decision making in the case of an incidental atrial mass.
CONCLUSION This case report highlights the importance of cardioncological surveillance during anticancer treatments to detect cardiac masses.
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Affiliation(s)
| | - Tiziana Leopizzi
- Cardiology and Intensive Care Unit, Ospedale SS. Annunziata, Taranto 74121, Italy
| | - Daniele La Forgia
- Department of Radiology, IRCCS Istituto Tumori “Giovanni Paolo II”, Bari 70124, Italy
| | - Pietro Scicchitano
- Cardiology and Intensive Care Unit, Ospedale “Fabio Perinei”, Altamura (Bari) 70022, Italy
| | - Donato Oreste
- Department of Radiology, IRCCS Istituto Tumori “Giovanni Paolo II”, Bari 70124, Italy
| | - Annarita Fanizzi
- Department of Oncology, IRCCS Istituto Tumori “Giovanni Paolo II”, Bari 70124, Italy
| | - Raffaella Massafra
- Department of Oncology, IRCCS Istituto Tumori “Giovanni Paolo II”, Bari 70124, Italy
| | - Stefano Oliva
- Cardio-Oncology, IRCCS Istituto Tumori “Giovanni Paolo II”, Bari 70124, Italy
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23
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Rector G, Koh SJ, Tabbaa R. A Case of Isolated Cardiac Burkitt Lymphoma Causing Right-Sided Heart Failure. Tex Heart Inst J 2022; 49:488993. [PMID: 36472919 PMCID: PMC9809082 DOI: 10.14503/thij-21-7575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Primary cardiac tumors are rare, as the most common cause of cardiac masses is from metastatic disease. In this article, a unique case of isolated cardiac Burkitt lymphoma causing right-sided heart failure in a 70-year-old man who presented to the emergency department with abdominal distension and lower-extremity swelling is described. The right ventricular mass was initially identified via computed tomographic scans of the abdomen and pelvis. Further workup included transthoracic echocardiogram and cardiac magnetic resonance imaging that showed extension of the mass into the right atrium and pericardium. Staging imaging and bone marrow biopsy revealed no evidence of metastatic disease. Cytology of the peritoneal fluid and biopsy of the right ventricular mass confirmed Burkitt lymphoma. The cardiac mass substantially decreased in size and the right-sided heart failure resolved after the initiation of chemotherapy, which highlights the importance of prompt diagnosis and treatment of Burkitt lymphoma.
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Affiliation(s)
- Graham Rector
- Department of Internal Medicine, Baylor College of Medicine, Houston, Texas
| | - Stephanie J. Koh
- Section of Cardiology, Department of Internal Medicine, Baylor College of Medicine, Houston, Texas
| | - Rashed Tabbaa
- Section of Cardiology, Department of Internal Medicine, Baylor College of Medicine, Houston, Texas
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24
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Yuan H, Qiu J, Chiu KWH, Chan LWC, Zhang F, Wei X, Jiang L. PET/CT morphology and cardiac conduction disorders help discriminate primary cardiac lymphoma from primary cardiac sarcoma. J Nucl Cardiol 2022; 29:2866-2877. [PMID: 35790691 DOI: 10.1007/s12350-022-03042-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 06/09/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND Primary cardiac lymphoma (PCL) and primary cardiac sarcoma (PCS) are similar in clinical presentation but differ in management and outcomes. We aim to explore the role of PET morphology and clinical characteristics in distinguishing PCL from PCS. METHODS Pretreatment 18F-FDG PET/CT and contrast-enhanced CT were performed in PCL (n = 14) and PCS (n = 15) patients. Patient demographics, overall survival, and progression-free survival were reviewed. PET/CT morphological and metabolic features were extracted. Specifically, R_Kurtosis, a PET-morphology parameter reflecting the tumor expansion within the heart, was calculated. RESULTS Compared with PCS, PCL occurred at an older age, resulted in more cardiac dysfunctions and arrhythmias, and showed higher glucometabolism (SUVmax, SUVpeak, SUVmean, MTV, and TLG). Curative treatments improved survival for PCL but not for PCS. Multivariable logistic regression identified R_Kurtosis (OR = 27.025, P = .007) and cardiac conduction disorders (OR = 37.732, P = .016) independently predictive of PCL, and classification and regression tree analysis stratified patients into three subgroups: R_Kurtosis ≥ 0.044 (probability of PCL 88.9%), R_Kurtosis < 0.044 with conduction disorders (80.0%), and R_Kurtosis < 0.044 without conduction disorders (13.3%). CONCLUSION PET-derived tumor expansion pattern (R_Kurtosis) and cardiac conduction disorders were helpful in distinguishing PCL from PCS, which might assist the clinical management.
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Affiliation(s)
- Hui Yuan
- PET Center, Department of Nuclear Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Er Road, Guangzhou, 510080, China
| | - Jia Qiu
- Department of Cardiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Keith W H Chiu
- Department of Diagnostic and Interventional Radiology, Kwong Wah Hospital, Hong Kong SAR, China
| | - Lawrence W C Chan
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Fen Zhang
- Department of Pathology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Xiaojuan Wei
- Division of Lymphoma, Department of Clinical Oncology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Er Road, Guangzhou, 510080, China.
| | - Lei Jiang
- PET Center, Department of Nuclear Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Er Road, Guangzhou, 510080, China.
- Guangdong Provincial Key Laboratory of Artificial Intelligence in Medical Image Analysis and Application, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
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25
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Bernhard B, Gräni C. 18F-FDG PET/CT imaging in the workup of cardiac and pericardial masses. J Nucl Cardiol 2022; 29:3466-3468. [PMID: 33604789 DOI: 10.1007/s12350-021-02539-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 01/11/2021] [Indexed: 01/18/2023]
Affiliation(s)
- Benedikt Bernhard
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, 3010, Bern, Switzerland
| | - Christoph Gräni
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, 3010, Bern, Switzerland.
