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Vicenty-Rivera S, Diaz-Rodriguez PE, Molina-Lopez VH, Machuca JN. Cardiac Angiosarcoma Presenting as Large Pericardial Effusion With Effusive-Constrictive Pericarditis. Cureus 2024; 16:e60623. [PMID: 38903323 PMCID: PMC11187464 DOI: 10.7759/cureus.60623] [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] [Accepted: 05/19/2024] [Indexed: 06/22/2024] Open
Abstract
Pericardial angiosarcoma is an extremely rare malignant tumor originating from the endothelial cells of blood vessels within the pericardium. We present a case of a 49-year-old male who presented with symptoms of pericardial effusion and was subsequently diagnosed with pericardial angiosarcoma. This case report highlights the diagnostic challenges and management options associated with this rare entity.
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Affiliation(s)
- Sonia Vicenty-Rivera
- Cardiology Section, Specialty Medicine Department, Bruce W. Carter Department of Veterans Affairs Medical Center, Miami, USA
| | | | | | - Jomar N Machuca
- Internal Medicine, Veterans Affairs Medical Center, San Juan, PRI
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2
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Mayooran N, Sherif A, Koulouroudias M, Gnanalingham S, Ahmed Saleh WU, Tan S, Boulemden A, Szafranek A. Surgical resection of primary intracardiac sarcomas and outcomes: A review of case reports over 20 years. Indian J Thorac Cardiovasc Surg 2024; 40:213-218. [PMID: 38389783 PMCID: PMC10879044 DOI: 10.1007/s12055-023-01618-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 09/13/2023] [Accepted: 09/14/2023] [Indexed: 02/24/2024] Open
Abstract
Objective A quarter of all cardiac tumors are malignant, and most (~ 95%) are sarcomas. It is the most aggressive malignant cardiac tumor carrying the worst prognosis. Tumor involvement with the vital intracardiac structures makes it difficult for complete surgical resection. We aimed to study the role of complete surgical resection and its importance in long-term outcomes. Methods We analyzed published literature from 2002 to 2022 using PubMed. Cases reported adult, intracardiac sarcomas, and received surgical resections were included. We reviewed 132 published case reports, including and analyzed the following variables: demographics, clinical presentations, diagnostic imaging modality, the extent of surgical resection, pathological diagnosis, tumor location, postoperative chemo-radiation therapy, and follow-up (including re-operation, local and distant recurrence). Results A total of 135 patients are included from 132 articles. The mean age was 46.69 (18-86) and 76 patients were females. The main complaints were dyspnea (70%) and chest pain (32%). Performed investigations were transthoracic echocardiography (TTE) in 114/135 (84%), computer tomography (CT) scan 89/135 (66%), trans-esophageal echocardiography (TOE) 22%, and cardiac magnetic resonance imaging (MRI) 29%. The most common location was the atrium (left 46%, right 30%). Complete surgical resection was performed in 91 cases (67%), and frozen section was performed in 62 patients (43 positives). Incomplete resections were in 42 cases. Patients who underwent complete surgical resection had mean survival of 14.58 months and median of 10.5 months, compared to incomplete resection patients with 9.12 months and 6.5 months respectively. Conclusion Our review shows complete surgical resection results in better short- and long-term outcomes in intracardiac sarcoma patients. Furthermore, combining chemo-radiotherapy has additional benefits towards long-term survival.
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Affiliation(s)
- Nithiananthan Mayooran
- Department of Cardiac Surgery, Trent Cardiac Centre, Nottingham University Hospital, Nottingham, UK
- Nottingham University Hospital, Nottingham, UK
| | - A. Sherif
- Department of Cardiac Surgery, Trent Cardiac Centre, Nottingham University Hospital, Nottingham, UK
| | - M. Koulouroudias
- Department of Cardiac Surgery, Trent Cardiac Centre, Nottingham University Hospital, Nottingham, UK
| | | | - W. U. Ahmed Saleh
- Department of Cardiac Surgery, Trent Cardiac Centre, Nottingham University Hospital, Nottingham, UK
| | - S. Tan
- Department of Cardiac Surgery, Trent Cardiac Centre, Nottingham University Hospital, Nottingham, UK
| | - A. Boulemden
- Department of Cardiac Surgery, Trent Cardiac Centre, Nottingham University Hospital, Nottingham, UK
| | - A. Szafranek
- Department of Cardiac Surgery, Trent Cardiac Centre, Nottingham University Hospital, Nottingham, UK
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Oktaviono YH, Saputra PBT, Arnindita JN, Afgriyuspita LS, Kurniawan RB, Pasahari D, Milla C, Wungu CDK, Susilo H, Multazam CECZ, Alkaff FF. Clinical characteristics and surgical outcomes of cardiac myxoma: A meta-analysis of worldwide experience. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2024; 50:107940. [PMID: 38219702 DOI: 10.1016/j.ejso.2023.107940] [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: 11/25/2023] [Accepted: 12/26/2023] [Indexed: 01/16/2024]
Abstract
Cardiac myxoma is the most common primary cardiac tumor. However, existing literature mainly consists of single-center experiences with limited subjects. This systematic review aimed to provide data on clinical characteristics and surgical outcomes of cardiac myxoma. We performed a thorough literature search on May 23, 2023 on PubMed, ProQuest, ScienceDirect, Scopus, and Web of Science. The inclusion criteria were English full-text, observational studies, and included >20 subjects. From the search, 112 studies with a total of 8150 patients were included in the analysis. The mean age was 51 years (95 % confidence interval [95%CI] = 49.1-52.3), and the majority were females (64.3 % [95 % CI = 62.8-65.8 %]). The most common clinical manifestation was cardiovascular symptoms. Echocardiography can diagnose almost all cases (98.1 % [95 % CI = 95.8-99.6 %]). Cardiac myxoma was mostly prevalent in left atrium (85.3 % [95%CI = 83.3-87 %]) and predominantly with pedunculated morphology (75.6 % [95%CI = 64.1-84.3 %]). Post-tumor excision outcomes were excellent, with an early mortality of 1.27 % (95 % CI = 0.8-1.8 %), late mortality rate of 4.7 (95 % CI = 2.5-7.4) per 1000 person-years, and recurrence rate at 0.5 (95 % CI = 0.0-1.1) per 1000 person-years. Tumor excision is warranted in a timely manner once the cardiac myxoma diagnosis is established.
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Affiliation(s)
- Yudi Her Oktaviono
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga - General Academic Hospital Dr. Soetomo, Surabaya, Indonesia; Cardiovascular Research and Innovation Center, Universitas Airlangga, Surabaya, Indonesia.
| | - Pandit Bagus Tri Saputra
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga - General Academic Hospital Dr. Soetomo, Surabaya, Indonesia; Cardiovascular Research and Innovation Center, Universitas Airlangga, Surabaya, Indonesia.
| | - Jannatin Nisa Arnindita
- Cardiovascular Research and Innovation Center, Universitas Airlangga, Surabaya, Indonesia; Faculty of Medicine, Universitas Airlangga, Indonesia
| | | | | | - Diar Pasahari
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga - General Academic Hospital Dr. Soetomo, Surabaya, Indonesia
| | - Clonia Milla
- Faculty of Medicine, Universitas Airlangga, Indonesia
| | - Citrawati Dyah Kencono Wungu
- Department of Physiology and Medical Biochemistry, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia; Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia
| | - Hendri Susilo
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga - Universitas Airlangga Hospital, Surabaya, East Java, Indonesia
| | | | - Firas Farisi Alkaff
- Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, Groningen, Netherlands; Division of Pharmacology and Therapy, Department of Anatomy, Histology, and Pharmacology, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.
