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Sadeghei A, Chaibakhsh Y, Ghadimi M, Hadipoorzadeh S, Shahandashti FJ, Shojaeifard M, Esmaeili A. Incidental cardiac lymphangioma misdiagnosed as atrial thrombus: A case report. Radiol Case Rep 2024; 19:3136-3140. [PMID: 38779199 PMCID: PMC11108840 DOI: 10.1016/j.radcr.2024.04.064] [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: 11/22/2023] [Revised: 04/11/2024] [Accepted: 04/20/2024] [Indexed: 05/25/2024] Open
Abstract
Cardiac lymphangioma is a characteristically benign primary neoplasm of the heart, previously reported only in a handful of cases. A right atrial lesion was found of a 56-years old healthy male patient. The lesion was surgically excised and identified as cardiac lymphangioma in postoperative pathological analysis. While open surgical tumor resection is preferred in patients with cardiac lymphangioma, preoperative characterization of suspected lesions may warrant conservative management in selected cases.
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Affiliation(s)
- Ali Sadeghei
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Yasamin Chaibakhsh
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Ghadimi
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Shima Hadipoorzadeh
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | | | - Maryam Shojaeifard
- Echocardiography Research Center, Rajaie Cardiovascular, Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Anahita Esmaeili
- Echocardiography Research Center, Rajaie Cardiovascular, Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
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Soltani S, Garousi M, Mirzaee E, Koolaji S, Nazari H, Emami S, Zare Mehrjardi A, Arefpour AM. A rare presentation of primary cardiac myxofibrosarcoma: Case report and literature review. Cancer Rep (Hoboken) 2024; 7:e2033. [PMID: 38600050 PMCID: PMC11006601 DOI: 10.1002/cnr2.2033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 02/06/2024] [Accepted: 02/26/2024] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND Primary cardiac myxofibrosarcoma is a rare and aggressive malignancy, with the majority of approaching strategies relying on case reports. This article provides insights into its diagnosis and treatment. CASE PRESENTATION This paper presents the case of a 40-year-old man with sudden onset hemoptysis, leading to the diagnosis of primary cardiac myxofibrosarcoma. Treatment involved open-heart surgery to excise the left atrium tumor, followed by 6 cycles of adjuvant chemotherapy. Unfortunately, brain metastasis developed, leading to the patient's death 1 year after initial diagnosis. CONCLUSION Primary cardiac myxofibrosarcoma remains a clinical challenge with an unfavorable prognosis. Early diagnosis through advanced imaging is crucial, and research is needed to explore innovative treatments. This case underscores the complexities of managing this rare cardiac malignancy and highlights the necessity for ongoing investigations to enhance patient outcomes.
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Affiliation(s)
- Sepideh Soltani
- Department of Radiation Oncology, School of MedicineIran University of Medical SciencesTehranIran
| | - Maryam Garousi
- Department of Radiation Oncology, School of MedicineIran University of Medical SciencesTehranIran
| | - Elahe Mirzaee
- Department of Radiation Oncology, School of MedicineIran University of Medical SciencesTehranIran
| | - Sogol Koolaji
- Non‐communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Hengameh Nazari
- Department of RadiologyIsfahan University of Medical SciencesIsfahanIran
| | - Sepideh Emami
- Department of Cardiology, Firoozgar Hospital, School of MedicineIran University of Medical SciencesTehranIran
| | - Ali Zare Mehrjardi
- Department of Pathology, Firoozgar HospitalIran University of Medical SciencesTehranIran
| | - Amir Mohammad Arefpour
- Department of Radiation Oncology, School of MedicineIran University of Medical SciencesTehranIran
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3
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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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Morimoto K, Miyasaka S, Ikeda Y, Nii R, Fujiwara Y. Primary angiosarcoma arising in the sinus of Valsalva: A case report. Int J Surg Case Rep 2024; 115:109308. [PMID: 38295745 PMCID: PMC10844813 DOI: 10.1016/j.ijscr.2024.109308] [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: 12/07/2023] [Revised: 01/23/2024] [Accepted: 01/24/2024] [Indexed: 02/12/2024] Open
Abstract
INTRODUCTION Primary angiosarcoma of the aorta, particularly within the sinus of Valsalva, is uncommon, with no documented instances of primary angiosarcoma. The absence of apparent clinical manifestations in this severe condition makes it challenging to diagnose, often resulting in a poor prognosis. CASE PRESENTATION A 60-year-old patient underwent procedures for fistula closure and coronary artery bypass grafting, which resulted in the rupture of an aneurysm within the sinus of Valsalva. Computed tomography examination 5 years after the procedure suggested no pathological abnormalities. Nevertheless, the patient required repeat surgery at 67 years due to the observed expansion of the sinus of Valsalva aneurysm noted during a clinical evaluation, prompted by elevated levels of inflammatory markers. Exploration of the residual aneurysmal locus within the sinus of Valsalva revealed an intraluminal thrombus devoid of any demonstrable hemodynamic access into the aneurysmal sac. Histopathological assessment of the aneurysmal wall confirmed a definitive diagnosis of primary angiosarcoma within the sinus of Valsalva. After surgery, the patient exhibited pyrexia. Magnetic resonance imaging substantiated multifocal osseous metastases, corroborated by histological analysis following a bone biopsy, confirming a diagnosis of angiosarcoma. Therefore, adjuvant chemotherapy with paclitaxel was initiated. After 1 year, a sustained state of disease stability was noted. DISCUSSION In this case, the need for surgical intervention, based on an expanded sinus of Valsalva aneurysm, culminated in the unanticipated detection of primary angiosarcoma. CONCLUSION Neoplastic etiologies may plausibly underlie the pathogenesis of aneurysm formation in cases where the etiology remains obscure in the early stages of therapeutic intervention.
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Affiliation(s)
- Kenichi Morimoto
- Department of Cardiovascular Surgery, Tottori Prefectural Central Hospital, 730 Ezu, Tottori 680-0901, Japan.
| | - Shigeto Miyasaka
- Department of Cardiovascular Surgery, Tottori Prefectural Central Hospital, 730 Ezu, Tottori 680-0901, Japan
| | - Yosuke Ikeda
- Department of Cardiovascular Surgery, Tottori Prefectural Central Hospital, 730 Ezu, Tottori 680-0901, Japan
| | - Rikuto Nii
- Department of Cardiovascular Surgery, Tottori Prefectural Central Hospital, 730 Ezu, Tottori 680-0901, Japan
| | - Yoshikazu Fujiwara
- Department of Cardiovascular Surgery, Tottori Prefectural Central Hospital, 730 Ezu, Tottori 680-0901, Japan
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Murata H, Miyauchi Y, Nitta T, Sakamoto SI, Kunugi S, Ishii Y, Shimizu A, Fujimoto Y, Hayashi H, Yamamoto T, Yodogawa K, Maruyama M, Kaneko S, Hayashi H, Soejima K, Nogami A, Asai K, Shimizu W, Iwasaki YK. Electrophysiological and Histopathological Characteristics of Ventricular Tachycardia Associated With Primary Cardiac Tumors. JACC Clin Electrophysiol 2024; 10:43-55. [PMID: 37855769 DOI: 10.1016/j.jacep.2023.08.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 08/11/2023] [Accepted: 08/30/2023] [Indexed: 10/20/2023]
Abstract
BACKGROUND Ventricular tachycardia (VT) associated with primary cardiac tumors (PCTs) originating from the ventricles is rare, but lethal, in young patients. OBJECTIVES This study aimed to clarify the mechanisms underlying primary cardiac tumor-related ventricular tachycardia (PCT-VT) and establish a therapeutic strategy for this form of VT. METHODS Among 67 patients who underwent surgery for VT at our institute between 1981 and 2020, 4 patients aged 1 to 34 years, including 3 males, showed PCT-VT (fibroma, 2; lipoma, 1; and hamartoma, 1), which was investigated using a combination of intraoperative electroanatomical mapping and histopathological studies. RESULTS All 4 patients developed electrical storms of sustained VTs refractory to multiple drugs and repetitive endocardial ablations. The VT mechanism was re-entry, and intraoperative electroanatomical mapping showed a centrifugal activation pattern originating from the border between the tumor and healthy myocardium, where fractionated potentials were detected during sinus rhythm. Histopathological studies of serial sections of specimens acquired from these areas revealed tumor infiltration into the surrounding myocardium with cell disorganization, exhibiting myocardial disarray. Several myocardia entrapped in the tumor edges contributed to the development and sustainment of re-entrant VT activation. In the 2 patients in whom complete resection was unfeasible, encircling cryoablation to entirely isolate the unresectable tumor was effective in suppressing VT occurrence. CONCLUSIONS The mechanism underlying PCT-VT involves re-entry localized at the tumor edges. Myocardial disarray associated with tumor infiltration is a substrate for this form of VT. Cryoablation along the border between the tumor and myocardium is a promising therapeutic option for unresectable PCT-VT.
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Affiliation(s)
- Hiroshige Murata
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan. https://twitter.com/Muratahiroshige
| | - Yasushi Miyauchi
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
| | - Takashi Nitta
- Department of Cardiovascular Surgery, Nippon Medical School, Tokyo, Japan
| | | | - Shinobu Kunugi
- Department of Analytic Human Pathology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Yosuke Ishii
- Department of Cardiovascular Surgery, Nippon Medical School, Tokyo, Japan
| | - Akira Shimizu
- Department of Analytic Human Pathology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Yuhi Fujimoto
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
| | - Hiroshi Hayashi
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
| | - Teppei Yamamoto
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
| | - Kenji Yodogawa
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
| | - Mitsunori Maruyama
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
| | - Shinji Kaneko
- Department of Cardiology, Toyota Kosei Hospital, Aichi, Japan
| | - Hidemori Hayashi
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Kyoko Soejima
- Department of Cardiology, Kyorin University, Tokyo, Japan
| | - Akihiko Nogami
- Department of Cardiology, Institute of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Kuniya Asai
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
| | - Wataru Shimizu
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
| | - Yu-Ki Iwasaki
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan.