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26
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Pino PG, Moreo A, Lestuzzi C. Differential diagnosis of cardiac tumors: General consideration and echocardiographic approach. JOURNAL OF CLINICAL ULTRASOUND : JCU 2022; 50:1177-1193. [PMID: 36218203 PMCID: PMC9828386 DOI: 10.1002/jcu.23309] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 08/21/2022] [Accepted: 08/23/2022] [Indexed: 06/16/2023]
Abstract
Cardiac tumors may be primary (either benign or malignant) or secondary (malignant) and are first detected by echocardiography in most cases. The cardiologist often challenges their identification, the differential diagnosis and the best therapeutic approach. Malignant tumors have usually a poor prognosis, which may be significantly improved by appropriate and timely therapies. The echocardiographic aspects of benign and malignant cardiac tumors described in this article, along with a clinical evaluation may orient the differential diagnosis and aid in choosing the further steps useful to define the nature of the mass.
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Affiliation(s)
- Paolo G. Pino
- Former Chief of Non Invasive Cardiovascular Diagnostics DepartmentOspedale San CamilloRomeItaly
| | - Antonella Moreo
- Cardiology IV, 'A.De Gasperis'DepartmentNiguarda Ca' Granda HospitalMilanItaly
| | - Chiara Lestuzzi
- Cardio‐oncological Rehabilitation Service, Azienda Sanitaria Friuli Occidentale (ASFO)c/o National Cancer Institute (CRO), IRCCSAvianoItaly
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27
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Li Y, Ren W, Wang X, Xiao Y, Feng Y, Shi P, Sun L, Wang X, Yang H, Song G. The diagnostic accuracy of contrast echocardiography in patients with suspected cardiac masses: A preliminary multicenter, cross-sectional study. Front Cardiovasc Med 2022; 9:1011560. [PMID: 36187014 PMCID: PMC9523017 DOI: 10.3389/fcvm.2022.1011560] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 08/29/2022] [Indexed: 12/04/2022] Open
Abstract
Background To evaluate the diagnostic accuracy of contrast echocardiography (CE) in patients with suspected cardiac masses. Methods A multicenter, prospective study involving 108 consecutive patients with suspected cardiac masses based on transthoracic echocardiography performed between November 2019 and December 2020 was carried out. CE examinations were performed in all patients. The echocardiographic diagnosis was established according to the qualitative (echogenicity, boundary, morphology of the base, mass perfusion, pericardial effusion, and motility) and quantitative (area of the masses and peak intensity ratio of the masses and adjacent myocardium A1/A2) evaluations. Results Final confirmed diagnoses were as follows: no cardiac mass (n = 3), pseudomass (n = 3), thrombus (n = 36), benign tumor (n = 30), and malignant tumor (n = 36). ROC analysis revealed the optimal A1/A2 with cutoff value of 0.295 for a cardiac tumor from a thrombus, with AUC, sensitivity, specificity, PPV, and NPV of 0.958 (95% confidence interval (CI): 0.899–0.988), 100, 91.7, 95.7, and 100%, respectively. CE was able to distinguish malignant from benign tumors with an AUC of 0.953 (95% CI: 0.870–0.990). Multivariate logistic regression analysis revealed that tumor area, base, and A1/A2 were associated with the risk of malignant tumor (OR = 1.003, 95% CI: 1.00003–1.005; OR = 22.64, 95% CI: 1.30–395.21; OR = 165.39, 95% CI: 4.68–5,850.94, respectively). When using A1/A2 > 1.28 as the only diagnostic criterion to identify the malignant tumor, AUC, sensitivity, specificity, PPV, and NPV were 0.886 (95% CI: 0.784–0.951), 80.6, 96.7, 96.7, and 80.7%, respectively. Conclusion CE has the potential to accurately differentiate cardiac masses by combining qualitative and quantitative analyses. However, more studies with a large sample size should be conducted to further confirm these findings. Clinical trial registration http://www.chictr.org.cn/, identifier: ChiCTR1900026809.
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Affiliation(s)
- Ying Li
- Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, China
| | - Weidong Ren
- Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xin Wang
- Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yangjie Xiao
- Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yueqin Feng
- Department of Ultrasound, The First Hospital of China Medical University, Shenyang, China
| | - Pengli Shi
- Department of Ultrasound, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
| | - Lijuan Sun
- Department of Ultrasound, The First Hospital of Qinhuangdao, Qinhuangdao, China
| | - Xiao Wang
- Department of Ultrasound, Anshan Central Hospital, Anshan, China
| | - Huan Yang
- Department of Ultrasound, Yingkou Central Hospital, Yingkou, China
| | - Guang Song
- Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, China
- *Correspondence: Guang Song
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28
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Restivo L, De Luca A, Fabris E, Pagura L, Pierri A, Korcova R, Franzese I, Fiocco A, Rauber E, Mazzaro E, Bussani R, Belgrano M, Pappalardo A, Sinagra G. A 20-year experience in cardiac tumors: a single center surgical experience and a review of literature. J Cardiovasc Med (Hagerstown) 2022; 23:722-727. [PMID: 36166324 DOI: 10.2459/jcm.0000000000001375] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Cardiac tumors are rare and heterogeneous entities which still remain a diagnostic and therapeutic challenge. The treatment for most cardiac tumors is prompt surgical resection. We sought to provide an overview of surgical results from a series of consecutive patients treated at our tertiary care center during almost a 20-year experience. METHODS AND RESULTS In this single center study, 55 consecutive patients with diagnosis of cardiac tumor underwent surgical treatment from January 2002 to April 2021. Of these, 23 (42%) were male and the mean age was 62 ± 12 years. Fifteen (27%) patients were symptomatic at the time of the diagnosis, mostly for dyspnea and palpitations. The most frequent benign cardiac tumor was myxoma (32; 58%), occurring mainly in the left atrium (31; 97%). Pleomorphic sarcoma was the most frequent primary malignant cardiac tumor (4; 7%), mainly located in the ventricles (1; 25% in the left ventricle; 2; 50% in the right ventricle). In all cases of benign tumors surgery was successful with no relapses. Two (50%) pleomorphic sarcomas showed subsequent relapses. After a median follow-up of 44 months, 15 (27%) patients died. Although malignant tumors presented a limited survival, benign tumors showed a very good prognosis. CONCLUSION Cardiac tumors require a multidisciplinary approach to guarantee a prompt diagnosis and appropriate treatment. In our surgical experience, outcome after surgery of benign tumors was excellent, while malignant tumors had poor prognosis despite radical surgery.