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4
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Nzomvuama ANN, Mutuale CN, Kongo RM, Mbanzulu IN, Nsiala JM. Huge left atrial myxoma: about 2 cases resected in the Democratic Republic of Congo. J Cardiothorac Surg 2023; 18:156. [PMID: 37081519 PMCID: PMC10116768 DOI: 10.1186/s13019-023-02286-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 04/11/2023] [Indexed: 04/22/2023] Open
Abstract
BACKGROUND Myxoma is the most common cardiac tumor, found in 75-80% of cases in the left atrium. It can grow quietly and therefore reach a large size before being symptomatic. Poor availability of echocardiography also contributes to delayed diagnosis. In Sub-Saharan African countries, myxoma diagnosis can be missed for many patients. Myxoma resection surgery, although technically simple, is not always possible, because of the lack of cardiac surgery development. The aim of this report is to describe the first two consecutive resection cases of huge left-atrial myxoma performed in Kinshasa, Democratic Republic of Congo (DRC) and to discuss the specificities of this surgery in this low-resource context. CASE PRESENTATION Two patients, 54 and 48 years old, were diagnosed with giant myxoma of the left atrium in the management of progressive dyspnea The first patient's transthoracic echocardiography revealed a pedunculated atrial mass (37 × 48 mm) on the interatrial septum, passing through the mitral valve. For the second patient, the mass (64 × 26 mm) was attached to the roof of the left atrium and protruded into the mitral valve, with significant mitro-tricuspid regurgitation The first patient underwent a simple resection of the myxoma. For the second patient, it was associated to a mitro-tricuspid annuloplasty. The postoperative course was simple for the first patient, but the second patient developed a biventricular failure requiring vasoactive drugs. Both patients were discharged alive from the hospital on postoperative days 10 and 12, respectively. They are regularly followed up and are doing well 2 years after surgery. DISCUSSION AND CONCLUSION Surgical resection is the only effective treatment of myxoma. Our first results are encouraging The poor availability of the echocardiography is a challenge in the diagnosis of myxoma. The development of cardiac surgery in DRC and ongoing country-level efforts to address diagnostic challenges for these often silent tumors will allow us to expect more resections to be performed locally and larger series published.
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Affiliation(s)
- Alphonse Ndonga N'sungu Nzomvuama
- Department of Thoracic and Cardiovascular Surgery, Kinshasa University Hospital, University of Kinshasa, BP 834, Kinshasa, Democratic Republic of the Congo.
- Department of Cardiovascular Surgery, Ngaliema Clinic, Kinshasa, Democratic Republic of the Congo.
| | | | - Roger Minga Kongo
- Department of Cardiovascular Surgery, Ngaliema Clinic, Kinshasa, Democratic Republic of the Congo
| | - Irène Nsolani Mbanzulu
- Department of Histopathology, Kinshasa General Hospital, Kinshasa, Democratic Republic of the Congo
| | - Joseph Makunza Nsiala
- Department of Cardiovascular Surgery, Ngaliema Clinic, Kinshasa, Democratic Republic of the Congo
- Department of Anesthesiology, Kinshasa University Hospital, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
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5
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Montoya-Beltran JS, Herrera LR, Marín PO, Navajas AN, Manrique Espinel FT. Atrial Fusocellular Sarcoma: An Uncommon Presentation. CASE 2023; 7:105-108. [PMID: 37065836 PMCID: PMC10103005 DOI: 10.1016/j.case.2022.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Liu W, Bu H. Strategies to rare primary cardiac lipomas in the left ventricle in a patient: case report. BMC Cardiovasc Disord 2022; 22:316. [PMID: 35840877 PMCID: PMC9288081 DOI: 10.1186/s12872-022-02748-w] [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: 12/28/2021] [Accepted: 07/04/2022] [Indexed: 11/28/2022] Open
Abstract
Background Primary cardiac tumors are rare in all age groups and are usually benign. Symptoms are usually related to tumor size, location, invasiveness, number, and growth rate. While histologically benign, cardiac arrest may be caused by blocked inflow or outflow or malignant ventricular arrhythmia. Surgical resection of left ventricular tumors, especially those involving the outflow tract, is challenging. Case presentation Herein, we present a rare case of an asymptomatic, 39-year-old woman who was referred to our cardiovascular department for a huge left ventricular cardiac mass incidentally discovered during the physical examination. Images showed a huge mass that quasi-circular low-density focus with a clear boundary and regular shape in the left ventricular cavity and fortunately had no significant effect on the peripheral valves and hemodynamics. Conclusions This illustrative report highlights the exact surgical management of a cardiac tumor depends largely on the site and extent of the mass. Mechanical compromise and not the neoplastic potential should be considered. A conservative approach and follow-up regularly are advocated to ensure that the patient gets the best diagnosis and treatment, however, surgery is indicated only for severely symptomatic patients with hemodynamic compromise.
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Affiliation(s)
- Wei Liu
- Department of Cardiovascular Surgery, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, People's Republic of China
| | - Haisong Bu
- Department of Cardiovascular Surgery, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, People's Republic of China.
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Yin H, Mao W, Tan H, Zhu N, Wan Q, Shi J, Qiu L, Xiu Y, Luo R, Yu H, Shi H. Role of 18F-FDG PET/CT imaging in cardiac and pericardial masses. J Nucl Cardiol 2022; 29:1293-1303. [PMID: 33462788 DOI: 10.1007/s12350-020-02510-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 12/21/2020] [Indexed: 01/18/2023]
Abstract
BACKGROUND Considering the few reported cardiac masses, PET/CT in the imaging workup of cardiac masses is not well established. This retrospective study analyzed the role of 18F-FDG PET/CT imaging in cardiac/pericardial masses. METHODS AND RESULTS Fifty-nine patients with newly diagnosed cardiac/pericardial masses who underwent PET/CT and transthoracic echocardiography (TTE) were recruited. Echocardiographic and PET/CT characteristics were evaluated for predictive value in differentiating malignant and non-malignant lesions using histologic confirmation as the gold standard. The McNemar test was used to test the differences in sensitivity between PET/CT and TTE. 18F-FDG PET/CT had higher sensitivity in determining the malignancy of cardiac/pericardial masses compared to TTE (sensitivity, 96.6% vs 72.4%, P = .039). However, when pericardial masses were excluded from the analysis, the difference in sensitivity between the two was not statistically significant (sensitivity, 95.6% vs 78.3%, P = .219). 18F-FDG PET/CT identified two malignant pericardial masses missed on TTE, changed the diagnostic orientation of TTE in 15 patients, and found seven patients with extracardiac lesions in 29 malignant patients. CONCLUSIONS PET/CT was an effective additional image modality in patients with suspected malignant cardiac mass for further confirmation and to screen for potential metastasis.
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Affiliation(s)
- Hongyan Yin
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Rd, Shanghai, 200032, China
| | - Wujian Mao
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Rd, Shanghai, 200032, China
| | - Hui Tan
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Rd, Shanghai, 200032, China
| | - Na Zhu
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Quan Wan
- Department of Echocardiology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Jing Shi
- Department of Echocardiology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Lin Qiu
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Rd, Shanghai, 200032, China
| | - Yan Xiu
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Rd, Shanghai, 200032, China
| | - Rongkui Luo
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Haojun Yu
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Rd, Shanghai, 200032, China
| | - Hongcheng Shi
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Rd, Shanghai, 200032, China.