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Aston A, Harowicz MR, Grizzard JD, Bottinor W. Massive Mysteries. Am J Cardiol 2023; 204:178-182. [PMID: 37544141 PMCID: PMC10528874 DOI: 10.1016/j.amjcard.2023.07.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 07/11/2023] [Indexed: 08/08/2023]
Abstract
Papillary fibroelastomas are benign masses often originating from the endocardium of the aortic and mitral valves. Rarely, these neoplasms are found in areas of the heart embryonically distinct from the aortic and mitral valves. Diagnosis of a papillary fibroelastoma relies on multimodal imaging as well as histologic assessment. A case series of papillary fibroelastomas in unusual locations is presented, highlighting the role of multimodal imaging techniques in identifying these intra-cardiac masses. Differential diagnoses, imaging characteristics, histopathology, and preferred management strategies for cardiac masses are reviewed. The unique imaging qualities of cardiac masses are discussed.
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Affiliation(s)
- Adam Aston
- Department of Internal Medicine, Virginia Commonwealth University Health System, Richmond, Virginia
| | - Michael R Harowicz
- Department of Radiology, Duke University Hospital, Durham, North Carolina
| | - John D Grizzard
- Department of Radiology, Virginia Commonwealth University Health System, Richmond, Virginia
| | - Wendy Bottinor
- Department of Cardiology, Virginia Commonwealth University Health System, Richmond, Virginia.
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7
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Sabzwari SRA, Tzou WS. Systemic Diseases and Heart Block. Cardiol Clin 2023; 41:429-448. [PMID: 37321693 DOI: 10.1016/j.ccl.2023.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Systemic diseases can cause heart block owing to the involvement of the myocardium and thereby the conduction system. Younger patients (<60) with heart block should be evaluated for an underlying systemic disease. These disorders are classified into infiltrative, rheumatologic, endocrine, and hereditary neuromuscular degenerative diseases. Cardiac amyloidosis owing to amyloid fibrils and cardiac sarcoidosis owing to noncaseating granulomas can infiltrate the conduction system leading to heart block. Accelerated atherosclerosis, vasculitis, myocarditis, and interstitial inflammation contribute to heart block in rheumatologic disorders. Myotonic, Becker, and Duchenne muscular dystrophies are neuromuscular diseases involving the myocardium skeletal muscles and can cause heart block.
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Affiliation(s)
- Syed Rafay A Sabzwari
- University of Colorado Anschutz Medical Campus, 12631 East 17th Avenue, Mail Stop B130, Aurora, CO 80045, USA
| | - Wendy S Tzou
- Cardiac Electrophysiology, University of Colorado Anschutz Medical Campus, 12401 E 17th Avenue, MS B-136, Aurora, CO 80045, USA.
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8
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Kuwauchi S, Hosono M, Uetsuki T, Kawazoe K. A surgical case of infected cardiac myxoma. SAGE Open Med Case Rep 2023; 11:2050313X221144514. [PMID: 37228570 PMCID: PMC10204046 DOI: 10.1177/2050313x221144514] [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: 07/27/2022] [Accepted: 11/22/2022] [Indexed: 05/27/2023] Open
Abstract
A 60-year-old woman presented with a fever of unknown origin. Echocardiography revealed a large left atrial tumor protruding into the left ventricle during diastole. Laboratory investigation showed an elevated white blood cell count, C-reactive protein concentration, and interleukin-6 concentration. Magnetic resonance imaging showed hyperacute microinfarcts and multiple old lacunar infarcts. Surgery was performed under suspicion of cardiac myxoma. A dark red jelly-like tumor with an irregular surface was removed. Histopathological examination revealed cardiac myxoma, the surface of which was covered with fibrin and bacterial masses. Preoperative blood culture was positive for Streptococcus vestibularis. These findings were compatible with a diagnosis of infected cardiac myxoma. We used an antibiotic therapeutic regimen for infective endocarditis, and the patient was discharged home on postoperative day 31. Prompt diagnosis and treatment, including effective and efficient antibiotic therapy and complete tumor resection, increased the chance of a better outcome in patients with infected cardiac myxoma.
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Affiliation(s)
- Shintaro Kuwauchi
- Shintaro Kuwauchi, Department of Cardiovascular
Surgery, Kansai Medical University, 2-5-1 Shinmachi, Hirakata, Osaka 573-1010, Japan.
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9
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Takano Y, Mazaki J, Tasaki K, Udo R, Tago T, Okazaki N, Kasahara K, Kuwabara H, Enomoto M, Isizaki T, Matsubayashi J, Nagao T, Nagakawa Y, Katsumata K, Tsuchida A. A case of premortem diagnosis of cardiac tamponade due to pericardial metastasis of rectal cancer. Oxf Med Case Reports 2023; 2023:omad039. [PMID: 37091690 PMCID: PMC10120427 DOI: 10.1093/omcr/omad039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 01/11/2023] [Accepted: 03/17/2023] [Indexed: 04/25/2023] Open
Abstract
Colorectal cancer rarely develops pericardial metastasis, and it is an extremely rare case that cardiac tamponade due to the metastasis of colorectal cancer during life. Our case is of a 50-year-old woman who underwent laparoscopic lower anterior resection for the rectal cancer with lung metastasis 4 years ago developed cardiac tamponade due to pericardial metastasis of rectal cancer. We performed pericardiocentesis as a temporary life-saving procedure, but pericardial fluid re-accumulated within a few days. She died 23 days after admission. When a patient with advanced colorectal cancer complains dyspnea, we should consider the pericardial metastasis, and perform the proper treatment as this case.
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Affiliation(s)
- Yuki Takano
- Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Shinjuku, Tokyo 1600023, Japan
| | - Junichi Mazaki
- Correspondence address. Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku, Tokyo 1600023, Japan. Tel/Fax: +81-3-3342-6111; E-mail:
| | - Koichiro Tasaki
- Department of Anatomic Pathology, Tokyo Medical University, Shinjuku, Tokyo 1600023, Japan
| | - Ryutaro Udo
- Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Shinjuku, Tokyo 1600023, Japan
| | - Tomoya Tago
- Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Shinjuku, Tokyo 1600023, Japan
| | - Naoto Okazaki
- Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Shinjuku, Tokyo 1600023, Japan
| | - Kenta Kasahara
- Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Shinjuku, Tokyo 1600023, Japan
| | - Hiroshi Kuwabara
- Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Shinjuku, Tokyo 1600023, Japan
| | - Masanobu Enomoto
- Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Shinjuku, Tokyo 1600023, Japan
| | - Tetsuo Isizaki
- Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Shinjuku, Tokyo 1600023, Japan
| | - Jun Matsubayashi
- Department of Anatomic Pathology, Tokyo Medical University, Shinjuku, Tokyo 1600023, Japan
| | - Toshitaka Nagao
- Department of Anatomic Pathology, Tokyo Medical University, Shinjuku, Tokyo 1600023, Japan
| | - Yuichi Nagakawa
- Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Shinjuku, Tokyo 1600023, Japan
| | - Kenji Katsumata
- Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Shinjuku, Tokyo 1600023, Japan
| | - Akihiko Tsuchida
- Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Shinjuku, Tokyo 1600023, Japan
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10
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Barua A, Warwick R. Interventricular septal mass with coronary artery disease-An unusual presentation in a septuagenarian patient. J Card Surg 2022; 37:5477-5479. [PMID: 36183372 DOI: 10.1111/jocs.16923] [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: 06/22/2022] [Revised: 08/04/2022] [Accepted: 08/29/2022] [Indexed: 01/06/2023]
Abstract
A 79-year-old male with a history of syncope attack was found to have a mass in the interventricular septum. The tumor was surgically removed, and the histological diagnosis was ectopic thyroid tissue. The outcome of the surgery was expected to be successful, however, the patient died from multiorgan failure.
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Affiliation(s)
- Anupama Barua
- Department of Cardiothoracic Surgery, University Hospitals North Midlands NHS Trust, Stoke-on-Trent, North Midlands, UK
| | - Richard Warwick
- Department of Cardiothoracic Surgery, University Hospitals North Midlands NHS Trust, Stoke-on-Trent, North Midlands, UK
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11
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Calabretta R, Hacker M. A PET-derived tumor expansion pattern to differentiate between primary cardiac lymphoma from primary cardiac sarcoma. J Nucl Cardiol 2022; 29:2878-2880. [PMID: 36417119 DOI: 10.1007/s12350-022-03097-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 08/17/2022] [Indexed: 11/24/2022]
Affiliation(s)
- Raffaella Calabretta
- Division of Nuclear Medicine, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Marcus Hacker
- Division of Nuclear Medicine, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
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12
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Babu RS, Lanjewar A, Jadhav U, Wagh P, Aurangabadkar G, Upadhyay P. A case series of malignant pericardial effusion. J Family Med Prim Care 2022; 11:6581-6585. [PMID: 36618249 PMCID: PMC9810958 DOI: 10.4103/jfmpc.jfmpc_263_22] [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: 02/01/2022] [Revised: 04/07/2022] [Accepted: 04/14/2022] [Indexed: 11/11/2022] Open
Abstract
The most common primary malignancies that affect the pericardium are lung cancers. Typically, pericardial involvement stays undiagnosed, with almost 1-20% of all tumor-related autopsies revealing invasion of the pericardium. Pericardial effusions are seldom the first location of metastasis and presentation of a primary malignancy. Malignant pericardial effusions are usually silent, although they cause dyspnea, chest discomfort, arrhythmias, cough, and, in rare cases, pericardial tamponade. In a patient with tamponade, a high index of tumor-related suspicion is crucial to rule out cancer. Emergency pericardiocentesis is indicated based on the clinical presentation, however, the patient frequently has a bad prognosis regardless of whether treatment is administered or not. In this case series, we report five cases of non-small cell lung cancer (NSCLC) with pericardial effusion as an initial presentation.