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Affiliation(s)
- Luca Restivo
- Cardiothoracovascular Department, Division of Cardiology, Azienda Sanitaria Universitaria Giuliano Isontina and University of Trieste
| | - Antonio De Luca
- Cardiothoracovascular Department, Division of Cardiology, Azienda Sanitaria Universitaria Giuliano Isontina and University of Trieste
| | - Enrico Fabris
- Cardiothoracovascular Department, Division of Cardiology, Azienda Sanitaria Universitaria Giuliano Isontina and University of Trieste
| | - Linda Pagura
- Cardiothoracovascular Department, Division of Cardiology, Azienda Sanitaria Universitaria Giuliano Isontina and University of Trieste
| | - Alessandro Pierri
- Cardiothoracovascular Department, Division of Cardiology, Azienda Sanitaria Universitaria Giuliano Isontina and University of Trieste
| | - Renata Korcova
- Cardiothoracovascular Department, Division of Cardiology, Azienda Sanitaria Universitaria Giuliano Isontina and University of Trieste
| | - Ilaria Franzese
- Cardiothoracovascular Department, Division of Cardiac Surgery, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste
| | - Alessandro Fiocco
- Cardiothoracovascular Department, Division of Cardiac Surgery, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste.,Department of Surgical, Medical and Molecular Pathology and Critical Care, Division of Cardiac Surgery, University of Pisa, Pisa
| | - Elisabetta Rauber
- Cardiothoracovascular Department, Division of Cardiac Surgery, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste
| | - Enzo Mazzaro
- Cardiothoracovascular Department, Division of Cardiac Surgery, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste
| | - Rossana Bussani
- Pathology Department, Azienda Sanitaria Universitaria Giuliano Isontina and University of Trieste
| | - Manuel Belgrano
- Department of Radiology, Azienda Sanitaria Universitaria Integrata and University of Trieste, Trieste, Italy
| | - Aniello Pappalardo
- Cardiothoracovascular Department, Division of Cardiac Surgery, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste
| | - Gianfranco Sinagra
- Cardiothoracovascular Department, Division of Cardiology, Azienda Sanitaria Universitaria Giuliano Isontina and University of Trieste
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Covington MK, Young PM, Bois MC, Maleszewski JJ, Anand V, Dearani JA, Klarich KW. Clinical Impact of Cardiac Fibromas. Am J Cardiol 2022; 182:95-103. [DOI: 10.1016/j.amjcard.2022.06.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 06/20/2022] [Accepted: 06/28/2022] [Indexed: 11/01/2022]
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30
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Rodríguez-Yánez T, Martínez-Ávila MC, Gutiérrez-Ariza JC, Almanza-Hurtado AJ, Cantillo-García K, Valencia-López J. Multimodality cardiac imaging in the diagnostic approach to chronic dyspnea: a patient with pericardial lipoma. Future Cardiol 2022; 18:673-677. [PMID: 35758139 DOI: 10.2217/fca-2022-0034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Cardiac masses are rare entities that present with a very varied spectrum of manifestations ranging from asymptomatic to severe hemodynamic compromise. They mainly correspond to benign neoplastic lesions; however, other pathologies may occur. The availability of high-definition imaging techniques has increased early detection. Nevertheless, these techniques do not allow the characterization and reliable differentiation of the nature of the mass. We describe a patient with no cardiovascular history with a chronic dyspnea, in whom the presence of a cardiac mass attached to the ventricle with slight deformation of the right cavities was identified by imaging studies. The patient underwent surgical resection, which confirmed the presence of lipoma by histopathology. This finding is the rarest of all benign cardiac tumors.
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Affiliation(s)
| | - María C Martínez-Ávila
- Epidemiology & Public Health Department, BIOTOXAM group, Universidad de Cartagena, Cartagena, Colombia
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31
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Kesiena O, Olokunlade T. The top 50 most cited articles on cardiac tumors: a bibliometric analysis. Future Cardiol 2022; 18:539-546. [PMID: 35735207 DOI: 10.2217/fca-2022-0011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: We evaluated the characteristics of the top 50 most cited articles on cardiac tumors using bibliometric analysis. Method: Independent reviewers queried the Web of Science database for articles within the past 50 years. Results: Most articles were published between 1991 and 2016, 18% (9/50) of the first authors were women, 52% (26/50) of the articles were focused on cardiac imaging in addition to other aspects of cardiac tumors and only 61.5% (16/26) of these were focused purely on cardiac imaging. A journal's impact factor and the number of citations of an article were positively correlated, r(48) = 0.24, p = 0.048. Conclusion: This study presents insight into the top 50 most cited articles on cardiac tumors and provides guidance for future research.
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Affiliation(s)
- Onoriode Kesiena
- Department of Internal Medicine, Piedmont Athens Regional Medical Center, Athens, GA 30606, USA
| | - Temitope Olokunlade
- Department of Environmental & Occupational Health, School of Public Health, Texas A & M University, College Station, TX 77843, USA
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32
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Saef J, Jellis C, Unai S, Tan C, Dresing T, Ayoub C. Multimodality imaging evaluation of incidentally discovered intracardiac mass. Echocardiography 2022; 39:837-840. [PMID: 35505607 DOI: 10.1111/echo.15354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 03/28/2022] [Accepted: 04/06/2022] [Indexed: 11/27/2022] Open
Abstract
Incidentally discovered intracardiac masses often represent diagnostic dilemmas. No guideline-directed algorithm exists for evaluation and management in these cases. Understanding the utility and limitations of different imaging modalities expedites evaluation of differential diagnoses and management, particularly when there are discordant imaging findings. This case further demonstrates that benign cardiac tumors may grow rapidly, and that new and rapid emergence of an intracardiac mass does not necessarily correlate with a diagnosis of thrombus or malignancy. It also highlights the importance of a broad differential diagnosis and a systematic management approach in patients with intracardiac masses.