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8
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Vu TT, Nguyen VT, Tran QT, Ngo Thi MH, Do TH, Le HS, Nguyen NT, Nguyen VT, Lam K. A case of a small-sized cavernous hemangioma in the right ventricle - an incidental finding. Radiol Case Rep 2022; 17:856-862. [PMID: 35035650 PMCID: PMC8753057 DOI: 10.1016/j.radcr.2021.12.038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 12/17/2021] [Accepted: 12/19/2021] [Indexed: 11/29/2022] Open
Abstract
A cardiac cavernous hemangioma is a rare, primary, benign tumor that is usually diagnosed in young or middle-aged patients. In this article, we report the case of a 71-year-old male patient whose doctors incidentally discovered a heart tumor on his transthoracic echocardiography. Triple-phase computed tomography (CT) (pre-contrast, arterial and portal venous) missed the lesion, and magnetic resonance imaging (MRI) revealed a small, oval tumor attached to the wall of the right ventricle. The tumor was successfully removed surgically, and the patient recovered after 2 weeks. A histopathological examination resulted in the diagnosis of a benign cavernous hemangioma.
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Affiliation(s)
- Thu Thuy Vu
- Department of Diagnostic Imaging, Hospital 108, Hanoi, Vietnam
| | | | - Quang Thai Tran
- Department of Cardiac and Vascular Surgery, Hospital 108, Hanoi, Vietnam
| | | | - Thanh Hoa Do
- Department of Emergency, Hospital 108, Hanoi, Vietnam
| | - Hai Son Le
- Department of Diagnostic Imaging, Hospital 108, Hanoi, Vietnam
| | | | - Van Thuy Nguyen
- Department of Diagnostic Imaging, Hospital 108, Hanoi, Vietnam
| | - Khanh Lam
- Department of Diagnostic Imaging, Hospital 108, Hanoi, Vietnam,Corresponding author.
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Badge V, Kohale M, Patil A, Revadekar A. Spindle-cell sarcoma of the heart: A case report of a rare cause of cardiac mass. Ann Card Anaesth 2022; 25:220-224. [PMID: 35417976 PMCID: PMC9244260 DOI: 10.4103/aca.aca_242_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Spindle cell sarcoma of heart are the least reported primary cardiac tumours. We present a case of a 60-year-old man reported to us following successful resuscitation after cardiac arrest. This patient presented with symptoms of dyspnoea on exertion. The echocardiography showed features of cardiac tamponade. CT scan chest+ Abdomen + Pelvis confirmed echocardiography findings, and showed significant pericardial effusion with early cardiac tamponade. Patient continued to suffer dyspnoea even after pericardiocentesis and was unstable in the intensive care unit, hence he was shifted to operating room for re-exploration. The mass was excised in a piecemeal without instituting cardiopulmonary bypass. The total weight of the mass was approximately 500gms. The macroscopic examination of the specimen revealed a cystic mass with solid grey brown tissue. Following surgical debulking, chest X -ray in Intensive Care Unit showed improvement. The patient visited the outpatient clinic after 15 days of surgery. 2-D echocardiography revealed minimal pericardial effusion and patient was comfortable.
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10
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Gonçalves I, Nunes C, Vieira C, Freitas D, Pinto L. Primary Cardiac Angiosarcoma: A Rare and Fatal Diagnosis. Cureus 2021; 13:e20816. [PMID: 35111478 PMCID: PMC8794415 DOI: 10.7759/cureus.20816] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2021] [Indexed: 11/08/2022] Open
Abstract
Primary cardiac angiosarcoma is a rare malignant neoplasm and occurs most frequently in middle-aged males. It has an aggressive nature, with highly variable clinical features, which results in delayed diagnosis and high mortality. We report a 19-year-old man presented to the ED with a three-month history of hemoptysis and one-week history of anterior chest pain. Additionally, an aortic diastolic murmur grade II/VI was found on physical examination. Thoracic CT scan revealed bilateral dispersed hypodense pulmonary nodes with peripheral halo, alveolar densification, and pericardial effusion. The transthoracic echocardiogram confirmed sizeable pericardial effusion and bicuspid aortic valve, without other significant findings. A pericardiocentesis removed 1300 mL of hemorrhagic fluid, consistent with an exudate without malignant cells. Both cardiac magnetic resonance and transesophageal echocardiogram revealed a large mass on the right atrium’s anterior wall. Mass biopsy was performed, revealing malignant cardiac angiosarcoma. The biopsy of the lung lesions was compatible with lung metastasis of primary cardiac angiosarcoma. The patient was submitted to palliative chemotherapy but died 12 months after the diagnosis.
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Valente T, Pignatiello M, Sica G, Bocchini G, Rea G, Cappabianca S, Scaglione M. Hemopericardium in the acute clinical setting: Are we ready for a tailored management approach on the basis of MDCT findings? LA RADIOLOGIA MEDICA 2020; 126:527-543. [PMID: 33136215 DOI: 10.1007/s11547-020-01303-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 10/20/2020] [Indexed: 11/26/2022]
Abstract
The clinical spectrum of pericardial effusions varies from innocuous serous fluid to life-threatening hemopericardium. A misdiagnosis may be made by similar clinical presentation of acute chest pain/hypotension. Echocardiography is the first-line test for diagnosis of pericardial effusion and its etiology, but sometimes there are different drawbacks to the correct cardiovascular ultrasound diagnosis. Radiologists are reporting an increasing amount of thoracic Multidetector CT examinations at the emergency department. Multidetector CT has now become an established and complementary method for cardiac imaging, and diseases of the pericardium can now be quickly identified with increasing certainty. The aim of this review is to discuss the hemopericardium key Multidetector CT features in acute clinical setting which indicate the need to proceed with predominantly medical or surgical treatment, however, being able to identify forms of bleeding pericardial effusion for which only "a watch and wait strategy" and/or deferred treatment is indicated. In the emergency care setting, radiologists must be aware of different findings of hemopericardium in order to address a tailored and timely management approach.
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Affiliation(s)
- Tullio Valente
- Department of Diagnostic Imaging, Section of General Radiology, Azienda Ospedali dei Colli, Monaldi Hospital, Via Leonardo Bianchi, Naples, Italy.
| | - Maria Pignatiello
- Department of Precision Medicine, University of Campania L. Vanvitelli, Naples, Italy
| | - Giacomo Sica
- Department of Diagnostic Imaging, Section of General Radiology, Azienda Ospedali dei Colli, Monaldi Hospital, Via Leonardo Bianchi, Naples, Italy
| | - Giorgio Bocchini
- Department of Diagnostic Imaging, Section of General Radiology, Azienda Ospedali dei Colli, Monaldi Hospital, Via Leonardo Bianchi, Naples, Italy
| | - Gaetano Rea
- Department of Diagnostic Imaging, Section of General Radiology, Azienda Ospedali dei Colli, Monaldi Hospital, Via Leonardo Bianchi, Naples, Italy
| | - Salvatore Cappabianca
- Department of Precision Medicine, University of Campania L. Vanvitelli, Naples, Italy
| | - Mariano Scaglione
- Department of Diagnostic Imaging, Pineta Grande Hospital, Castelvolturno, Italy
- Department of Radiology, Tesside University, Middlesbrough, UK
- James Cook University Hospital, Middlesbrough, UK
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12
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Tyebally S, Chen D, Bhattacharyya S, Mughrabi A, Hussain Z, Manisty C, Westwood M, Ghosh AK, Guha A. Cardiac Tumors: JACC CardioOncology State-of-the-Art Review. JACC: CARDIOONCOLOGY 2020; 2:293-311. [PMID: 34396236 PMCID: PMC8352246 DOI: 10.1016/j.jaccao.2020.05.009] [Citation(s) in RCA: 205] [Impact Index Per Article: 51.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 05/07/2020] [Accepted: 05/11/2020] [Indexed: 12/13/2022]
Abstract
Cardiac masses are rare, but remain an important component of cardio-oncology practice. These include benign tumors, malignant tumors (primary and secondary) and tumor-like conditions (e.g., thrombus, Lambl’s excrescences, and pericardial cyst). The advent of multimodality imaging has enabled identification of the etiology of cardiac masses in many cases, especially in conjunction with information from clinical settings. This paper provides a comprehensive review of the epidemiology, clinical presentation, imaging, diagnosis, management, and outcomes of cardiac masses. Cardiac tumors are rare and should be considered as part of the differential diagnosis of any space-occupying mass noted on cardiovascular and/or thoracic imaging modalities. It may be possible to get close to a diagnosis without biopsy using a structured imaging approach. The prognosis and treatment of each tumor is different, although early diagnosis is usually associated with a better outcome.