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Affiliation(s)
- Reshma S. Babu
- Department of Respiratory Medicine, Jawaharlal Nehru Medical College, Sawangi (Meghe), Wardha, Maharashtra, India
| | - Ajay Lanjewar
- Department of Respiratory Medicine, Jawaharlal Nehru Medical College, Sawangi (Meghe), Wardha, Maharashtra, India,Address for correspondence: Dr. Ajay Lanjewar, Department of Respiratory Medicine, JNMC, Sawangi (Meghe), Wardha - 442 001, Maharashtra, India. E-mail:
| | - Ulhas Jadhav
- Department of Respiratory Medicine, Jawaharlal Nehru Medical College, Sawangi (Meghe), Wardha, Maharashtra, India
| | - Pankaj Wagh
- Department of Respiratory Medicine, Jawaharlal Nehru Medical College, Sawangi (Meghe), Wardha, Maharashtra, India
| | - Gaurang Aurangabadkar
- Department of Respiratory Medicine, Jawaharlal Nehru Medical College, Sawangi (Meghe), Wardha, Maharashtra, India
| | - Puja Upadhyay
- Department of Respiratory Medicine, Jawaharlal Nehru Medical College, Sawangi (Meghe), Wardha, Maharashtra, India
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13
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Multiple cardiac metastases from urothelial carcinoma case report. Egypt Heart J 2022; 74:28. [PMID: 35416567 PMCID: PMC9008108 DOI: 10.1186/s43044-022-00264-y] [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: 02/01/2022] [Accepted: 04/05/2022] [Indexed: 11/21/2022] Open
Abstract
Background Cardiac metastases are rare and frequently remain undiagnosed due to the absence of clinical signs in the majority of cases. Malignancies found to most commonly metastasise to the heart include lung carcinoma, breast carcinoma and lymphoma, while urothelial carcinoma is a rare cause of cardiac metastasis. The patient presented with pyrexia, a rare presentation of metastatic cardiac involvement. Single metastatic lesions are mainly reported in the literature, while multiple metastatic deposits such as in this case are less common. Case presentation A 74-year-old gentleman presented with frequent febrile spikes, a month after undergoing a nephroureterectomy for poorly differentiated urothelial carcinoma. No febrile source was identified, and a computed tomography identified two cardiac lesions. A transthoracic echocardiogram could not detect the cardiac lesions; therefore, cardiac magnetic resonance (CMR) imaging was performed. Three spherical intramyocardial masses were noted at the basal septum, LV apex and the anteromedial papillary muscle. The lesions demonstrated signal characteristics suggestive of cardiac metastases (high fluid content, absence of fat, presence of a surrounding rim of increased extravascular space, absence of deformation within the masses) from the previously resected urothelial carcinoma. The patient was palliated, and he shortly succumbed to his condition. Conclusions Urothelial carcinoma is an exceedingly rare cause of cardiac metastasis. CMR is an important imaging modality for localisation and characterisation of suspicious cardiac lesions, aiding in the diagnosis of cardiac metastasis.
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14
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Chin BW, King KA, George NK, Neeki MM, Mistry JT. A Rare Cause of Chest Pain Identified on Point-of-care Echocardiography: A Case Report. Clin Pract Cases Emerg Med 2022; 6:1-4. [PMID: 35701360 PMCID: PMC9197749 DOI: 10.5811/cpcem.2021.9.53553] [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: 06/07/2021] [Accepted: 09/19/2021] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION Cardiac masses are a rare cause of chest pain. They can often be missed on a chest radiograph performed to evaluate non-specific chest pain and are not readily evaluated with traditional laboratory testing. However, these masses can be visualized with point-of-care ultrasound. CASE REPORT We present a case of a 19-year-old female presenting with intermittent chest pain, palpitations, and weakness present for two months. The patient had previously been evaluated at our emergency department one week earlier and was diagnosed with anxiety before being discharged. Besides a tachycardic and labile heart rate, physical examination and laboratory testing were unremarkable. Point-of-care cardiac echocardiography subsequently demonstrated findings concerning for a cardiac mass. CONCLUSION Cardiac masses are a rare cause of chest pain and palpitations that are easily missed. The advent of point-of-care ultrasonography has afforded us the ability to rapidly assess for structural and functional cardiac abnormalities at bedside, and incorporation of this tool into the evaluation of patients with chest pain offers the ability to detect these rare pathologies.
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Affiliation(s)
- Brian W. Chin
- Arrowhead Regional Medical Center, Department of Emergency Medicine, Colton, California
| | - Kassandra A. King
- Arrowhead Regional Medical Center, Department of Medicine, Colton, California
| | - Nicholas K. George
- Arrowhead Regional Medical Center, Department of Emergency Medicine, Colton, California
| | - Michael M. Neeki
- Arrowhead Regional Medical Center, Department of Emergency Medicine, Colton, California
| | - Jamshid T. Mistry
- Arrowhead Regional Medical Center, Department of Emergency Medicine, Colton, California,Riverside Community Hospital, Department of Critical Care, Riverside, California
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15
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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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16
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Peng X, Xiao Y, Guo Y, Zhu Z, Liao L, Liao X, Hu X, Fang Z, Li X, Zhou S. Clinical Significance of Angiographically Detectable Neovascularity in Patients with Cardiac Myxoma. CARDIOVASCULAR INNOVATIONS AND APPLICATIONS 2021. [DOI: 10.15212/cvia.2021.0025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background: Myxomas are the most common primary cardiac tumors. Angiographically detectable neovascularity (ADN) of myxoma is increasingly being reported as a result of the use of coronary angiography (CAG) to detect coronary artery disease. However, the clinical significance
of these findings is not fully understood.Methods: We enrolled 59 patients with cardiac myxoma who also underwent CAG between January 2013 and October 2018. Patients were followed up for a mean of 28.9 months (range 1‐69 months). The clinical features, echocardiography measurements,
pathological examination findings, CAG results, and outcomes during follow-up were compared between patients with ADN and patients without ADN.Results: ADN was found in 25 patients (42.4%). The arteries feeding the ADN included the right coronary artery (n=15), the left circumflex
coronary artery (n=7), and both arteries (n=3). The patients with ADN had a higher proportion of eosinophils (3.2% vs. 2.2%, P=0.03) and higher low-density lipoprotein cholesterol level (2.7 mmol/L vs. 2.2 mmol/L, P=0.02). Myxoma pedicles were more likely to be located in the
interatrial septum in patients with ADN (96% vs. 73.5%, P=0.02). No significant correlation was observed between the groups in clinical manifestations, atrial arrhythmia, myxoma size, cardiac chamber size, left ventricular ejection fraction, and the prevalence of complication with coronary
artery disease [16% in the ADN group (n=4) vs. 20.6% in the non-ADN group (n=7), P=0.66]. However, patients with ADN tended to have a lower incidence of major adverse cardiac and cerebrovascular events on long-term follow-up (0% vs. 14.7%, P=0.07).Conclusion: CAG-detected
ADN in patients with cardiac myxoma is associated with a borderline lower rate of major adverse cardiac and cerebrovascular events.
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Affiliation(s)
- Xiaofan Peng
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yichao Xiao
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yanan Guo
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Zhaowei Zhu
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Liyan Liao
- Department of Pathology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xiaobo Liao
- Department of Cardiovascular and Thoracic Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xinqun Hu
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Zhenfei Fang
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xuping Li
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Shenghua Zhou
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
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17
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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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18
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Abstract
Systemic diseases can cause heart block owing to the involvement of the myocardium and thereby the conduction system. Younger patients (<60) with heart block should be evaluated for an underlying systemic disease. These disorders are classified into infiltrative, rheumatologic, endocrine, and hereditary neuromuscular degenerative diseases. Cardiac amyloidosis owing to amyloid fibrils and cardiac sarcoidosis owing to noncaseating granulomas can infiltrate the conduction system leading to heart block. Accelerated atherosclerosis, vasculitis, myocarditis, and interstitial inflammation contribute to heart block in rheumatologic disorders. Myotonic, Becker, and Duchenne muscular dystrophies are neuromuscular diseases involving the myocardium skeletal muscles and can cause heart block.
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19
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Rahman AU, Folaranmi O, Chan V, Chaudary A. Anaplastic Lymphoma Kinase-Positive Primary Lung Adenocarcinoma Presenting With Pericardial Effusion and Tamponade in a COVID-19 Patient: A Case Report. Cureus 2021; 13:e19127. [PMID: 34868767 PMCID: PMC8627680 DOI: 10.7759/cureus.19127] [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: 10/29/2021] [Indexed: 11/23/2022] Open
Abstract
Primary lung cancer usually presents in older adults with a smoking history. However, there is an estimated incidence of 15-20% among men who have never smoked. The diagnosis of lung malignancy can often be incidental. Moreover, cardiac tamponade can be an initial presentation of malignancy, especially lung cancer, as these are the most common tumors that involve the pericardium. Here, we present a 54-year-old male with no known medical history presented with dyspnea on exertion. He was found to have a large pericardial effusion with tamponade physiology on a bedside echocardiogram. He was also found to have bilateral deep vein thrombosis and pulmonary embolism on admission. The patient underwent an emergent pericardiocentesis due to hemodynamic compromise, and pericardial fluid cytology suggested adenocarcinoma with lung primary. Subsequently, gene testing revealed anaplastic lymphoma kinase-positive adenocarcinoma of the lung. The patient was discharged home with close oncology follow-up. It is imperative to recognize malignant pericardial effusion as one of the causes of dyspnea. Emergent pericardiocentesis may be needed in case of hemodynamic compromise and tenuous clinical status.
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Affiliation(s)
| | | | - Vernon Chan
- Internal Medicine, WellSpan York Hospital, York, USA
| | - Amna Chaudary
- Internal Medicine, WellSpan York Hospital, York, USA
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20
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Griborio-Guzman AG, Aseyev OI, Shah H, Sadreddini M. Cardiac myxomas: clinical presentation, diagnosis and management. Heart 2021; 108:827-833. [PMID: 34493547 DOI: 10.1136/heartjnl-2021-319479] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 08/24/2021] [Indexed: 11/04/2022] Open
Abstract
Cardiac myxomas (CM) are the most common type of primary cardiac tumours in adults, which have an approximate incidence of up to 0.2% in some autopsy series. The purpose of this review is to summarise the literature on CM, including clinical presentation, differential diagnosis, work-up including imaging modalities and histopathology, management, and prognosis. CM are benign neoplasms developed from multipotent mesenchyme and usually present as an undifferentiated atrial mass. They are typically pedunculated and attached at the fossa ovalis, on the left side of the atrial septum. Potentially life-threatening, the presence of CM calls for prompt diagnosis and surgical resection. Infrequently asymptomatic, patients with CM exhibit various manifestations, ranging from influenza-like symptoms, heart failure and stroke, to sudden death. Although non-specific, a classic triad for CM involves constitutional, embolic, and obstructive or cardiac symptoms. CM may be purposefully characterised or incidentally diagnosed on an echocardiogram, CT scan or cardiac MRI, all of which can help to differentiate CM from other differentials. Echocardiogram is the first-line imaging technique; however, it is fallible, potentially resulting in uncommonly situated CM being overlooked. The diagnosis of CM can often be established based on clinical, imaging and histopathology features. Definitive diagnosis requires macroscopic and histopathological assessment, including positivity for endothelial cell markers such as CD31 and CD34. Their prognosis is excellent when treated with prompt surgical resection, with postsurgical survival rates analogous to overall survival in the age-matched general population.