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Affiliation(s)
- Josh Saef
- Department of Cardiovascular Disease, Sydell & Arnold Miller Family Heart & Vascular Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Christine Jellis
- Department of Cardiovascular Disease, Sydell & Arnold Miller Family Heart & Vascular Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Shinya Unai
- Department of Thoracic and Cardiovascular Surgery, Sydell & Arnold Miller Family Heart & Vascular Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Carmela Tan
- Department of Anatomic Pathology, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Thomas Dresing
- Department of Cardiovascular Disease, Sydell & Arnold Miller Family Heart & Vascular Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Chadi Ayoub
- Department of Cardiovascular Disease, Mayo Clinic, Scottsdale, Arizona, USA
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33
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Gripari P, Pepi M, Fusini L, Tamborini G, Mancini ME, Andreini D, Pontone G, Saccocci M, Giambuzzi I, Alamanni F, Zanobini M. Cardiac tumors: imaging findings, clinical correlations and surgical treatment in a 15 years single-center experience. THE JOURNAL OF CARDIOVASCULAR SURGERY 2022; 63:212-221. [PMID: 34825795 DOI: 10.23736/s0021-9509.21.12052-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND The aims of this study were: to present the clinical and pathological characteristics of cardiac tumors in a single-center series of patients; to describe the association of imaging characteristics, clinical presentation and surgical treatment; to analyze if second level imaging tests, computed tomography (CT) and cardiac magnetic resonance (CMR); and to improve the diagnostic accuracy when compared to first-line imaging technique (transthoracic echocardiography [TTE]). METHODS We reviewed the medical and surgical records, TTE, CT and CMR examinations of 86 patients with a histological diagnosis of cardiac tumors between 2004 and 2019. RESULTS The majority were benign tumors (81%) with myxoma accounting for 66% of cases. Among malignancies, metastasis (8%) and primary tumors (10%) were equally recognized. Symptoms at presentation (45% of patients) were associated to larger diameters at TTE. Malignancies were larger (mean diameter 37±14 mm vs. 27±13 mm, P<0.01), more frequently exhibited irregular shape (67% vs. 17%, P<0.01), frayed or polylobulated surface (73% vs. 38%, P=0.035), heterogeneous aspect (67% vs. 32%, P=0.012). A maximum diameter >28 mm and a minimum diameter >19.5 mm emerged as possible cut-off values for the differentiation of benign and malignant tumors. The ability of TTE, CT and CMR features in identifying malignancies was moderate (diagnostic accuracy of 84%, 81%, 76% respectively). The mean survival time after surgery was 1.6±1.4 years in malignancies and 6.8±4.7 years in benign tumors. CONCLUSIONS Cardiac tumors are rare and mostly benign; their nature and clinics related to TTE appearance. CT and CMR may be used synergically with TTE. Surgery is curative in benign tumors, survival remains scarce in malignancies.
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Affiliation(s)
| | - Mauro Pepi
- Centro Cardiologico Monzino IRCCS, Milan, Italy
| | | | | | | | | | | | - Matteo Saccocci
- Division of Cardiac Surgery, Poliambulanza Foundation, Brescia, Italy
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34
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Mahalwar G, Barve N, Furqan MM, Reyaldeen RM, Kumar A, Collier P, Klein AL. Role of Echocardiography in Diagnosing Metastatic Testicular Carcinoma in a Young Patient Presenting as Right Heart Failure. CASE 2022; 6:63-66. [PMID: 35492298 PMCID: PMC9050579 DOI: 10.1016/j.case.2021.11.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Metastatic GCTs may initially present as right heart failure. TTE and TEE can diagnose cardiac metastasis and monitor cardiac function. Multimodality imaging informs about tumor burden in metastatic cardiac tumors.
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Affiliation(s)
| | | | - Muhammad M. Furqan
- Center for the Diagnosis and Treatment of Pericardial Diseases, Section of Cardiovascular Imaging, Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio
| | - Reza M. Reyaldeen
- Center for the Diagnosis and Treatment of Pericardial Diseases, Section of Cardiovascular Imaging, Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio
| | - Ashwin Kumar
- Center for the Diagnosis and Treatment of Pericardial Diseases, Section of Cardiovascular Imaging, Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio
| | - Patrick Collier
- Center for the Diagnosis and Treatment of Pericardial Diseases, Section of Cardiovascular Imaging, Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio
| | - Allan L. Klein
- Center for the Diagnosis and Treatment of Pericardial Diseases, Section of Cardiovascular Imaging, Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio
- Reprint requests: Allan L. Klein, MD, Pericardial Disease Center, Department of Cardiovascular Medicine Cleveland Clinic, 9500 Euclid Avenue, Desk J1-5, Cleveland, OH 44195.
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35
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Diagnosis and staging of cardiac masses: additional value of CMR with 18F-FDG-PET compared to CMR with CECT. Eur J Nucl Med Mol Imaging 2022; 49:2232-2241. [PMID: 35247063 DOI: 10.1007/s00259-022-05709-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 01/25/2022] [Indexed: 11/04/2022]
Abstract
PURPOSE Characterization of malignant cardiac masses is usually performed with cardiac magnetic resonance (CMR) and staging with whole-body contrast-enhanced computed tomography (CECT). In this study, our objective was to evaluate the role of 18Fluor-fluorodeoxyglucose positron emission tomography (18F-FDG-PET) with CMR for both characterization and staging of cardiac masses. METHODS Patients with cardiac masses who underwent CMR, CECT, and 18F-FDG-PET were retrospectively identified. For the characterization of cardiac masses, we calculated the respective performances of CMR alone, 18F-FDG-PET alone, and the combination of 18F-FDG-PET and CMR. For staging, we compared head-to-head the respective performances of 18F-FDG-PET and CECT. Histology served as gold standard for malignancy, and response to anticoagulation for thrombus. RESULTS In a total of 28 patients (median age 60.5 years, 60.7% women), CMR accurately distinguished malignant from benign masses with sensitivity (Se) of 86.7%, specificity (Sp) of 100%, positive predictive value (PPV) of 100%, negative predictive value (NPV) of 86.7%, and accuracy of 92.9%. 18F-FDG-PET demonstrated 93.3% Se, 84.6% Sp, 87.5% PPV, 91.7% NPV, and 89.3% accuracy. Combining CMR with 18F-FDG-PET allowed to benefit from the high sensitivity of 18F-FDG-PET (92.9%) and the excellent specificity of CMR (100%) for malignant diseases. For staging, 18F-FDG-PET outperformed CECT on per-patient (66.7% vs 55.6% correct diagnosis, respectively), per-organ (10 vs 7 organs, respectively), and per-lesion basis (> 29 vs > 25 lesions, respectively). CONCLUSION Combining 18F-FDG-PET with CMR improved the characterization of cardiac masses compared to each modality alone. Additionally, the diagnostic performance of 18F-FDG-PET was better than CECT for staging. This study suggests that the combination of CMR and 18F-FDG-PET is the most effective for the characterization of cardiac masses and the staging of these lesions.