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Affiliation(s)
- Sara Tyebally
- Cardiology Department, Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom
| | - Daniel Chen
- Cardiology Department, Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom.,Cardio-Oncology Service, University College London Hospital, London, United Kingdom
| | - Sanjeev Bhattacharyya
- Cardiology Department, Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom
| | - Abdallah Mughrabi
- Jordan University of Science and Technology, Al Ramtha, Irbid, Jordan
| | - Zeeshan Hussain
- Division of Cardiology, Loyola University Medical Center, Chicago, Illinois, USA
| | - Charlotte Manisty
- Cardiology Department, Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom
| | - Mark Westwood
- Cardiology Department, Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom
| | - Arjun K Ghosh
- Cardiology Department, Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom.,Cardio-Oncology Service, University College London Hospital, London, United Kingdom
| | - Avirup Guha
- Cardio-Oncology Program, Division of Cardiology, Ohio State University, Columbus, Ohio, USA.,Harrington Heart and Vascular Institute, Case Western Reserve University, Cleveland, Ohio, USA
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Rahouma M, Arisha MJ, Elmously A, El-Sayed Ahmed MM, Spadaccio C, Mehta K, Baudo M, Kamel M, Mansor E, Ruan Y, Morsi M, Shmushkevich S, Eldessouki I, Rahouma M, Mohamed A, Gambardella I, Girardi L, Gaudino M. Cardiac tumors prevalence and mortality: A systematic review and meta-analysis. Int J Surg 2020; 76:178-189. [PMID: 32169566 DOI: 10.1016/j.ijsu.2020.02.039] [Citation(s) in RCA: 65] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 02/21/2020] [Accepted: 02/26/2020] [Indexed: 12/30/2022]
Abstract
OBJECTIVES Cardiac tumors and their associated outcomes are poorly characterized. This study sought to comprehensively assess the epidemiology and natural history of primary and secondary malignant cardiac tumors (PMCT and SMCT), a well as establish predictors of mortality. METHODS A comprehensive literature review was performed to identify articles reporting on PMCTs and SMCTs. The prevalence of important cardiac tumor (CT) subtypes was evaluated and further stratified based on the continental region. Outcomes of interest included short- and long-term mortality and utilization of heart transplantation (HTX). A random effect model was adopted, and a meta-regression was performed to determine predictors of the prevalence of CTs as well as predictors of operative mortality. RESULTS Of the 1,226 retrieved articles, 74 were included in our study (n = 8,849 patients). The mean follow-up was 2.27 years, mean age was 42.9 years, and 55% of the patients were females. There was a total number of 7,484 benign primary cardiac tumors (PCTs) (5,140 were myxoma), 862 (9.7%) malignant PCTs, and 355 secondary cardiac tumors. The prevalence of PMCTs among PCTs was 10.83% [95%CI = 09.11; 12.83%] with a trend towards being lower in South America compared to other continents (Prevalence = 5.80%). The prevalence of HTX among all patients was 2.45% [1.36; 4.38%]. The pooled short-term mortality was 5.90% [4.70; 7.39%] and the incidence of late mortality in all CTs, benign CT and PMCTs was 2.55% [1.76; 3.72%], 0.79% [0.46; 1.37%] and 14.77% [9.32; 23.40%], respectively. On meta-regression, the annual volume of cardiac tumor cases per center was the only predictor of lower early mortality (Beta = -0.14 ± 0.03, P < 0.0001). CONCLUSIONS PMCTs represent the minority of PCT (~10%) and have a higher prevalence in Europe and North America. Survival is higher in benign pathology and is significantly improved by treatment in specialized high-volume centers. Approximately 2% of patients with CTs undergo heart transplantation.
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Affiliation(s)
- Mohamed Rahouma
- Cardiothoracic Surgery Department, Weill Cornell Medicine/New York Presbyterian Hospital, New York, USA; Surgical Oncology Department, National Cancer Institute, Cairo University, Egypt.
| | - Mohammed J Arisha
- Internal Medicine Department, West Virginia University Charleston Division, Charleston Area Medical Center, Charleston, WV, USA
| | - Adham Elmously
- Cardiothoracic Surgery Department, Weill Cornell Medicine/New York Presbyterian Hospital, New York, USA
| | | | - Cristiano Spadaccio
- Department of Cardiothoracic Surgery, Golden Jubilee National Hospital, Clydebank, Glasgow, G814DY, UK; Institute of Cardiovascular and Medical Sciences, Veterinary and Life Sciences, College of Medical, University of Glasgow, Glasgow, G128QQ, UK
| | - Kritika Mehta
- Cardiothoracic Surgery Department, Weill Cornell Medicine/New York Presbyterian Hospital, New York, USA
| | - Massimo Baudo
- Cardiothoracic Surgery Department, Weill Cornell Medicine/New York Presbyterian Hospital, New York, USA
| | - Mohamed Kamel
- Cardiothoracic Surgery Department, Weill Cornell Medicine/New York Presbyterian Hospital, New York, USA; Surgical Oncology Department, National Cancer Institute, Cairo University, Egypt
| | - Esraa Mansor
- Internal Medicine Department, West Virginia University Charleston Division, Charleston Area Medical Center, Charleston, WV, USA
| | - Yongle Ruan
- Cardiothoracic Surgery Department, Weill Cornell Medicine/New York Presbyterian Hospital, New York, USA
| | - Mahmoud Morsi
- Cardiothoracic Surgery Department, Weill Cornell Medicine/New York Presbyterian Hospital, New York, USA
| | - Shon Shmushkevich
- Cardiothoracic Surgery Department, Weill Cornell Medicine/New York Presbyterian Hospital, New York, USA
| | - Ihab Eldessouki
- Medical Oncology Department, University of Cincinnati Cancer Institute, Cincinnati, OH, USA
| | - Mostafa Rahouma
- Information Technology Department, National Cancer Institute, Cairo University, Egypt
| | - Abdelrahamn Mohamed
- Surgical Oncology Department, National Cancer Institute, Cairo University, Egypt
| | - Ivancarmine Gambardella
- Cardiothoracic Surgery Department, Weill Cornell Medicine/New York Presbyterian Hospital, New York, USA
| | - Leonard Girardi
- Cardiothoracic Surgery Department, Weill Cornell Medicine/New York Presbyterian Hospital, New York, USA
| | - Mario Gaudino
- Cardiothoracic Surgery Department, Weill Cornell Medicine/New York Presbyterian Hospital, New York, USA
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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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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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16
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Peregud-Pogorzelska M, Lewandowski M, Trzcińska-Butkiewicz B, Brzosko M. Right atrial myxoma: a potential accelerator of pulmonary hypertension in the course of systemic sclerosis. The role of interleukin-6. Postepy Dermatol Alergol 2019; 36:354-357. [PMID: 31333353 PMCID: PMC6640019 DOI: 10.5114/ada.2018.79439] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 07/11/2018] [Indexed: 11/17/2022] Open
Affiliation(s)
| | | | - Beata Trzcińska-Butkiewicz
- Department of Rheumatology, Internal Diseases and Geriatrics, Pomeranian Medical University, Szczecin, Poland
| | - Marek Brzosko
- Department of Rheumatology, Internal Diseases and Geriatrics, Pomeranian Medical University, Szczecin, Poland
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18
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Watson R, Frye J, Trieu M, Yang MX. Primary undifferentiated pleomorphic cardiac sarcoma with MDM2 amplification presenting as acute left-sided heart failure. BMJ Case Rep 2018; 2018:bcr-2018-226073. [PMID: 30275026 PMCID: PMC6169688 DOI: 10.1136/bcr-2018-226073] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Primary cardiac tumours are a rare clinical entity that can present with myriad of non-specific cardiopulmonary symptoms. We describe a case of a 61-year-old previously healthy woman who presented with progressive dyspnoea and lower extremity swelling, suggestive of acute left-sided heart failure. Transthoracic echocardiogram revealed a large, 3.7×3.2 cm intracardiac mass resulting in severe mitral valvular dysfunction. The patient underwent surgical resection of the mass, however, negative margins were not obtained, and the tumour quickly returned. Histological and molecular analysis was consistent with the diagnosis of undifferentiated pleomorphic sarcoma with murine double minute 2 (MDM2) amplification. Given the overall grim prognosis, the patient chose to pursue comfort-based care. She died at home 9 months after the initial diagnosis. Here, we provide an updated review of the literature for the classification of undifferentiated pleomorphic cardiac sarcoma and potential treatment modalities.