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Affiliation(s)
- Andres G Griborio-Guzman
- Division of Cardiology, Department of Internal Medicine, Thunder Bay Regional Health Sciences Centre, Thunder Bay, Ontario, Canada .,Department of Internal Medicine, Northern Ontario School of Medicine, Thunder Bay, Ontario, Canada
| | - Olexiy I Aseyev
- Department of Medical Oncology, Thunder Bay Regional Health Sciences Centre, Thunder Bay, Ontario, Canada.,Department of Oncology, Northern Ontario School of Medicine, Thunder Bay, Ontario, Canada
| | - Hyder Shah
- Division of Neurology, Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Masoud Sadreddini
- Division of Cardiology, Department of Internal Medicine, Thunder Bay Regional Health Sciences Centre, Thunder Bay, Ontario, Canada.,Department of Internal Medicine, Northern Ontario School of Medicine, Thunder Bay, Ontario, Canada
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21
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Jabri A, Deutch Z, Butt M, Soltero-Mariscal E, Finkelhor R, Aneja A, Karim S. A diagnostic dilemma upon discovery of a left atrial mass using an intracardiac echocardiogram. HeartRhythm Case Rep 2021; 7:507-509. [PMID: 34434696 PMCID: PMC8377274 DOI: 10.1016/j.hrcr.2021.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
- Ahmad Jabri
- Heart and Vascular Institute, MetroHealth Medical Center/Case Western Reserve University, Cleveland, Ohio
| | - Zachary Deutch
- Heart and Vascular Institute, MetroHealth Medical Center/Case Western Reserve University, Cleveland, Ohio
| | - Muhammad Butt
- Heart and Vascular Institute, MetroHealth Medical Center/Case Western Reserve University, Cleveland, Ohio
| | - Enrique Soltero-Mariscal
- Heart and Vascular Institute, MetroHealth Medical Center/Case Western Reserve University, Cleveland, Ohio
| | - Robert Finkelhor
- Heart and Vascular Institute, MetroHealth Medical Center/Case Western Reserve University, Cleveland, Ohio
| | - Ashish Aneja
- Heart and Vascular Institute, MetroHealth Medical Center/Case Western Reserve University, Cleveland, Ohio
| | - Saima Karim
- Heart and Vascular Institute, MetroHealth Medical Center/Case Western Reserve University, Cleveland, Ohio
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22
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Matteucci M, Ferrarese S, Mantovani V, Ronco D, Torchio F, Franzosi C, Marazzato J, De Ponti R, Lorusso R, Beghi C. Surgical treatment of primary cardiac tumors in the contemporary era: A single-centre analysis. J Card Surg 2021; 36:3540-3546. [PMID: 34254361 PMCID: PMC8518736 DOI: 10.1111/jocs.15813] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 06/16/2021] [Accepted: 07/05/2021] [Indexed: 12/18/2022]
Abstract
Background Primary cardiac tumors (PCT) are rare lesions but have the potential to cause significant morbidity if not timely treated. We reviewed our single‐center experience in the surgical treatment of PCT with a focus on the long‐term outcome. Methods From 2001 to 2020, 57 consecutive patients underwent surgical resection of PCT at our Institution. Data including the demographic characteristics, tumor histology, surgical procedure, and postoperative outcomes were collected and analyzed. Results Mean age at presentation was 63.6 ± 11.2 years, and 33 (57.9%) of the patients were female. A total of 55 (96.5%) subjects were diagnosed with benign cardiac tumor, while the remaining had malignant tumors. The most common histopathological type was myxoma. All patients survived to hospital discharge. Main postoperative complications were: acute kidney injury (n = 3), sepsis (n = 3), and stroke (n = 2). Mean follow‐up time was 9 ± 5.9 years. Long‐term mortality was 22.8% (13/57). No tumor recurrence was observed among survivors. There was a significant relationship between mortality and pathological characteristics of the tumor, and myxomas had higher survival rates. Conclusion Surgical treatment of PCT is a safe and highly effective strategy associated with excellent short‐term outcomes. Long‐term survival remains poor for primary malignant tumors of the heart.
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Affiliation(s)
- Matteo Matteucci
- Department of Surgical and Morphological Sciences, Circolo Hospital, University of Insubria, Varese, Italy.,Department of Cardiothoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Sandro Ferrarese
- Department of Surgical and Morphological Sciences, Circolo Hospital, University of Insubria, Varese, Italy
| | - Vittorio Mantovani
- Department of Surgical and Morphological Sciences, Circolo Hospital, University of Insubria, Varese, Italy
| | - Daniele Ronco
- Department of Surgical and Morphological Sciences, Circolo Hospital, University of Insubria, Varese, Italy
| | - Federica Torchio
- Department of Surgical and Morphological Sciences, Circolo Hospital, University of Insubria, Varese, Italy
| | - Cinzia Franzosi
- Department of Medicine and Surgery, Circolo Hospital, University of Insubria, Varese, Italy
| | - Jacopo Marazzato
- Department of Medicine and Surgery, Circolo Hospital, University of Insubria, Varese, Italy
| | - Roberto De Ponti
- Department of Medicine and Surgery, Circolo Hospital, University of Insubria, Varese, Italy
| | - Roberto Lorusso
- Department of Cardiothoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Cesare Beghi
- Department of Surgical and Morphological Sciences, Circolo Hospital, University of Insubria, Varese, Italy
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23
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Sawada H, Toyota K, Hakoda K, Kajiwara R, Hotta R, Inoue M, Ohmori I, Miyamoto K, Sadamoto S, Takahashi T. A Case of Stage II Ascending Colon Cancer with Cardiac Tamponade Due to Pericardial Metastasis. AMERICAN JOURNAL OF CASE REPORTS 2021; 22:e932239. [PMID: 34092783 PMCID: PMC8197445 DOI: 10.12659/ajcr.932239] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Patient: Female, 63-year-old Final Diagnosis: Cardiac metastasis Symptoms: Dyspnea Medication:— Clinical Procedure: Surgery Specialty: Oncology
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Affiliation(s)
- Hiroyuki Sawada
- Department of Surgery, National Hospital Organization Higashihiroshima Medical Center, Hiroshima, Japan
| | - Kazuhiro Toyota
- Department of Surgery, National Hospital Organization Higashihiroshima Medical Center, Hiroshima, Japan
| | - Keishi Hakoda
- Department of Surgery, National Hospital Organization Higashihiroshima Medical Center, Hiroshima, Japan
| | - Ryotaro Kajiwara
- Department of Surgery, National Hospital Organization Higashihiroshima Medical Center, Hiroshima, Japan
| | - Ryuichi Hotta
- Department of Surgery, National Hospital Organization Higashihiroshima Medical Center, Hiroshima, Japan
| | - Masashi Inoue
- Department of Surgery, National Hospital Organization Higashihiroshima Medical Center, Hiroshima, Japan
| | - Ichiro Ohmori
- Department of Surgery, National Hospital Organization Higashihiroshima Medical Center, Hiroshima, Japan
| | - Kazuaki Miyamoto
- Department of Surgery, National Hospital Organization, Higashihiroshima Medical Center, Hiroshima, Japan
| | - Seiji Sadamoto
- Department of Surgery, National Hospital Organization Higashihiroshima Medical Center, Hiroshima, Japan
| | - Tadateru Takahashi
- Department of Surgery, National Hospital Organization Higashihiroshima Medical Center, Hiroshima, Japan.,Department of Gastrointestinal and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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24
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Vemireddy LP, Jain N, Aqeel A, Jeelani HM, Shayuk M. Lung Adenocarcinoma Presenting as Malignant Pericardial Effusion/Tamponade. Cureus 2021; 13:e13762. [PMID: 33842138 PMCID: PMC8025797 DOI: 10.7759/cureus.13762] [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] [Indexed: 01/18/2023] Open
Abstract
Lung cancers are the most common primary tumors that involve the pericardium with a prevalence of up to 50%. Usually, pericardial involvement goes undetected with almost 10%-12% found among all cancer related autopsies. Rarely pericardial effusions can be the initial site of metastasis and initial manifestation of a primary tumor. In our case, we report a 57-year-old female presenting with cardiac tamponade and subsequent testing was done which revealed lung adenocarcinoma. Malignant pericardial effusions are often silent, but certain times can present with symptoms of shortness of breath, chest pain, cough, arrhythmias, and rarely as pericardial tamponade. A high index of suspicion is required when a patient presents with tamponade to diagnose malignancy. Emergent pericardiocentesis may be warranted depending on the clinical presentation but quite often, patients tend to have a poor prognosis despite therapy given the extent of disease.
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Affiliation(s)
- Lalitha Padmanabha Vemireddy
- Internal Medicine, Chicago Medical School Internal Medicine Residency Program at Northwestern McHenry Hospital, McHenry, USA
| | - Nikita Jain
- Internal Medicine, Chicago Medical School Internal Medicine Residency Program at Northwestern McHenry Hospital, McHenry, USA
| | - Ammar Aqeel
- Internal Medicine, Chicago Medical School Internal Medicine Residency Program at Northwestern McHenry Hospital, McHenry, USA
| | - Hafiz Muhammad Jeelani
- Internal Medicine, Chicago Medical School Internal Medicine Residency Program at Northwestern McHenry Hospital, McHenry, USA
| | - Maryna Shayuk
- Internal Medicine, Chicago Medical School Internal Medicine Residency Program at Northwestern McHenry Hospital, McHenry, USA
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25
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Prol T, Petro J, Jain H, Raja S, Rachofsky E, Koulogiannis KP, Horgan S. Primary Cardiac Sarcoma Involving the Mitral Valve, an Insidious Form of Heart Failure. CASE 2021; 5:56-61. [PMID: 33644515 PMCID: PMC7887519 DOI: 10.1016/j.case.2020.10.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Multimodality cardiac imaging can assess cardiac sarcomas and guide biopsy. Cardiac MRI differentiates cardiac tumors from thrombus and identifies thrombus tumor. Cardiac sarcoma treatment includes surgical and adjuvant options. Survival rates of cardiac sarcoma are based on tumor location within the heart.