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36
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Primary and secondary cardiac tumors: clinical presentation, diagnosis, surgical treatment, and results. Gen Thorac Cardiovasc Surg 2022; 70:107-115. [PMID: 35000140 DOI: 10.1007/s11748-021-01754-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 11/28/2021] [Indexed: 01/04/2023]
Abstract
Cardiac tumours are some of the rarest primary tumours, while cardiac metastasis are more common yet still relatively rare. Seventy five percent of primary cardiac tumours are benign tumours. Cardiac tumours present with a range of obstructive, embolic, arrhythmic or systemic symptoms, and in many cases may present asymptomatically. The clinical presentation depends largely on the size and location of the mass. With advances in cardiac imagining and the introduction of cardiopulmonary bypass, the diagnosis and surgical treatment of these rare tumours has improved the prognosis and outlook for benign and malignant tumours. Management depends on tumour histology, size and location as well as the clinical presentation. Conservative management is reserved for small, benign tumours that can undergo regular echocardiographic follow-up. Symptomatic benign tumours are treated with surgical resection and the results are excellent. Malignant primary cardiac tumours have a poor prognosis with high rates of relapse and a median survival of 10-24 months.
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37
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Mararenko A, Udongwo N, Desai D, Schoenfeld MS. Left Atrial Myxoma Masquerading as Pulmonary Embolism on Electrocardiogram: A Case Report. J Med Cases 2022; 12:511-515. [PMID: 34970376 PMCID: PMC8683111 DOI: 10.14740/jmc3775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Accepted: 10/05/2021] [Indexed: 11/17/2022] Open
Abstract
Primary cardiac tumors are an incredibly rare finding. Cardiac myxomas are the most primary cardiac tumors that often occur within the left atrium. When left untreated, they pose a high risk of causing hemodynamic collapse by obstruction or can embolize and result in thromboembolic stroke. The presentation of cardiac myxoma varies greatly and can be associated with significant morbidity and mortality when undiagnosed. A careful physical examination and high degree of suspicion is crucial in early diagnosis and intervention. Our team presents a 46-year-old female patient with no significant past medical history that presented to the emergency department with a neurological deficit that was concerning for a transient ischemic attack. Initial laboratory workup and electrocardiogram was suggestive for pulmonary embolism; however, upon evaluation with imaging, the patient was found to have a 1.6 × 3.4 cm mass fixed to the mitral leaflet that was then confirmed on transthoracic echocardiography. Our patient was found to have non-obstructive coronary artery disease on cardiac catheterization and ultimately underwent successful mass resection by cardiothoracic surgery.
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Affiliation(s)
- Anton Mararenko
- Department of Internal Medicine, Jersey Shore University Medical Center, Neptune, NJ, USA
| | - Ndausung Udongwo
- Department of Cardiology, Jersey Shore University Medical Center, Neptune, NJ, USA
| | - Dhaval Desai
- Department of Cardiology, Jersey Shore University Medical Center, Neptune, NJ, USA
| | - Matthew S Schoenfeld
- Department of Cardiology, Jersey Shore University Medical Center, Neptune, NJ, USA
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38
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Sampson B, Hammers J, Stram M. Forensic aspects of cardiovascular pathology. Cardiovasc Pathol 2022. [DOI: 10.1016/b978-0-12-822224-9.00003-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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39
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Clinical and echocardiographic characteristics of patients with pathology proven right-sided papillary fibroelastomas. Int J Cardiol 2021; 349:123-126. [PMID: 34871621 DOI: 10.1016/j.ijcard.2021.11.083] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 10/10/2021] [Accepted: 11/29/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Papillary fibroelastoma (PFE) are one of the most common primary cardiac neoplasms. They are most commonly found on cardiac valves especially on the left side of the heart and have been associated with an increased risk of embolization. To date, no large studies looked at the clinical significance of right-sided PFE (R-PFE). Therefore, we sought to better characterize patients with R-PFE and its clinical sequelae. METHODS We retrospectively identified patients with pathology-proven PFEs at a single center between January 1995 and December 2018 (n = 279). Patients with R-PFE were analyzed. Medical records and echocardiograms were reviewed for clinical and PFE characteristics. RESULTS Twenty-nine patients with R-PFE (mean age 70 ± 11 years; 62% women) were included in the analysis. PFEs were located on the right atrial (RA) wall in 31%, tricuspid valve in 34%, right ventricular (RV) wall in 7%, RV outflow tract in 4%, and pulmonary valve in 10% of patients. The remaining patients (14%) had multifocal PFEs. Around 38% of patients had cancer diagnosed before PFE diagnosis, and 34% had associated congenital heart disease. Seventeen (59%) patients had angina or dyspnea at the time of the presentation, and 3 (10%) had embolic symptoms. One patient with PFE located on the RA with associated patent foramen ovale had a stroke at time of presentation. Two patients, one with PFE on the RA wall and another patient with PFE at the tricuspid valve, had pulmonary embolism at the time of presentation. Median maximal length for PFE varied by location, ranging from a media of 8 mm to 16 mm. Of the 12 patients with follow up echocardiogram 1 year after PFE removal; 3/12 (25%) had documented PFE recurrence. CONCLUSION R-PFE can be present in patients thromboembolic events when there is a right-to-left shunt. They can be a rare cause of pulmonary embolism, and at least in those that had follow-up echocardiograms, had a significant recurrence rate.
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40
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Hibino M, Yanagawa B, Pandey AK, Verma S. Ambient temperature and aortic dissection: do pipes burst in freezing weather? Eur Heart J 2021; 43:236-238. [PMID: 34849698 DOI: 10.1093/eurheartj/ehab792] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Makoto Hibino
- Division of Cardiac Surgery, St Michael's Hospital, University of Toronto, Ontario, Canada
| | - Bobby Yanagawa
- Division of Cardiac Surgery, St Michael's Hospital, University of Toronto, Ontario, Canada
| | - Arjun K Pandey
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Subodh Verma
- Division of Cardiac Surgery, St Michael's Hospital, University of Toronto, Ontario, Canada
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41
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Luo L, Zhao W, Wang Y, Liu K. Cardiac angiosarcoma: A case report and review of the literature. Echocardiography 2021; 38:2083-2090. [PMID: 34806222 DOI: 10.1111/echo.15221] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 09/18/2021] [Accepted: 09/27/2021] [Indexed: 11/29/2022] Open
Abstract
Primary cardiac tumors are extremely rare, among which malignancies comprise about 15-25%. As the most common type of primary cardiac malignancies, angiosarcomas tend to arise in the right heart, especially right atrium. In this case report, we presented a 32-year-old female with primary cardiac angiosarcoma in the right atrial appendage detected by transesophageal echocardiography, as it is difficult to display on conventional transthoracic echocardiography.