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Affiliation(s)
- Richard Watson
- Department of Internal Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Joseph Frye
- Department of Pathology, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Megan Trieu
- Department of Medicine, Ronald Reagan UCLA Medical Center, Los Angeles, California, USA
| | - Michael X Yang
- Department of Internal Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA
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Abstract
Cardiac masses present a diagnostic challenge given their relative rarity and the overall difficulty imaging the heart. With the increasing frequency and quality of imaging in general, however, the incidental discovery of cardiac masses is increasing. Cardiac masses seldom produce symptoms, and they are more commonly found during imaging for noncardiac indications. While echocardiography is useful in the initial evaluation of a suspected mass, cardiac magnetic resonance (MR) imaging is the best imaging modality to characterize cardiac tumors due to its superior tissue characterization and its higher contrast resolution. Due to the risk of embolization and arrhythmia, most benign cardiac tumors are removed, and imaging plays an important role in treatment planning. While primary resection remains the mainstay of treatment, new treatment strategies may prolong survival and slow the growth of metastases. A fundamental knowledge of common cardiac masses is vital to all radiologists, and here, we discuss the most pertinent imaging approach to cardiac masses emphasizing MR imaging.
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20
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He S, Cao Y, Qin W, Chen W, Yin L, Chai H, Tao Z, Tang S, Qiu Z, Chen X. Prevalence of primary cardiac tumor malignancies in retrospective studies over six decades: a systematic review and meta-analysis. Oncotarget 2018; 8:43284-43294. [PMID: 28489604 PMCID: PMC5522145 DOI: 10.18632/oncotarget.17378] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 03/30/2017] [Indexed: 12/21/2022] Open
Abstract
The incidence of patients diagnosed with primary malignant cardiac tumors (PMCTs) has increased greatly in the past few decades. Whether this rising prevalence is due to overdiagnosis or an increased malignancy rate of primary cardiac tumors (PCTs) remains unclear. Therefore, we performed a systematic review and meta-analysis of published retrospective studies to determine whether the malignancy rate has been increasing over time. Published studies containing relevant data between 1956 and 2014 were evaluated. Two authors searched for all retrospective studies that included patients diagnosed with PCT and PMCT. Two other investigators independently extracted the data, and discrepancies were resolved by consensus. A random-effects meta-analysis model and cumulative meta-analysis model were used to evaluate the pooled prevalence and trend of dynamic change in PCT malignancies. The effects of time, study period and sample size were studied using a logit-linear regression model with robust error variance and a time variable. Thirty-eight studies involving 5,586 patients were analyzed. The pooled prevalence of PMCT among the patients diagnosed with PCT was 9.9% (95% CI, 8.4% to 11.4%) (I2=70%; P< 0.001), and this prevalence has been stable since around 2003. In the regression model, the malignancy odds ratio remained stable from 1975 onward, and no time effect was observed. Our study confirms that PMCT is uncommon, and the prevalence of PCT malignancies remained stable in the past few decades. The clinically observed increase in incidence is unlikely to reflect a true population-level increase in tumorigenesis. This result strongly suggests that the observed increase in incidence of PMCT most likely reflects increased diagnostic detection over time.
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Affiliation(s)
- Shuai He
- Department of Thoracic and Cardiovascular Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yide Cao
- Department of Thoracic and Cardiovascular Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Wei Qin
- Department of Thoracic and Cardiovascular Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Wen Chen
- Department of Thoracic and Cardiovascular Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Li Yin
- Department of Thoracic and Cardiovascular Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Hao Chai
- Department of Thoracic and Cardiovascular Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Zhonghao Tao
- Department of Thoracic and Cardiovascular Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Shaowen Tang
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Zhibing Qiu
- Department of Thoracic and Cardiovascular Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Xin Chen
- Department of Thoracic and Cardiovascular Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
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Viteri Malone MA, Ares GR, De Velasco G, Brandão R, Lin X, Norton C, Simantov R, Moslehi J, Krajewski KM, Choueiri TK, McKay RR. The Clinical Presentation, Survival Outcomes, and Management of Patients With Renal Cell Carcinoma and Cardiac Metastasis Without Inferior Vena Cava Involvement: Results From a Pooled Clinical Trial Database and Systematic Review of Reported Cases. Clin Genitourin Cancer 2017; 16:e327-e333. [PMID: 29361425 DOI: 10.1016/j.clgc.2017.11.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 11/15/2017] [Accepted: 11/27/2017] [Indexed: 02/03/2023]
Abstract
BACKGROUND Cardiac metastases from renal cell carcinoma (RCC) are uncommon and there are limited data regarding the presentation and outcomes of this population. The objective of this study was to evaluate the characteristics and outcomes of patients with RCC with cardiac metastasis without inferior vena cava (IVC) involvement. MATERIALS AND METHODS We conducted a pooled retrospective analysis of metastatic RCC patients treated in 4 clinical trials. Additionally, we conducted a systematic review of cases reported in the literature from 1973 to 2015. Patients with cardiac metastases from RCC without IVC involvement were included. Patient and disease characteristics were described. Additionally, treatments, response to therapy, and survival outcomes were summarized. RESULTS Of 1765 metastatic RCC patients in the clinical trials database, 10 had cardiac metastases without IVC involvement. All patients received treatment with targeted therapy. There was 1 observed partial response (10%) and 6 patients showed stable disease (60%). The median progression-free survival was 6.9 months. The systematic review of reported clinical cases included 39 patients. In these patients, the most common cardiac site of involvement was the right ventricle (51%; n = 20). Patients were treated with medical (28%; n = 11) and/or surgical treatment (49%; n = 19) depending on whether disease was isolated (n = 13) or multifocal (n = 26). CONCLUSION To our knowledge, this is the first series to report on the presentation and outcomes of patients with cardiac metastasis without IVC involvement in RCC. We highlight that although the frequency of patients with cardiac metastases without IVC involvement is low, these patients have a unique clinical presentation and warrant special multidisciplinary management.