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26
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Chía-Vázquez NG, Fuentes-Ramos G, Patiño-Bahena EJ, Guillén-González A, Buendía-Hernández A. [Importance of heart rabdomioma in pediatric population. A 39 year experience. Case series]. ARCHIVOS DE CARDIOLOGIA DE MEXICO 2020; 91:84-92. [PMID: 33328688 PMCID: PMC8258899 DOI: 10.24875/acm.19000381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 11/05/2020] [Indexed: 11/17/2022] Open
Abstract
Introducción: Los rabdomiomas son los tumores cardiacos benignos más prevalentes en la etapa fetal y durante la infancia. Objetivo: Nuestro objetivo es dar a conocer nuestra experiencia durante 39 años en pacientes pediátricos con rabdomioma en nuestra institución, así como enfatizar la importancia de su detección, estudio y control por la asociación que tiene con esclerosis tuberosa (ET). Material y métodos: Realizamos un estudio retrospectivo y descriptivo, de enero de 1980 a marzo del 2018. Veinticuatro cumplieron con nuestros criterios, recogimos información respecto a la clínica y estudios de gabinete, así como su evolución y el tratamiento dado. Se les llamó vía telefónica para conocer su evolución y estado actual. Resultados: Encontramos 51 pacientes con diagnóstico de tumor cardiaco, de los cuales 24 eran rabdomiomas. El diagnóstico se hizo prenatal en 8 pacientes, 5 al nacimiento y en 11 durante el primer año de vida. Las manifestaciones clínicas más frecuentes fueron la presencia de soplo, arritmias, cianosis, disnea y diaforesis. En 17 de ellos se hizo diagnóstico de ET. La mitad tuvo seguimiento por neurología, 10 por dermatología, 8 por oftalmología y 4 con genética. La mitad se dejó en vigilancia, a 7 se les dio tratamiento médico y 5 requirieron cirugía. En cuanto a la evolución, 17 pacientes se mantuvieron estables, 5 presentaron regresión espontánea y 2 fallecieron. Conclusiones: El rabdomioma es un tumor benigno poco frecuente, su evolución puede ser maligna y asociado a ET ensombrece el pronóstico.
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Affiliation(s)
- Nadia G. Chía-Vázquez
- Departamento de Cardiología Pediátrica, Insituto Nacional de Cardiología Ignacio Chávez
| | | | | | - Atziri Guillén-González
- Departamento de Imagen, Instituto Nacional de Cardiología Ignacio Chávez. Ciudad de México, México
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27
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Alotaibi MS, Shah SH, Khan MS, Almalki ST, Alfaifi SA. Low Grade Primary Leiomyosarcoma of the Right Atrium: Promising Survival with Complete Surgical Resection. J Saudi Heart Assoc 2020; 32:476-478. [PMID: 33537195 PMCID: PMC7849844 DOI: 10.37616/2212-5043.1149] [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: 07/07/2020] [Revised: 11/01/2020] [Accepted: 11/02/2020] [Indexed: 11/20/2022] Open
Abstract
Primary cardiac leiomyosarcoma has an extremely low incidence with overall median survival of approximately 6 months. Here, We report the case of a 60-year-old man who underwent complete surgical excision of right atrial mass. Histologic examination revealed leiomyosarcoma. The patient made a full recovery with no evidence of recurrence at 24 months. To the best of our knowledge, this is the first reported case or primary cardiac leiomyosarcoma in the Middle East.
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Affiliation(s)
- Meshaal Saud Alotaibi
- Cardiac Surgery Department, King Salman Heart Center, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Shabir Hussain Shah
- Cardiac Surgery Department, King Salman Heart Center, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Mohammad Shahbaaz Khan
- Cardiac Surgery Department, King Salman Heart Center, King Fahad Medical City, Riyadh, Saudi Arabia
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28
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Hosain N, Quaium Chowdhury MA, Maruf MF, Chowdhury MR, Barua S, Rahman M. Surgical Treatment of Atrial Myxomas: Outstanding Outcome of a Treacherous Tumor. CJC Open 2020; 3:354-360. [PMID: 33778452 PMCID: PMC7985015 DOI: 10.1016/j.cjco.2020.10.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 10/30/2020] [Indexed: 01/08/2023] Open
Abstract
Background Primary cardiac tumors are quite rare and mostly benign in nature. Most of the benign heart tumors are myxomas. These might present with a wide range of symptoms from being completely asymptomatic to having life-threatening complications like stroke, heart failure, or even sudden death. This study summarizes our 6-year clinical experience with surgical resection of cardiac tumors at Chittagong Medical College and Hospital, Chattogram, Bangladesh. Methods Twenty patients who underwent surgical excision of primary intracardiac myxoma between February 2014 and February 2020 were included in the study. Seventeen (85%) of them were female and 3 (15%) were male. Mean age was 43.4 ± 14.1 years. The tumors were located in the left atrium in 19 patients and in 1 patient it was in the right atrium. The most common attachment site was the interatrial septum. Most of the patients presented with dyspnea. Preoperative diagnosis was established using transthoracic echocardiography with colour Doppler. Surgery for all patients was via median sternotomy. Results All 20 patients survived the surgery. Mean tumor dimension was 4.6 ± 3.5 cm in the longest diameter. Solid tumors were detected in 13 patients (65%) whereas papillary myxomas were found in 7 patients (35%). On follow-up of these 20 patients, there was no perioperative death. One patient presented with recurrence 28 months after the surgery. Conclusions Although cardiac myxomas carry the risk of serious systemic and cardiac symptoms, prompt surgical excision gives excellent outcome.
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Affiliation(s)
- Nazmul Hosain
- Department of Cardiac Surgery, Chittagong Medical College and Hospital, Chattogram, Bangladesh
| | | | - Mohammad Fazle Maruf
- Department of Cardiac Surgery, Chittagong Medical College and Hospital, Chattogram, Bangladesh
| | | | - Subir Barua
- Department of Cardiac Surgery, Chittagong Medical College and Hospital, Chattogram, Bangladesh
| | - Mamunur Rahman
- Department of Anesthesia, Marine City Medical College and Hospital, Chattogram, Bangladesh
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Ghodasara SA, Balasubramanian R, Varadharajan S, Shobhanaa PS. Cardiac phoenix in the brain-occult intracranial hemorrhagic metastases from completely resected atrial myxoma. Surg Neurol Int 2020; 11:383. [PMID: 33408917 PMCID: PMC7771508 DOI: 10.25259/sni_410_2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 10/22/2020] [Indexed: 11/14/2022] Open
Abstract
Background: Cardiac myxomas are sporadic in nature and can often recur with a frequency of 3%, especially in middle-aged women, and 22% of the cases account to a part of Carney complex. Complete surgical removal of the myxoma is usually curative. Recurrence has been related with partial surgical excision, multicentricity, and embolism of tumor fragments. Case Description: We report a case of a patient with single brain metastases due to tumor embolization, from a cardiac myxoma operated prior. This case is exclusive, as tumor embolization from atrial myxoma to the cerebral cortex can be possible, within a short duration. In our case, the patient was evaluated with a magnetic resonance imaging brain and a solitary hemorrhagic lesion in the eloquent cerebral cortex was observed. To determine the primary etiology, the diagnosis of probable metastases was thought of, and a thorough workup was planned. Surprisingly, no primary lesion was detected, and as a histological diagnosis was required, he underwent a navigation-guided excisional biopsy of lesion. The biopsy was indicative of a metastatic deposit from an atrial myxoma. Conclusion: In eloquent cortex lesions, gross total resection is challenging for a neurosurgeon especially when the patient has no significant neurological deficits. Timely gross total resection of a solitary metastatic lesion can improve the patient’s outcome and can enhance early recovery with less or no morbidity.
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Affiliation(s)
| | - Rohit Balasubramanian
- Department of Neurosurgery, Kovai Medical Center and Hospitals, Coimbatore, Tamil Nadu, India
| | - Shriram Varadharajan
- Department of Neuro-Imaging and Stroke Interventions, Kovai Medical Center and Hospitals, Coimbatore, Tamil Nadu, India
| | - P. S. Shobhanaa
- Department of Neuropathology, Kovai Medical Center and Hospitals, Coimbatore, Tamil Nadu, India
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Joshi M, Kumar S, Noshirwani A, Harky A. The Current Management of Cardiac Tumours: a Comprehensive Literature Review. Braz J Cardiovasc Surg 2020; 35:770-780. [PMID: 33118743 PMCID: PMC7598975 DOI: 10.21470/1678-9741-2019-0199] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVE To understand the current evidence and guidelines behind the appropriate management of cardiac tumours. METHODS A comprehensive electronic literature search has been performed in major databases - PubMed, Embase, Scopus, Ovid, and Google Scholar. All articles that discussed all different forms of cardiac tumours, their clinical presentation, diagnosis, and management methods have been critically appraised in this narrative review. RESULTS All relevant studies have been summarized in appropriate sections within our review. Cardiac tumours are rare but can be catastrophic and life-threatening if not identified and managed on timely manner. Utilization of all the available imaging methods can be of equivocal importance, relevant to each cardiac tumour. Surgical excision is the ultimate treatment method, however histopathological results can guide the adjunct treatment. CONCLUSION Early detection of cardiac tumours has significant effect on planning the method of intervention. Technological advancements and increased availability of imaging modalities have enabled earlier and more accurate detection of these tumours. Novel medical therapies, recommendations for screening, and operative techniques have all contributed to overall improving knowledge of these tumours and ultimately patient outcomes.