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Affiliation(s)
- Limin Luo
- Department of Echocardiography, Zhongshan Hospital Fudan University Xiamen Branch, Xiamen City, Fujian Province, China
| | - Weipeng Zhao
- Department of Echocardiography, Zhongshan Hospital Fudan University Xiamen Branch, Xiamen City, Fujian Province, China.,Department of Echocardiography, Zhongshan Hospital Fudan University, Shanghai, China
| | - Yongshi Wang
- Department of Echocardiography, Zhongshan Hospital Fudan University Xiamen Branch, Xiamen City, Fujian Province, China.,Department of Echocardiography, Zhongshan Hospital Fudan University, Shanghai, China
| | - Kun Liu
- Department of Pathology, Zhongshan Hospital Fudan University Xiamen Branch, Xiamen City, Fujian Province, China
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42
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Rana Y, Tummala R, Engstrom K, Kukar N, Misra D. Discovery of Tricuspid Fibroelastoma on Echocardiography. Cureus 2021; 13:e17359. [PMID: 34567899 PMCID: PMC8453665 DOI: 10.7759/cureus.17359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2021] [Indexed: 11/10/2022] Open
Abstract
Papillary fibroelastoma (PFE) is a benign cardiac tumor usually incidentally found on cardiac imaging. They are typically located on the left-sided heart valves and are concerning primarily due to their risk for embolization into the periphery. Right-sided PFE, however, is very rare and their management is not well known. We present a 66-year-old male with a past medical history of HIV on antiretroviral therapy presenting with new exertional dyspnea. Upon workup, he was found to have a mass on the tricuspid valve seen on echocardiography which was ultimately resected and found to be a tricuspid fibroelastoma. The clinical management of right-sided PFE is poorly documented. Treatment of PFE in an asymptomatic is dependent on characteristics such as location, mobility, and risk of embolization. Echocardiography has made the incidental diagnosis of PFE a common issue in asymptomatic patients such as ours.
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Affiliation(s)
- Yesha Rana
- Department of Internal Medicine, Icahn School of Medicine at Mount Sinai, Mount Sinai Beth Israel Medical Center, New York City, USA
| | - Ramyashree Tummala
- Department of Cardiology, Icahn School of Medicine at Mount Sinai, Mount Sinai Beth Israel Medical Center, New York City, USA
| | - Krysthel Engstrom
- Department of Cardiology, Icahn School of Medicine at Mount Sinai, Mount Sinai West Hospital, New York City, USA
| | - Nina Kukar
- Department of Cardiology, Icahn School of Medicine at Mount Sinai, Mount Sinai West Hospital, New York City, USA
| | - Deepika Misra
- Department of Cardiology, Icahn School of Medicine at Mount Sinai, Mount Sinai Beth Israel Medical Center, New York City, USA
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43
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Dimov I, Meuleman N, de Cannière D, Unger P. Role of imaging for diagnosis and management of aortic valve papillary fibroelastoma and cardiac amyloid light chain amyloidosis: a case report. EUROPEAN HEART JOURNAL-CASE REPORTS 2021; 5:ytab322. [PMID: 34514307 PMCID: PMC8422351 DOI: 10.1093/ehjcr/ytab322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 06/22/2021] [Accepted: 07/26/2021] [Indexed: 11/14/2022]
Abstract
Background We report the case of a patient who presented with concomitant aortic valve papillary fibroelastoma (PFE) and cardiac amyloidosis. Although histologically benign, PFE confers an increased thromboembolic risk, and surgical excision is often indicated. However, outcomes of cardiac surgery are poor in patients with cardiac amyloidosis. Case summary A 61-year-old man with complaints of dyspnoea and weight loss of 10 kg developing over the past 5 months was evaluated in the cardiology clinic. Echocardiography revealed sessile aortic valve PFE and was also highly suggestive of cardiac amyloidosis. The diagnosis of amyloid light chain amyloidosis secondary to indolent multiple myeloma was eventually confirmed. Therapy with daratumumab, bortezomib, cyclophosphamide, and dexamethasone allowed full remission over a 6-month period and resulted in marked improvement in symptoms and cardiac function as evaluated by global longitudinal strain. Further workup with cerebral magnetic resonance revealed multiple vascular sequelae. Surgical removal of the aortic fibroelastoma with bioprosthetic aortic valve replacement was performed successfully and the patient had an uneventful recovery. Discussion Papillary fibroelastoma and cardiac amyloidosis are rare and most likely unrelated entities. Concomitant presentation of both conditions in the same patient presents a unique therapeutic challenge. By allowing cardiac function to be monitored during chemotherapy, speckle-tracking echocardiography can prove instrumental in determining the optimal timing of surgical intervention.
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Affiliation(s)
- Ivan Dimov
- Cardiology Department, CHU Saint-Pierre, Université Libre de Bruxelles (ULB), 322 rue Haute, 1000 Brussels, Belgium
| | - Nathalie Meuleman
- Hematology Department, Institut Jules Bordet, Université Libre de Bruxelles (ULB), 121 boulevard de Waterloo, 1000 Brussels, Belgium
| | - Didier de Cannière
- Cardiac Surgery Department, CHU Saint-Pierre, Université Libre de Bruxelles (ULB), 322 rue Haute, 1000 Brussels, Belgium
| | - Philippe Unger
- Cardiology Department, CHU Saint-Pierre, Université Libre de Bruxelles (ULB), 322 rue Haute, 1000 Brussels, Belgium
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Tan NY, Najam M, Lyle MA, Maleszewski JJ, Collins JD, Klarich KW. Dramatic Presentation of Cardiac Pleomorphic Liposarcoma. Circ Cardiovasc Imaging 2021; 14:e012620. [PMID: 34387092 DOI: 10.1161/circimaging.121.012620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Nicholas Y Tan
- Department of Cardiovascular Medicine (N.Y.T., M.N., K.W.K.), Mayo Clinic, Rochester, MN
| | - Maria Najam
- Department of Cardiovascular Medicine (N.Y.T., M.N., K.W.K.), Mayo Clinic, Rochester, MN
| | - Melissa A Lyle
- Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, FL (M.A.L.)