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Affiliation(s)
| | - Gustavo Ruiz Ares
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
| | | | - Raphael Brandão
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Xun Lin
- Pfizer Oncology, New York, NY
| | - Craig Norton
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
| | | | - Javid Moslehi
- Cardio-Oncology Program, Division of Cardiovascular Medicine, Department of Medicine, Vanderbilt University, Nashville, TN
| | | | - Toni K Choueiri
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Rana R McKay
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA; Department of Medicine, Division of Hematology/Oncology, University of California, San Diego, La Jolla, CA.
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22
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Shewale SD, Bhat P, Gupta AK, Manjunath CN. Right atrial spindle cell sarcoma as a rare cause of tricuspid stenosis. BMJ Case Rep 2016; 2016:bcr-2016-216373. [PMID: 27436036 DOI: 10.1136/bcr-2016-216373] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Spindle cell sarcomas of the right atrium are extremely rare primary cardiac tumours with very few cases reported in the medical literature. The prognosis of this malignant neoplasm remains poor due to delay in diagnosis, early metastasis and few available therapeutic options. It responds poorly to chemotherapy and radiotherapy. Surgical excision is the mainstay of treatment. We report a 42-year-old man, who presented to emergency room with dyspnoea and fatigue (New York Heart Association classification II) since 1 month. Transthoracic echocardiogram showed massive pericardial effusion with tamponade. The patient underwent emergency pericardiocentesis; postpericardiocentesis echocardiogram showed large right atrial mass involving the right ventricle and the tricuspid valve causing tricuspid stenosis. Findings were confirmed by cardiac CT scan. Percutaneous transvenous biopsy was carried out which revealed spindle cell sarcoma.
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Affiliation(s)
- Sunil D Shewale
- Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences & Research, Bangalore, Karnataka, India
| | - Prabhavathi Bhat
- Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences & Research, Bangalore, Karnataka, India
| | - Anshul Kumar Gupta
- Sri Jayadeva Institute of Cardiovascular Sciences & Research, Bangalore, Karnataka, India
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Yin L, He D, Shen H, Ling X, Li W, Xue Q, Wang Z. Surgical treatment of cardiac tumors: a 5-year experience from a single cardiac center. J Thorac Dis 2016; 8:911-9. [PMID: 27162666 DOI: 10.21037/jtd.2016.03.87] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Cardiac tumors are rare but manifested with various clinical presentations and often cause unexpected symptoms or sudden death. The objective is to review the clinical presentation, histopathological spectrum, mortality and follow-up data of patients with cardiac tumors following surgery treatment over a period of 5 years. METHODS We retrospectively collected the medical records of all patients diagnosed of cardiac tumors in the period between January 2008 and December 2013 at the cardiac center of our university. Clinical histories, perioperative data, surgical findings, efficacy and follow-up data were reviewed in our study. Patients were divided into two groups according to site distribution of the tumors in the heart. RESULTS A total of 131 patients underwent surgical treatment of cardiac tumors were enrolled in this study, with a mean age of 51.39±16.37. The result of analysis showed that 79.47% (n=104) of the primary intracardiac tumors were benign, while primary malignant neoplasms accounted for 16.03% (n=21) of all patients, with the remainder (n=6, 4.6%) metastatic tumors transferred from other organs. Among all patients there were 2 in-hospital deaths and the survival rate in all patients at 1-year, 3-year and 5-year follow up was 83.20%, 78.62% and 66.41% respectively. Both patients with tumors in the left and right heart had similar basic characteristics except sex gender (P=0.002), BSA (P=0.045) and weight (P=0.033). Compared with patients with tumors in the right heart, patients with tumors in the left heart had significant higher CPB time (P<0.001), cross clamp time (P<0.001) and time of mechanical ventilation (P<0.001), and they also had longer ICU stay (P<0.001) but not total hospital stay (P=0.434). CONCLUSIONS Surgical resection represents an effective protocol in treating cardiac tumors. Data in our study of cardiac tumors on frequency and allocation were consistent with previous reports which may provide useful clinical evidence on shared data, and data revealed that patients with malignant cardiac tumors had significant lower survival both in hospital and long-term follow-up.
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Affiliation(s)
- Liang Yin
- Department of Cardiothoracic Surgery, Changzheng Hospital, the Second Military Medical University, Shanghai 200003, China
| | - Dengke He
- Department of Cardiothoracic Surgery, Changzheng Hospital, the Second Military Medical University, Shanghai 200003, China
| | - Hua Shen
- Department of Cardiothoracic Surgery, Changzheng Hospital, the Second Military Medical University, Shanghai 200003, China
| | - Xinyu Ling
- Department of Cardiothoracic Surgery, Changzheng Hospital, the Second Military Medical University, Shanghai 200003, China
| | - Wei Li
- Department of Cardiothoracic Surgery, Changzheng Hospital, the Second Military Medical University, Shanghai 200003, China
| | - Qian Xue
- Department of Cardiothoracic Surgery, Changzheng Hospital, the Second Military Medical University, Shanghai 200003, China
| | - Zhinong Wang
- Department of Cardiothoracic Surgery, Changzheng Hospital, the Second Military Medical University, Shanghai 200003, China
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Costa DA, Barata P, Gouveia E, Mafra M. Right cardiac intracavitary metastases from a primary intracranial myxofibrosarcoma. BMJ Case Rep 2016; 2016:bcr-2015-214052. [PMID: 27013654 DOI: 10.1136/bcr-2015-214052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Primary intracranial myxofibrosarcoma is exceedingly rare, with less than 10 cases published. We present a case of a 23-year-old man with previous history of a primary low grade myxofibrosarcoma of the left parietal-occipital convexity resected in March 1999. He subsequently underwent several interventions for multiple local recurrent disease until March 2004. At that time, complete remission was documented. About 8 years later, in February 2012, the patient was admitted to the emergency room with refractory acute pulmonary oedema. On work up, sustained monomorphic ventricular tachycardia and hyperechoic myocardial mass with invasion of the right ventricular cavity were detected. Electrical cardioversion was unsuccessful and irreversible cardiac arrest followed. The autopsy confirmed multiple bilateral lung metastases, malignant pulmonary embolism and myocardial invasion by the primary tumour, with intracavitary cardiac thrombosis and absence of intracranial disease. To the best of our knowledge, this is the first report of extracranial metastases of this neoplasm.