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Affiliation(s)
- Mihika Joshi
- Countess of Chester Hospital Chester United Kingdom Countess of Chester Hospital, Chester, United Kingdom
| | - Siddhant Kumar
- Aintree University Hospital Liverpool United Kingdom Aintree University Hospital, Liverpool, United Kingdom
| | - Arish Noshirwani
- Countess of Chester Hospital Chester United Kingdom Countess of Chester Hospital, Chester, United Kingdom
| | - Amer Harky
- Liverpool Heart and Chest Hospital Department of Cardiothoracic Surgery Liverpool United Kingdom Department of Cardiothoracic Surgery, Liverpool Heart and Chest Hospital, Liverpool, United Kingdom
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Kunioka S, Fujita K, Iwasa S, Murakami H, Kamiya H, Yamazaki K, Tsukui H. A rare form of cardiac myxoma: interatrial septum tumor. J Surg Case Rep 2020; 2020:rjaa333. [PMID: 32968478 PMCID: PMC7497063 DOI: 10.1093/jscr/rjaa333] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 07/28/2020] [Indexed: 01/14/2023] Open
Abstract
A myxoma is one of the most common tumors in cardiac surgery, with most of them originating from the left or right atrial walls and causing embolic complications. An 84-year-old woman was referred to our institution after echocardiography showed an interatrial septum tumor that was presumed to be a thrombus; however, postoperative pathological examination revealed it to be a cardiac myxoma. This atypical myxoma was covered with a solid capsule containing connective tissue and substantial calcifications, which had made it difficult to establish a diagnosis of myxoma.
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Affiliation(s)
- Shingo Kunioka
- Department of Cardiac Surgery, Asahikawa Medical University, Hokkaido, Japan
| | - Kishu Fujita
- Department of Cardiovascular Surgery, Hokkaido Cardiovascular Hospital, Hokkaido, Japan
| | - Shizuko Iwasa
- Department of Cardiovascular Surgery, Hokkaido Cardiovascular Hospital, Hokkaido, Japan
| | - Hironori Murakami
- Department of Cardiology, Hokkaido Cardiovascular Hospital, Hokkaido, Japan
| | - Hiroyuki Kamiya
- Department of Cardiology, Hokkaido Cardiovascular Hospital, Hokkaido, Japan
| | - Kenji Yamazaki
- Department of Cardiovascular Surgery, Hokkaido Cardiovascular Hospital, Hokkaido, Japan
| | - Hiroyuki Tsukui
- Department of Cardiothoracic Surgery, Excela Health Westmoreland Hospital, Greensburg, PA, USA
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Raza M, Ikram S, Williams N, Otero D, Barry N, Kelsey N, Kahlon T, Singh V. Cardiac Lymphoma Presenting with Recurrent STEMI. Methodist Debakey Cardiovasc J 2020; 16:158-161. [PMID: 32670477 DOI: 10.14797/mdcj-16-2-158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
The incidence of primary cardiac tumors is exceedingly rare, whereas secondary cardiac tumors are more common in the global population. Cardiac involvement is seen in approximately 18% of patients with non-Hodgkin's lymphoma at the time of autopsy. Clinical manifestations of cardiac involvement are subtle and often go unrecognized until advanced stages of the disease. We present a rare case of metastatic cardiac lymphoma that presented as an ST-segment elevation myocardial infarction complicated by left ventricular free wall rupture and cardiogenic shock due to transmural myocardial necrosis from malignant cell infiltration.
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Affiliation(s)
- Munis Raza
- UNIVERSITY OF LOUISVILLE, LOUISVILLE, KENTUCKY
| | | | | | - Diana Otero
- UNIVERSITY OF LOUISVILLE, LOUISVILLE, KENTUCKY
| | - Neil Barry
- UNIVERSITY OF LOUISVILLE, LOUISVILLE, KENTUCKY
| | | | | | - Vikas Singh
- UNIVERSITY OF LOUISVILLE, LOUISVILLE, KENTUCKY
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Di Bari N, Vitale N, Marzullo A, Loizzo T, Marraudino N, Lionetti G, Milano AD. Deceptive appearance of a rapidly growing left atrial myxoid sarcoma with pancreatic metastasis. J Card Surg 2020; 35:3176-3178. [PMID: 32743871 DOI: 10.1111/jocs.14920] [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: 10/23/2022]
Abstract
The third case reported in the literature of a left atrial neoplasm characterized by a very deceptive, low grade cellular component at its early stage of growth, so as to be diagnosed as a myxoma is presented. Two months after surgical excision, regrowth of the mass occurred, producing a pancreatic mass also. The new atrial mass was excised; a left atrial myxoid sarcoma and a pancreatic metastasis were diagnosed. One week later the atrial sarcoma grew again. This time surgery was contraindicated and the patient underwent chemotherapy with a satisfactory control of the sarcoma growth. The myxoid sarcoma may present with the deceptive appearance of a myxoma in their early stages. Therefore, patients who have undergone surgical removal of a myxoma should have a close follow-up to monitor unexpected malignant turnover.
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Affiliation(s)
- Nicola Di Bari
- Department of Emergency and Organ Transplant, Division of Cardiac Surgery, Policlinico Hospital, University of Bari, Bari, Italy
| | - Nicola Vitale
- Department of Emergency and Organ Transplant, Division of Cardiac Surgery, Policlinico Hospital, University of Bari, Bari, Italy
| | - Andrea Marzullo
- Department of Emergency and Organ Transplant, Division of Pathology, Policlinico Hospital, University of Bari, Bari, Italy
| | - Tommaso Loizzo
- Department of Emergency and Organ Transplant, Division of Cardiac Surgery, Policlinico Hospital, University of Bari, Bari, Italy
| | - Nicola Marraudino
- Department of Emergency and Organ Transplant, Division of Cardiac Surgery, Policlinico Hospital, University of Bari, Bari, Italy
| | - Giosuè Lionetti
- Department of Emergency and Organ Transplant, Division of Cardiac Surgery, Policlinico Hospital, University of Bari, Bari, Italy
| | - Aldo D Milano
- Department of Emergency and Organ Transplant, Division of Cardiac Surgery, Policlinico Hospital, University of Bari, Bari, Italy
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Liu ET, Sun TT, Dong HJ, Wang SY, Chen ZR, Liu C, Shao D, Lian ZY, Xie Q, Wang SX. Combined PET/CT with thoracic contrast-enhanced CT in assessment of primary cardiac tumors in adult patients. EJNMMI Res 2020; 10:75. [PMID: 32632639 PMCID: PMC7338301 DOI: 10.1186/s13550-020-00661-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 06/23/2020] [Indexed: 12/26/2022] Open
Abstract
Background 18F-FDG PET/CT is a key molecular imaging modality to noninvasively assess and differentiate benign and malignant cardiac tumors. However, few benign cardiac tumors can be characterized by increased 18F-FDG uptake, which makes differential diagnosis difficult. This study sought to retrospectively evaluate whether combined 18F-FDG PET/CT with thoracic contrast-enhanced CT (CECT) helps in assessing primary cardiac tumors in adult patients, compared with CECT or PET/CT alone. Methods Forty-six consecutive patients who were diagnosed as primary cardiac tumors were enrolled. All patients underwent 18F-FDG PET/CT followed by thoracic CECT before biopsy or surgery. Visual qualitative interpretation and quantitative analysis were performed, and diagnostic performance was evaluated. Results More than half (16/29) of benign tumors exhibited with mild 18F-FDG uptake. There were significant differences in 18F-FDG uptake and the degree of absolute enhancement between benign and malignant tumors (P < 0.001). The combination of two modalities improved the specificity from 79 to 93%, the positive predictive value from 73 to 89%, and the accuracy of diagnosis from 85 to 93%. There were significant differences between PET/CT alone or thoracic CECT alone and combined modalities (P = 0.034 and P = 0.026, respectively). The combination with the optimal SUVmax cutoff value generated 94% sensitivity, 100% specificity, 97% negative predictive values, 100% positive predictive values, and 98% accuracy rates. Conclusions Combining 18F-FDG PET/C with thoracic CECT significantly improved specificity and accuracy compared to CECT or PET/CT alone in detecting tumors. This combination of diagnostic imaging is effective in differentiating malignant from benign masses.
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Affiliation(s)
- En-Tao Liu
- WeiLun PET Center, Department of Nuclear Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Room 517, 5/F, Weilun Building of Guangdong Provincial People's Hospital, 106 Zhongshan Er Road, Guangzhou, 510080, Guangdong, People's Republic of China
| | - Tao-Tao Sun
- WeiLun PET Center, Department of Nuclear Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Room 517, 5/F, Weilun Building of Guangdong Provincial People's Hospital, 106 Zhongshan Er Road, Guangzhou, 510080, Guangdong, People's Republic of China
| | - Hao-Jian Dong
- Department of Cardiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Er Road, Guangzhou, 510080, Guangdong, People's Republic of China
| | - Si-Yun Wang
- WeiLun PET Center, Department of Nuclear Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Room 517, 5/F, Weilun Building of Guangdong Provincial People's Hospital, 106 Zhongshan Er Road, Guangzhou, 510080, Guangdong, People's Republic of China
| | - Ze-Rui Chen
- Department of Cardiovascular Surgery, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Er Road, Guangzhou, 510080, Guangdong, People's Republic of China
| | - Chao Liu
- Department of Pathology and Laboratory Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Er Road, Guangzhou, 510080, Guangdong, People's Republic of China
| | - Dan Shao
- WeiLun PET Center, Department of Nuclear Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Room 517, 5/F, Weilun Building of Guangdong Provincial People's Hospital, 106 Zhongshan Er Road, Guangzhou, 510080, Guangdong, People's Republic of China
| | - Zhou-Yang Lian
- Department of Radiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Er Road, Guangzhou, 510080, Guangdong, People's Republic of China
| | - Qiu Xie
- Division of Adult Echocardiography, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Er Road, Guangzhou, 510080, Guangdong, People's Republic of China
| | - Shu-Xia Wang
- WeiLun PET Center, Department of Nuclear Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Room 517, 5/F, Weilun Building of Guangdong Provincial People's Hospital, 106 Zhongshan Er Road, Guangzhou, 510080, Guangdong, People's Republic of China.