| | - Joseph J Maleszewski
- Department of Laboratory Medicine and Pathology (J.J.M.), Mayo Clinic, Rochester, MN
| | | | - Kyle W Klarich
- Department of Cardiovascular Medicine (N.Y.T., M.N., K.W.K.), Mayo Clinic, Rochester, MN
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45
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Artico J, Belgrano M, Bussani R, Sinagra G. The curious case of a massive right heart thrombosis: a case report. EUROPEAN HEART JOURNAL-CASE REPORTS 2021; 5:ytab156. [PMID: 34377897 PMCID: PMC8343560 DOI: 10.1093/ehjcr/ytab156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 10/08/2020] [Accepted: 03/29/2021] [Indexed: 11/16/2022]
Abstract
Background Intraventricular masses are a relatively rare condition ranging from asymptomatic to potentially life-threatening situations. Case summary Herein, we report a case of a 49-year-old woman under investigation for a massive right ventricular (RV) mass who underwent complete investigation for possible differential diagnosis, in the suspect of RV tumour. Multimodality imaging with cardiac computed tomography and magnetic resonance imaging showed the presence of a massive thrombus partially obliterating the right ventricle. Surgical removal of the mass showed a large area of stratified thrombosis with an underlying area of endocardial fibrosis. The patient has been then discharged in good clinical condition and with lifetime oral anticoagulation. Discussion Massive RV thrombosis is a rare yet potentially fatal condition. Invasive management is preferable and lifetime anticoagulation is required to reduce possible downstream thrombotic complications.
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Affiliation(s)
- Jessica Artico
- Cardiovascular Department, Azienda Sanitaria Universitaria Integrata and University of Trieste, Via Pietro Valdoni 7, 34100 Trieste, Italy
| | - Manuel Belgrano
- Department of Radiology, Azienda Sanitaria Universitaria Integrata and University of Trieste, Trieste, Italy
| | - Rossana Bussani
- Department of Pathology, Azienda Sanitaria Universitaria Integrata and University of Trieste, Trieste, Italy
| | - Gianfranco Sinagra
- Cardiovascular Department, Azienda Sanitaria Universitaria Integrata and University of Trieste, Via Pietro Valdoni 7, 34100 Trieste, Italy
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46
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Restivo L, De Luca A, Pinamonti B, Grilli G, Bussani R, Cominotto F, Crisafulli C, Dore F, Sinagra G, Pappalardo A. A case of primary cardiac sarcoma with an acute presentation: The role of multimodality imaging. Clin Case Rep 2021; 9:e04219. [PMID: 34178334 PMCID: PMC8212016 DOI: 10.1002/ccr3.4219] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 04/08/2021] [Accepted: 04/12/2021] [Indexed: 11/12/2022] Open
Abstract
The case highlights the value of contrast echocardiography in raising clinical suspicion of malignancy, allowing a diagnostic work-up and the treatment of the primitive heart tumors.
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Affiliation(s)
- Luca Restivo
- Division of CardiologyCardiothoracovascular DepartmentAzienda Sanitaria Universitaria Giuliano‐Isontina and University of TriesteTriesteItaly
| | - Antonio De Luca
- Division of CardiologyCardiothoracovascular DepartmentAzienda Sanitaria Universitaria Giuliano‐Isontina and University of TriesteTriesteItaly
| | - Bruno Pinamonti
- Division of CardiologyCardiothoracovascular DepartmentAzienda Sanitaria Universitaria Giuliano‐Isontina and University of TriesteTriesteItaly
| | - Giulia Grilli
- Division of CardiologyCardiothoracovascular DepartmentAzienda Sanitaria Universitaria Giuliano‐Isontina and University of TriesteTriesteItaly
| | - Rossana Bussani
- Pathology DepartmentAzienda Sanitaria Universitaria Giuliano‐Isontina and University of TriesteTriesteItaly
| | - Franco Cominotto
- Emergency Medicine DepartmentAzienda Sanitaria Universitaria Giuliano‐IsontinaTriesteItaly
| | - Carmelo Crisafulli
- Nuclear Medicine DepartmentAzienda Sanitaria Universitaria Giuliano‐IsontinaTriesteItaly
| | - Franca Dore
- Nuclear Medicine DepartmentAzienda Sanitaria Universitaria Giuliano‐IsontinaTriesteItaly
| | - Gianfranco Sinagra
- Division of CardiologyCardiothoracovascular DepartmentAzienda Sanitaria Universitaria Giuliano‐Isontina and University of TriesteTriesteItaly
| | - Aniello Pappalardo
- Division of Cardiac SurgeryCardiovascular DepartmentAzienda Sanitaria Universitaria Giuliano‐IsontinaTriesteItaly
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47
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Sheikhy A, Fallahzadeh A, Ahmadi-Tafti SH, Hosseini K, Mohseni-Badalabadi R, Shahbazi N, Ghorashi SM, Tajdini M. Intrapericardial solitary fibrous tumor: A case report and review of literature. Echocardiography 2021; 38:1052-1056. [PMID: 33934398 DOI: 10.1111/echo.15047] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 03/13/2021] [Accepted: 03/30/2021] [Indexed: 12/13/2022] Open
Abstract
Solitary fibrous tumor (SFT) is a mesenchymal neoplasm mostly originates from pleura, but rarely from other parts of the body including pericardium. We report a case of a 44-year-old woman with dyspnea and intermittent edema in whom a large intrapericardial mass was discovered by echocardiography. Computed tomography (CT) revealed a focal pericardial calcification in right AV grove with pressure on right ventricle and right atrial, with no connection to cardiac chambers. Histopathological findings after complete resection of the mass revealed fibroconnective tissue with heavy calcification and no evidence of inflammation or malignancy. We reviewed the literature on pericardial solitary fibrous tumors up to 2020.