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Affiliation(s)
- Diogo Alpuim Costa
- Department of Medical Oncology, Instituto Português de Oncologia de Lisboa Francisco Gentil, EPE, Lisbon, Portugal Underwater and Hyperbaric Medicine Centre, Portuguese Navy, Lisbon, Portugal Nova Medical School, Lisbon, Portugal
| | - Pedro Barata
- Nova Medical School, Lisbon, Portugal Department of Medical Oncology, Centro Hospitalar de Lisboa Central, Lisbon, Portugal
| | - Emanuel Gouveia
- Department of Medical Oncology, Instituto Português de Oncologia de Lisboa Francisco Gentil, EPE, Lisbon, Portugal
| | - Manuela Mafra
- Pathology Department, Centro Hospitalar de Lisboa Central, Lisbon, Portugal Instituto Português de Oncologia de Lisboa Francisco Gentil, EPE, Lisbon, Portugal
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Mori M, Hosoba S, Iturra S, Teo E, Jhanjee R, Thourani VH. Large Primary Right Ventricular Teratoma in an Adult. Ann Thorac Surg 2015; 99:1799-801. [DOI: 10.1016/j.athoracsur.2014.07.060] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2014] [Revised: 06/29/2014] [Accepted: 07/14/2014] [Indexed: 11/16/2022]
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Muturi A, Kotecha V, Ruturi J, Muhinga M, Waweru W. High-grade spindle cell sarcoma of the heart: a case report and review of literature. J Cardiothorac Surg 2015; 10:46. [PMID: 25888133 PMCID: PMC4382851 DOI: 10.1186/s13019-015-0245-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Accepted: 03/13/2015] [Indexed: 11/20/2022] Open
Abstract
Primary cardiac spindle cell sarcomas are extremely rare and have poor prognosis. Complete surgical resection represents the only treatment option proven to work. We report a case of a 28-year-old man who was referred to our cardiothoracic unit with a right ventricular mass extending to the main pulmonary artery with a provisional diagnosis of a thrombus or a right ventricular myxoma. He sought medical attention after experiencing shortness of breath, cough, chest pain, abdominal pain and bilateral leg swelling for about 6 weeks. Two dimensional transthoracic echocardiogram showed a mass arising from the right ventricle and extending into the main pulmonary artery; findings that were confirmed with contrast chest CT scan. He underwent extensive resection of the mass and had uneventful postoperative period with immediate symptomatic relieve. He is on adjuvant chemotherapy using vincristine, adriamycin and cyclophosphamide (VAC). Right ventricular sarcoma is a very rare cause of right sided heart failure, a very aggressive tumour whose only chance of successful treatment is complete surgical excision.
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Affiliation(s)
- Alex Muturi
- Department of Surgery, University of Nairobi, Nairobi, Kenya.
| | - Vihar Kotecha
- Department of Surgery, University of Nairobi, Nairobi, Kenya.
| | - Josiah Ruturi
- Department of Cardiothoracic Surgery, Kenyatta National Hospital, Nairobi, Kenya.
| | - Morris Muhinga
- Department of Cardiothoracic Surgery, Kenyatta National Hospital, Nairobi, Kenya.
| | - Wairimu Waweru
- Department of Pathology, University of Nairobi, Nairobi, Kenya.
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Pacini D, Careddu L, Pantaleo A, Parolari A, Leone O, Daprati A, Gargiulo GD, Di Bartolomeo R. Primary malignant tumors of the heart: Outcomes of the surgical treatment. Asian Cardiovasc Thorac Ann 2015; 23:645-51. [DOI: 10.1177/0218492315573674] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background Malignant cardiac tumors are rare and have an extremely poor prognosis even when complete resection is attempted. The aim of this study was to review the experience of primary malignant cardiac tumors in 2 Italian academic hospitals. Methods The hospital records were searched to identify patients with primary malignant cardiac tumors who underwent surgery between January 1979 and December 2012. Secondary cardiac tumors, whether metastatic or invasive, were excluded as were primary sarcomas of the great arteries. Fourteen patients selected from our institution’s surgical series were identified. Eleven (78.6%) were men and 3 (21.4%) were women, and the mean age at surgery was 47.4 years. Results The most common histological type was angiosarcoma (28.6%). The mean survival was 28.8 ± 28 months and it was better in men than in women (30.5 ± 8.7 vs. 21.1 ± 3.2 months). Patients with a radical resection at the first surgery had a longer survival compared to patients with a partial resection (39.9 ± 23.2 vs. 24 ± 4 months). Conclusions The treatment outcome for patients affected by primary malignant heart tumors remains poor. Aggressive surgery alone does not provide good results in terms of survival rate. A new multidisciplinary approach is mandatory to improve long-term survival.
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Affiliation(s)
- Davide Pacini
- Cardiac Surgery Department, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Lucio Careddu
- Pediatric Cardiac Surgery and GUCH Unit, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Antonio Pantaleo
- Cardiac Surgery Department, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | | | - Ornella Leone
- Department of Pathology, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Andrea Daprati
- Cardiac Surgery Department, Monzino Hospital, Milano, Italy
| | - Gaetano Domenico Gargiulo
- Pediatric Cardiac Surgery and GUCH Unit, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Roberto Di Bartolomeo
- Cardiac Surgery Department, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
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Bertrand D, Chng KR, Sherbaf FG, Kiesel A, Chia BKH, Sia YY, Huang SK, Hoon DSB, Liu ET, Hillmer A, Nagarajan N. Patient-specific driver gene prediction and risk assessment through integrated network analysis of cancer omics profiles. Nucleic Acids Res 2015; 43:e44. [PMID: 25572314 PMCID: PMC4402507 DOI: 10.1093/nar/gku1393] [Citation(s) in RCA: 83] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Accepted: 12/24/2014] [Indexed: 12/11/2022] Open
Abstract
Extensive and multi-dimensional data sets generated from recent cancer omics profiling projects have presented new challenges and opportunities for unraveling the complexity of cancer genome landscapes. In particular, distinguishing the unique complement of genes that drive tumorigenesis in each patient from a sea of passenger mutations is necessary for translating the full benefit of cancer genome sequencing into the clinic. We address this need by presenting a data integration framework (OncoIMPACT) to nominate patient-specific driver genes based on their phenotypic impact. Extensive in silico and in vitro validation helped establish OncoIMPACT's robustness, improved precision over competing approaches and verifiable patient and cell line specific predictions (2/2 and 6/7 true positives and negatives, respectively). In particular, we computationally predicted and experimentally validated the gene TRIM24 as a putative novel amplified driver in a melanoma patient. Applying OncoIMPACT to more than 1000 tumor samples, we generated patient-specific driver gene lists in five different cancer types to identify modes of synergistic action. We also provide the first demonstration that computationally derived driver mutation signatures can be overall superior to single gene and gene expression based signatures in enabling patient stratification and prognostication. Source code and executables for OncoIMPACT are freely available from http://sourceforge.net/projects/oncoimpact.