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Lau YM, Tse HF. A Woman in Her 50s With Dyspnea, Palpitation, and Severely Elevated Pulmonary Artery Pressure. JAMA Cardiol 2020; 5:842. [DOI: 10.1001/jamacardio.2020.1048] [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: 11/14/2022]
Affiliation(s)
- Yuk Ming Lau
- Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong
| | - Hung Fat Tse
- Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong
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Mendes GS, Abecasis J, Ferreira A, Ribeiras R, Abecasis M, Gouveia R, Andrade MJ, Mendes M, Ramos S, Saraiva C, Neves JP. Cardiac tumors: three decades of experience from a tertiary center: are we changing diagnostic work-up with new imaging tools? Cardiovasc Pathol 2020; 49:107242. [PMID: 32629212 DOI: 10.1016/j.carpath.2020.107242] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 04/05/2020] [Accepted: 05/07/2020] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Primary cardiac tumours are relatively rare. Cardiac myxomas are the most prevalent and in a significant proportion of cases they are accidentally discovered in asymptomatic patients. Noninvasive definitive diagnosis remains challenging despite improvements provided by newer imaging tools. Our aim was to describe the long-term experience of a tertiary cardiac center managing cardiac tumours. METHODS We analyzed 154 consecutive patients admitted to a single-tertiary center with the diagnosis of a cardiac mass or tumor between 1990 and 2018. Data files including clinical presentation, noninvasive investigations, presumptive diagnosis and histopathology were collected. The follow-up was obtained from clinical records or telephone contact. RESULTS In 154 patients with a median age at diagnosis of 61 (51-71) years, 62% were females. Anatomopathology studywas obtained in 144 cases, from which 81% were benign tumours (106 myxomas; 11 papillary fibroelastomas). In comparison with malignant lesions, patients with benign tumours were older (62 versus 48 years) and more often women (65% versus 27%, P = .021). Incidental diagnosis of a benign tumor occurred in 36% of the cases. Transthoracic echocardiography was the initial technique for diagnostic suspicion in the great majority of patients. Both cardiac computed tomography and magnetic resonance were rarely performed before excision. Imaging based (mostly echocardiography) pre-operative presumptive diagnosis was discordant with histopathologic findings in 21% of the benign and in 55% of malignant lesions (previously considered as benign). Uncommon histologic findings were found in 18% of myxomas. During the follow-up period of 11 ± 12 years there were 12 recurrences. CONCLUSION Among surgically excised cardiac tumours benign cardiac tumors are far more common than both primary and secondary malignancies. In this series of patients, there was a significant proportion of asymptomatic lesions. Preoperative misdiagnosis could be related to the scarce use of adjunctive noninvasive imaging tools beyond echocardiography. Preoperative noninvasive investigation should be expanded to improve diagnostic presumption and better plan the best therapeutic approach.
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Affiliation(s)
- Gustavo Sá Mendes
- Cardiology Department, Hospital de Santa Cruz - Centro Hospitalar de LisboaOcidental, Carnaxide, Portugal.
| | - João Abecasis
- Cardiology Department, Hospital de Santa Cruz - Centro Hospitalar de LisboaOcidental, Carnaxide, Portugal; Nova Medical School, Lisboa, Portugal
| | - António Ferreira
- Cardiology Department, Hospital de Santa Cruz - Centro Hospitalar de LisboaOcidental, Carnaxide, Portugal
| | - Regina Ribeiras
- Cardiology Department, Hospital de Santa Cruz - Centro Hospitalar de LisboaOcidental, Carnaxide, Portugal
| | - Miguel Abecasis
- Cardiothoracic Surgery Department, Hospital de Santa Cruz - Centro Hospitalar de LisboaOcidental, Carnaxide, Portugal
| | - Rosa Gouveia
- Pathology Department, Hospital de Santa Cruz - Centro Hospitalar de LisboaOcidental, Carnaxide, Portugal; Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Forensic Pathology, InstitutoNacional de Medicina Legal e CiênciasForenses, Coimbra, Portugal
| | - Maria João Andrade
- Cardiology Department, Hospital de Santa Cruz - Centro Hospitalar de LisboaOcidental, Carnaxide, Portugal
| | - Miguel Mendes
- Cardiology Department, Hospital de Santa Cruz - Centro Hospitalar de LisboaOcidental, Carnaxide, Portugal
| | - Sância Ramos
- Pathology Department, Hospital de Santa Cruz - Centro Hospitalar de LisboaOcidental, Carnaxide, Portugal
| | - Carla Saraiva
- Radiology Department, Centro Hospitalar de LisboaOcidental, Lisboa, Portugal
| | - José Pedro Neves
- Cardiothoracic Surgery Department, Hospital de Santa Cruz - Centro Hospitalar de LisboaOcidental, Carnaxide, Portugal
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Sia CH, Goh FQ, Kong WKF, Wu B, Paranjothy S. Cardiac sarcoma attached to pacemaker lead. J Card Surg 2020; 35:1148-1151. [PMID: 32293046 DOI: 10.1111/jocs.14541] [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: 11/30/2022]
Abstract
BACKGROUND AND AIM Cardiac sarcoma is a rare condition and may mimic atrial myxoma. We present a case report of a man with a cardiac sarcoma. METHOD Case report presentation. RESULTS A 68-year-old man with a permanent pacemaker presented to us with a 4-month history of breathlessness. Echocardiography revealed a large right atrial mass adherent to the pacemaker lead and a provisional diagnosis of atrial myxoma was made based on echocardiographic appearance. A 60 x 30 x 30 mm irregular lobulated tumour was surgically resected from the right atrium. Upon histopathologic examination, the tumour was consistent with an undifferentiated pleomorphic sarcoma. CONCLUSION Cardiac sarcomas have an extremely poor prognosis and more unfortunately this man developed a surgical site infection and died of acute mediastinitis. We discuss the presentation, imaging and current surgical approaches to cardiac sarcoma. Curative treatment is currently limited for this disease.
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Affiliation(s)
- Ching-Hui Sia
- Department of Cardiology, National University Heart Centre Singapore, Singapore, Singapore.,Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Fang Qin Goh
- School of Medicine, University of Nottingham, Nottingham, UK
| | - William Kok-Fai Kong
- Department of Cardiology, National University Heart Centre Singapore, Singapore, Singapore.,Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Bingcheng Wu
- Department of Pathology, National University Hospital, Singapore, Singapore
| | - Suresh Paranjothy
- Department of Anaesthesia, National University Hospital, Singapore, Singapore
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Xiao J, Brozzi N, Cifuentes R, Ghodsizad A, Loebe M. Application of total artificial heart in patients with primary malignant cardiac tumors-current treatment strategies. Ann Cardiothorac Surg 2020; 9:113-115. [PMID: 32309160 DOI: 10.21037/acs.2020.02.12] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Jiewen Xiao
- Division of Thoracic Transplantation & Mechanical Circulatory Support, Department of Surgery, Miller School of Medicine, University of Miami, Coral Gables, FL, USA
| | - Nicolas Brozzi
- Division of Thoracic Transplantation & Mechanical Circulatory Support, Department of Surgery, Miller School of Medicine, University of Miami, Coral Gables, FL, USA
| | - Renzo Cifuentes
- Division of Thoracic Transplantation & Mechanical Circulatory Support, Department of Surgery, Miller School of Medicine, University of Miami, Coral Gables, FL, USA
| | - Ali Ghodsizad
- Division of Thoracic Transplantation & Mechanical Circulatory Support, Department of Surgery, Miller School of Medicine, University of Miami, Coral Gables, FL, USA
| | - Matthias Loebe
- Division of Thoracic Transplantation & Mechanical Circulatory Support, Department of Surgery, Miller School of Medicine, University of Miami, Coral Gables, FL, USA
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Primary Cardiac Lymphoma Manifesting as Complete Heart Block. Case Rep Cardiol 2020; 2020:3825312. [PMID: 33062338 PMCID: PMC7537681 DOI: 10.1155/2020/3825312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 01/16/2020] [Indexed: 11/17/2022] Open
Abstract
Primary cardiac tumors are exceedingly rare with variable clinical manifestations. This case involves a patient presentation of symptomatic complete heart block and cardiac imaging revealing a right atrial mass invading the myocardium consistent with Burkitt lymphoma on histopathology. The patient received definitive bradytherapy with a pacemaker and chemotherapy for the primary cardiac lymphoma. After three cycles of chemotherapy, the right atrial mass regressed significantly with restoration of atrioventricular conduction and no pacing burden. Primary cardiac lymphomas infrequently manifest as atrioventricular block and this case highlights cardiac masses as a potential etiology when evaluating new conduction disturbances and bradyarrhythmias.
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40
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Hale A, Vann J, Henderson P, Harrison T, Trehan S. A Case of a Left Atrial Mass in an Orthotopic Heart Transplant Recipient. CASE (PHILADELPHIA, PA.) 2020; 4:33-38. [PMID: 32099942 PMCID: PMC7026533 DOI: 10.1016/j.case.2019.10.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Echocardiography is useful in differentiating intracardiac masses. Cardiac thrombus may be mistaken for atrial myxomas by echocardiography. Echocardiographic contrast can aid in the diagnosis of atrial thrombus.
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Affiliation(s)
- Andrew Hale
- Oklahoma State University Medical Center, Tulsa, Oklahoma
| | - John Vann
- Oklahoma State University Medical Center, Tulsa, Oklahoma
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41
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Fernandes GC, Alejandro Pajares W, Amboss N, Salerno TA, Mendoza C. Right atrial myxoma with peripheral eosinophilia: Eosinophilia in cardiac myxoma. J Card Surg 2019; 35:507-510. [DOI: 10.1111/jocs.14405] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | | | - Natalia Amboss
- Department of MedicineFaculdade de Medicina Souza Marques Rio de Janeiro Brazil
| | - Tomas A. Salerno
- Department of Cardiothoracic SurgeryJackson Memorial Hospital Miami Florida
| | - Cesar Mendoza
- Division of CardiologyJackson Memorial Hospital Miami Florida
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Ntinopoulos V, Dushaj S, Brugnetti D, Rings L, Loeblein H, Dzemali O. Left atrial myxoma: Unusual presentation as a cystic tumor. J Card Surg 2019; 35:511-513. [PMID: 31856315 DOI: 10.1111/jocs.14401] [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: 11/27/2022]
Abstract
Myxomas are the most common cardiac tumors, benign, and usually located in the left atrium. Typically echocardiography reveals a solid tumor, whereas cystic myxomas are rare with only a few cases documented in the literature. We describe the case of a 63-year-old, female patient with an unusual presentation of a left atrial myxoma as a cystic tumor.