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Affiliation(s)
- Ali Sheikhy
- Research Department, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Aida Fallahzadeh
- Research Department, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Kaveh Hosseini
- Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Mohseni-Badalabadi
- Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Narges Shahbazi
- Department of Pathology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyyed Mojtaba Ghorashi
- Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Masih Tajdini
- Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
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48
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Tumoral Phenocopies of Hypertrophic Cardiomyopathy: The Role of Cardiac Magnetic Resonance. J Clin Med 2021; 10:jcm10081683. [PMID: 33919877 PMCID: PMC8070813 DOI: 10.3390/jcm10081683] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 04/01/2021] [Accepted: 04/09/2021] [Indexed: 12/04/2022] Open
Abstract
Hypertrophic cardiomyopathy (HCM) is a genetic cardiac disease that presents with cardiac hypertrophy. HCM phenocopies are clinical conditions that are phenotypically undistinguishable from HCM, but with a different underlying etiology. Cardiac tumors are rare entities that can sometimes mimic HCM in their echocardiographic appearance, thus representing an example of HCM phenocopy. At present, only case reports of tumoral HCM phenocopies can be found in literature. In this systematic review, we analyzed all the published cases in which a cardiac tumor mimicked HCM to the point of misleading the diagnosis, providing a structured overview of the currently available evidence on this topic.
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49
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Andres MS, Pan J, Lyon AR. What Does a Cardio-oncology Service Offer to the Oncologist and the Haematologist? Clin Oncol (R Coll Radiol) 2021; 33:483-493. [PMID: 33832839 DOI: 10.1016/j.clon.2021.03.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 02/15/2021] [Accepted: 03/17/2021] [Indexed: 12/11/2022]
Abstract
Cardio-oncology is an emerging subspecialty arising from the need for multidisciplinary collaboration to address the increasing prominence of cardiovascular disease (CVD) among cancer patients. This overview outlines the case for establishing cardio-oncology services and defines the ways in which these services benefit cancer patients. The primary objective of cardio-oncology is to manage CVDs in order to allow cancer patients to complete the best cancer treatments safely and with minimal interruption. In the decades since the first discovery of heart failure induced by anthracycline chemotherapy, both cardiovascular and oncological science have advanced considerably. Cardio-oncology services aim to bring together expertise from these two fast moving fields in order to provide optimal evidence-based care for cancer patients with CVDs. Here we discuss the basis of cardio-oncology services by presenting their rationale and key components, as well as their essential roles in education, training and research. At each stage of the cancer care pathway, a cardio-oncology service can add value by ensuring cancer patients have timely access to specialist care backed up by cutting edge diagnostic tools and treatment options, as well as holistic supports. We highlight areas of recent and upcoming developments in the field that are likely to change established clinical practice. Improved cardiac imaging modalities can detect chemotherapy-related cardiac dysfunction earlier and are also essential for the prompt diagnosis of an expanding range of cardiovascular effects complicating newer cancer therapeutics, such as immune checkpoint inhibitors and other targeted therapies. Modern cancer therapy has dramatically improved cancer survival and as such CVD is becoming one of the principal determinants of overall outcome for cancer patients. A dedicated cardio-oncology service can facilitate the optimisation of cardiovascular treatment and enable the completion of cancer therapy. A multidisciplinary collaborative approach is key to achieving these objectives.
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Affiliation(s)
- M S Andres
- Cardio-Oncology Service, Royal Brompton Hospital, London, UK.
| | - J Pan
- Cardio-Oncology Service, Royal Brompton Hospital, London, UK
| | - A R Lyon
- Cardio-Oncology Service, Royal Brompton Hospital, London, UK; National Heart and Lung Institute, Imperial College London, London, UK
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50
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Torabi S, Arjomandi Rad A, Vardanyan R, Lopuszko AT, Van den Eynde J, Zubarevich A, Sá MPBO, Szczechowicz M, Weymann A. Surgical and multimodality treatment of cardiac sarcomas: A systematic review and meta-analysis. J Card Surg 2021; 36:2476-2485. [PMID: 33797789 DOI: 10.1111/jocs.15538] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 03/17/2021] [Accepted: 03/18/2021] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Primary cardiac sarcomas (PCSs) are an extremely rare and aggressive type of malignancies that have been described only by a limited number of observational studies. This study aimed to evaluate the currently existing evidence comparing surgical to multimodality treatment of PCS. METHODS We systematically reviewed Embase, MEDLINE, Cochrane Database, and Google Scholar, from inception to December 2020, for original articles about surgical and multimodality treatment of PCS. The outcomes included were mortality at various time points, resection margin status, and mean estimated survival. The pooled treatment effects were calculated using a random-effects model. RESULTS Ten studies including a total of 1570 patients met our inclusion criteria. Surgery was associated with significantly lower mortality when compared to conservative treatment at 1, 2, and 3 years, whereas no significant difference was found at 5 years. Furthermore, multimodality treatment showed significantly lower mortality at 1 year when compared to surgery alone, but not at 2 and 5 years. We found no difference in mortality between angiosarcomas and other PCS subtypes. CONCLUSION Overall, surgery was found to provide a significant mortality advantage to PCS patients up to 3 years following treatment. Multimodality treatment might be of additional benefit, although only within the first year. Prospective randomized studies are needed to further explore these differences in the treatment of PCS.
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Affiliation(s)
- Saeed Torabi
- Department of Anesthesiology and Intensive Care Medicine, University Hospital of Cologne, Cologne, Germany
| | - Arian Arjomandi Rad
- Department of Medicine, Faculty of Medicine, Imperial College London, London, UK
| | - Robert Vardanyan
- Department of Medicine, Faculty of Medicine, Imperial College London, London, UK
| | - Aleksandra T Lopuszko
- Faculty of Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Jef Van den Eynde
- Department of Cardiovascular Sciences, Unit of Cardiac Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Alina Zubarevich
- Department of Thoracic and Cardiovascular Surgery, West German Heart and Vascular Center Essen, University Hospital of Essen, University Duisburg-Essen, Essen, Germany
| | - Michel P B O Sá
- Division of Cardiovascular Surgery-PROCAPE, Universidade de Pernambuco (UPE), Recife, Brazil
| | - Marcin Szczechowicz
- Department of Anesthesiology and Intensive Care Medicine, University Hospital of Cologne, Cologne, Germany
| | - Alexander Weymann
- Department of Thoracic and Cardiovascular Surgery, West German Heart and Vascular Center Essen, University Hospital of Essen, University Duisburg-Essen, Essen, Germany
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