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Affiliation(s)
- Vasileios Ntinopoulos
- Department of Cardiac Surgery, Allianz Herzchirurgie Zurich, Triemli Hospital, Zurich, Switzerland
| | - Stak Dushaj
- Department of Cardiac Surgery, Allianz Herzchirurgie Zurich, Triemli Hospital, Zurich, Switzerland
| | - Daniele Brugnetti
- Department of Cardiac Surgery, Allianz Herzchirurgie Zurich, Triemli Hospital, Zurich, Switzerland
| | - Laura Rings
- Department of Cardiac Surgery, Allianz Herzchirurgie Zurich, Triemli Hospital, Zurich, Switzerland
| | - Helen Loeblein
- Department of Cardiac Surgery, Allianz Herzchirurgie Zurich, Triemli Hospital, Zurich, Switzerland
| | - Omer Dzemali
- Department of Cardiac Surgery, Allianz Herzchirurgie Zurich, Triemli Hospital, Zurich, Switzerland
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Wallis J, Okpala I, Mallouppas M, Patterson C, Thomas D, Parmar J, Sudarshan C. An Incidental Finding at Transplant Assessment: Case Report. Transplant Proc 2019; 51:3189-3190. [PMID: 31619343 DOI: 10.1016/j.transproceed.2019.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 08/13/2019] [Indexed: 11/28/2022]
Abstract
A 43-year-old woman with chronic hypersensitivity pneumonitis was referred for lung transplant assessment. An echocardiogram as part of her work-up revealed a large left atrial myxoma, presenting a conundrum on how best to manage her combined pathology. Because of the level of pulmonary disease, early intervention to remove the myxoma was not thought be viable without postoperative support. Use of extracorporeal membrane oxygenation to bridge patients for lung transplant is feasible, yet risks increased perioperative mortality. We present the first reported case of simultaneous cardiac myxoma removal and lung transplant.
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Affiliation(s)
- James Wallis
- Division of Transplant Medicine, Royal Papworth Hospital NHS Foundation Trust, Cambridge, England.
| | - Iheoma Okpala
- Division of Transplant Medicine, Royal Papworth Hospital NHS Foundation Trust, Cambridge, England
| | - Michael Mallouppas
- Division of Transplant Medicine, Royal Papworth Hospital NHS Foundation Trust, Cambridge, England
| | - Caroline Patterson
- Division of Transplant Medicine, Royal Papworth Hospital NHS Foundation Trust, Cambridge, England
| | - Debra Thomas
- Division of Transplant Medicine, Royal Papworth Hospital NHS Foundation Trust, Cambridge, England
| | - Jasvir Parmar
- Division of Transplant Medicine, Royal Papworth Hospital NHS Foundation Trust, Cambridge, England
| | - Catherine Sudarshan
- Division of Transplant Surgery, Royal Papworth Hospital NHS Foundation Trust, Cambridge, England
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Mlika M, Daoud N, Braham E, Marghli A, El Mezni F. Primary Cardiac Tumors: A Retrospective Study. CURRENT RESPIRATORY MEDICINE REVIEWS 2019. [DOI: 10.2174/1573398x15666190430122451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Objectives:Primary cardiac tumors are rare and account for 0.001 to 0.03% of cardiac lesions. The authors aim to describe the clinical, the microscopic and the therapeutic characteristics of these tumors through a 13-year-experience in order to highlight the diagnostic challenges faced.Methods:We report 10 primary cardiac tumors diagnosed in the Departments of Pathology and Thoracic Surgery of the same hospital through a 13-year-period.Results:Our study was conducted on 7 women and 3 men. The mean age of the patients was 54.22 years (average, 12 to 79 years). Dyspnea represented the most frequent symptom. Physical examination was normal in all patients. Trans-thoracic ultra-sound examination was performed in all patients. Cardiac MRI allowed localizing the tumors in 2 patients. They were located into the left auricle (6 cases), the right auricle (1 case) and the pericardium (3 cases). The microscopic examination was concluded to myxoma (7 cases), haemangioma (2 cases) and hemangioendothelioma (1 case). Surgical resection was possible in 9 patients. It was impossible in the case of hemangioendothelioma because of the adherence. One death was recorded secondary to postoperative arrhythmia. The other patients presented no complications after a follow-up period ranging from 2 months to 5 years.Conclusion:Cardiac tumors are challenging in their diagnosis and management. A positive diagnosis is based on microscopic examination. Surgical treatment plays a key role and is possible in the majority of benign tumors. The prognosis of malignant tumors remains poor even if a complete surgical resection is possible.
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Affiliation(s)
- Mona Mlika
- Department of Pathology, AbderrahmanMami Hospital, Aryanah, Tunisia
| | - Nouha Daoud
- Department of Pathology, AbderrahmanMami Hospital, Aryanah, Tunisia
| | - Emna Braham
- Department of Pathology, AbderrahmanMami Hospital, Aryanah, Tunisia
| | - Adel Marghli
- Department of Thoracic Surgery, AbderrahmanMami Hospital, Research Lab: LR18SP06, Universite de Tunis El Manar, Faculte de Medecine, Tunis El Manar, Tunis, Tunisia
| | - Faouzi El Mezni
- Department of Pathology, AbderrahmanMami Hospital, Aryanah, Tunisia
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Abstract
Intracardiac masses are classified as neoplastic or non-neoplastic. Prognosis varies based on the diagnosis of the mass since treatment options differ greatly. As novel imaging techniques emerge, a multimodality approach to the evaluation of intracardiac masses becomes an important part of non-invasive evaluation prior to potential surgical planning or oncological treatment. The purpose of this article is to compare the available imaging modalities-echocardiography, cardiovascular magnetic resonance, cardiac computed tomography, nuclear imaging, and emerging novel hybrid imaging techniques for future clinical applications-and to review the characteristic features seen on those modalities for the most common intracardiac masses.
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Liddy S, McQuade C, Walsh KP, Loo B, Buckley O. The Assessment of Cardiac Masses by Cardiac CT and CMR Including Pre-op 3D Reconstruction and Planning. Curr Cardiol Rep 2019; 21:103. [DOI: 10.1007/s11886-019-1196-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Kaulen LD, Tietz F, Gradistanac T, Thiele H, Rommel KP. Cardiac melanoma metastases as a cause of sudden cardiac death. Clin Res Cardiol 2019; 108:716-718. [PMID: 30535800 DOI: 10.1007/s00392-018-1402-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 12/03/2018] [Indexed: 10/27/2022]
Affiliation(s)
- Leon D Kaulen
- Department of Cardiology, Heart Center Leipzig at University of Leipzig, Strümpellstr. 39, 04289, Leipzig, Germany
| | - Franziska Tietz
- Department of Cardiology, Heart Center Leipzig at University of Leipzig, Strümpellstr. 39, 04289, Leipzig, Germany
| | - Tanja Gradistanac
- Institute of Pathology, University Hospital Leipzig, Leipzig, Germany
| | - Holger Thiele
- Department of Cardiology, Heart Center Leipzig at University of Leipzig, Strümpellstr. 39, 04289, Leipzig, Germany
| | - Karl-Philipp Rommel
- Department of Cardiology, Heart Center Leipzig at University of Leipzig, Strümpellstr. 39, 04289, Leipzig, Germany.
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Little devil takes your breath away. Neth Heart J 2019; 27:639-640. [PMID: 31077077 PMCID: PMC6890881 DOI: 10.1007/s12471-019-1284-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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49
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Brailovsky Y, Darki A, Mathew V. Case report of a metastatic squamous cell carcinoma to the pericardium masquerading as ST elevation myocardial infarction on ECG. EUROPEAN HEART JOURNAL-CASE REPORTS 2019; 2:yty095. [PMID: 31020172 PMCID: PMC6177043 DOI: 10.1093/ehjcr/yty095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 07/13/2018] [Indexed: 12/02/2022]
Affiliation(s)
- Yevgeniy Brailovsky
- Division of Cardiology, Loyola University of Chicago Stritch School of Medicine, 2160 South First ave, Maywood, IL, USA
| | - Amir Darki
- Division of Cardiology, Loyola University of Chicago Stritch School of Medicine, 2160 South First ave, Maywood, IL, USA
| | - Verghese Mathew
- Division of Cardiology, Loyola University of Chicago Stritch School of Medicine, 2160 South First ave, Maywood, IL, USA
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Burns EA, Ahmed A, Sunkara A, Khan U, Sharif R, Abdelrahim M, Reardon M, Trachtenberg B. Primary cardiac angiosarcoma diagnosed in the first trimester of pregnancy. Ecancermedicalscience 2019; 13:922. [PMID: 31281419 PMCID: PMC6546259 DOI: 10.3332/ecancer.2019.922] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Indexed: 11/06/2022] Open
Abstract
Primary cardiac angiosarcoma (PCAS) is a malignancy seldom seen in pregnancy. A 23-year-old G1P0 Chinese female was found to have PCAS during her first trimester when she presented with tamponade physiology. The transthoracic echocardiography (TTE) results did not indicate the presence of an intracardiac lesion, and pericardial fluid cytology analysis showed no evidence of malignancy. Cardiac magnetic resonance imaging (CMRI) exhibited a right atrial mass, and tissue biopsy indicated a high-grade angiosarcoma. MRI of the abdomen was suggestive of liver metastasis. She underwent an abortion and was started on combination chemotherapy, with a reduction in both the cardiac and liver masses. In cardiac angiosarcomas, advanced imaging modalities such as MRI should be utilised when there is high clinical suspicion or in the case of pregnancy when trying to minimise foetal harm. Prognosis is poor, and a standardised treatment protocol regardless of pregnancy continues to elude the medical community.
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Affiliation(s)
- Ethan A Burns
- Internal Medicine, Houston Methodist Hospital, Houston, TX 77030, USA
| | - Amna Ahmed
- Internal Medicine, Houston Methodist Hospital, Houston, TX 77030, USA
| | - Anusha Sunkara
- Houston Methodist DeBakey Heart and Vascular Center, Houston, TX 77030, USA
| | - Usman Khan
- Houston Methodist Cancer Center, Houston, TX 77030, USA
| | | | | | - Michael Reardon
- Houston Methodist DeBakey Heart and Vascular Center, Houston, TX 77030, USA
| | - Barry Trachtenberg
- Houston Methodist DeBakey Heart and Vascular Center, Houston, TX 77030, USA
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