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Affiliation(s)
- Denis Bertrand
- Computational and Systems Biology, Genome Institute of Singapore, Singapore 138672, Singapore
| | - Kern Rei Chng
- Computational and Systems Biology, Genome Institute of Singapore, Singapore 138672, Singapore
| | - Faranak Ghazi Sherbaf
- Cancer Therapeutics and Stratified Oncology, Genome Institute of Singapore, Singapore 138672, Singapore
| | - Anja Kiesel
- Computational and Systems Biology, Genome Institute of Singapore, Singapore 138672, Singapore
| | - Burton K H Chia
- Computational and Systems Biology, Genome Institute of Singapore, Singapore 138672, Singapore
| | - Yee Yen Sia
- Cancer Therapeutics and Stratified Oncology, Genome Institute of Singapore, Singapore 138672, Singapore
| | - Sharon K Huang
- Department of Molecular Oncology, John Wayne Cancer Institute, Santa Monica, CA 90404, USA
| | - Dave S B Hoon
- Department of Molecular Oncology, John Wayne Cancer Institute, Santa Monica, CA 90404, USA
| | - Edison T Liu
- Cancer Therapeutics and Stratified Oncology, Genome Institute of Singapore, Singapore 138672, Singapore The Jackson Laboratory for Genomic Medicine, Farmington, CT 06030, USA
| | - Axel Hillmer
- Cancer Therapeutics and Stratified Oncology, Genome Institute of Singapore, Singapore 138672, Singapore
| | - Niranjan Nagarajan
- Computational and Systems Biology, Genome Institute of Singapore, Singapore 138672, Singapore
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29
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Yusuf SW, Reardon MJ, Banchs J. Cardiac tumors. Cardiology 2014; 129:197-8. [PMID: 25341877 DOI: 10.1159/000368074] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Accepted: 09/03/2014] [Indexed: 11/19/2022]
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Fu B, Yu H, Yang J. Primary intimal (spindle cell) sarcoma of the left atrium. Echocardiography 2014; 32:192-4. [PMID: 25196496 DOI: 10.1111/echo.12777] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Affiliation(s)
- Bo Fu
- Department of Cardiovascular Surgery, West China Hospital of Sichuan University, ChengDu, China
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31
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Pazos-López P, Pozo E, Siqueira ME, García-Lunar I, Cham M, Jacobi A, Macaluso F, Fuster V, Narula J, Sanz J. Value of CMR for the differential diagnosis of cardiac masses. JACC Cardiovasc Imaging 2014; 7:896-905. [PMID: 25129516 DOI: 10.1016/j.jcmg.2014.05.009] [Citation(s) in RCA: 129] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Revised: 05/12/2014] [Accepted: 05/13/2014] [Indexed: 12/15/2022]
Abstract
OBJECTIVES The goal of this study was to evaluate the diagnostic value of CMR features for the differential diagnosis of cardiac masses. BACKGROUND Differentiation of cardiac tumors and thrombi and differentiation of benign from malignant cardiac neoplasms is often challenging but important in clinical practice. Studies assessing the value of cardiac magnetic resonance (CMR) in this regard are scarce. METHODS We reviewed the CMR scans of patients with a definite cardiac thrombus or tumor. Mass characteristics on cine, T1-weighted turbo spin echo (T1w-TSE) and T2-weighted turbo spin echo (T2w-TSE), contrast first-pass perfusion (FPP), post-contrast inversion time (TI) scout, and late gadolinium enhancement (LGE) sequences were analyzed. RESULTS There were 84 thrombi, 17 benign tumors, and 25 malignant tumors in 116 patients. Morphologically, thrombi were smaller (median area 1.6 vs. 8.5 cm(2); p < 0.0001), more homogeneous (99% vs. 46%; p < 0.0001), and less mobile (13% vs. 33%; p = 0.007) than tumors. Hyperintensity compared with normal myocardium on T2w-TSE, FPP, and LGE were more common in tumors than in thrombi (85% vs. 42%, 70% vs. 4%, and 71% vs. 5%, respectively; all p < 0.0001). A pattern of hyperintensity/isointensity (compared with normal myocardium) with short TI and hypointensity with long TI was very frequent in thrombi (94%), rare in tumors (2%), and had the highest accuracy (95%) for the differentiation of both entities. Regarding the characterization of neoplastic masses, malignant tumors were larger (median area 11.9 vs. 6.3 cm(2); p = 0.006) and more frequently exhibited FPP (84% vs. 47%; p = 0.03) and LGE (92% vs. 41%; p = 0.001). The ability of CMR features to distinguish benign from malignant neoplasms was moderate, with LGE showing the highest accuracy (79%). CONCLUSIONS CMR features demonstrated excellent accuracy for the differentiation of cardiac thrombi from tumors and can be helpful for the distinction of benign versus malignant neoplasms.
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Affiliation(s)
- Pablo Pazos-López
- The Zena and Michael A. Wiener Cardiovascular Institute/Marie-Josée and Henry R. Kravis Center for Cardiovascular Health, Mount Sinai Hospital, New York, New York; Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain
| | - Eduardo Pozo
- The Zena and Michael A. Wiener Cardiovascular Institute/Marie-Josée and Henry R. Kravis Center for Cardiovascular Health, Mount Sinai Hospital, New York, New York
| | - Maria E Siqueira
- The Zena and Michael A. Wiener Cardiovascular Institute/Marie-Josée and Henry R. Kravis Center for Cardiovascular Health, Mount Sinai Hospital, New York, New York
| | - Inés García-Lunar
- The Zena and Michael A. Wiener Cardiovascular Institute/Marie-Josée and Henry R. Kravis Center for Cardiovascular Health, Mount Sinai Hospital, New York, New York; Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain
| | - Matthew Cham
- The Zena and Michael A. Wiener Cardiovascular Institute/Marie-Josée and Henry R. Kravis Center for Cardiovascular Health, Mount Sinai Hospital, New York, New York
| | - Adam Jacobi
- The Zena and Michael A. Wiener Cardiovascular Institute/Marie-Josée and Henry R. Kravis Center for Cardiovascular Health, Mount Sinai Hospital, New York, New York
| | - Frank Macaluso
- The Zena and Michael A. Wiener Cardiovascular Institute/Marie-Josée and Henry R. Kravis Center for Cardiovascular Health, Mount Sinai Hospital, New York, New York
| | - Valentín Fuster
- The Zena and Michael A. Wiener Cardiovascular Institute/Marie-Josée and Henry R. Kravis Center for Cardiovascular Health, Mount Sinai Hospital, New York, New York; Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain
| | - Jagat Narula
- The Zena and Michael A. Wiener Cardiovascular Institute/Marie-Josée and Henry R. Kravis Center for Cardiovascular Health, Mount Sinai Hospital, New York, New York
| | - Javier Sanz
- The Zena and Michael A. Wiener Cardiovascular Institute/Marie-Josée and Henry R. Kravis Center for Cardiovascular Health, Mount Sinai Hospital, New York, New York.
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Abstract
A 70-year-old man presented in advanced heart failure with jaundice. Transthoracic echocardiography revealed a 21 × 24-mm mass in the left atrium attached to the posterior mitral valve leaflet. Surgical excision was attempted, but the tumor had infiltrated the entire left atrial wall and was deemed too extensive to be resectable. Histology confirmed a high-grade pleomorphic sarcoma with malignant fibrous histiocytoma-like features. Liver biopsy revealed a high-grade liver sarcoma.
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Affiliation(s)
- Wern Miin Soo
- Cardiac Department, National University Heart Centre, Singapore Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Yin Huei Pang
- Pathology Department, National University Health System, Singapore
| | - Kian-Keong Poh
- Cardiac Department, National University Heart Centre, Singapore Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Primary malignant cardiac tumors. J Cancer Res Clin Oncol 2014; 140:1047-55. [DOI: 10.1007/s00432-014-1651-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Accepted: 03/14/2014] [Indexed: 10/25/2022]
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Thariat J, Clément-Colmou K, Vogin G, Beckendorf V, Ducassou A, Ali AM, Salas S, Saada E, Thyss A, Lapeyre M, Isambert N. [Radiation therapy of cardiac sarcomas]. Cancer Radiother 2014; 18:125-31. [PMID: 24637021 DOI: 10.1016/j.canrad.2014.02.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2013] [Revised: 12/23/2013] [Accepted: 02/05/2014] [Indexed: 11/16/2022]
Abstract
PURPOSE Primary cardiac sarcomas represent less than 10 yearly cases in France. Their median survival is approximately 18 months. The treatment consists of surgery when possible. The role of chemotherapy and radiation therapy is controversial, especially with respect to limiting cardiac radiation dose that is theoretically incompatible with the requirement of a tumoricidal dose for sarcoma. A recent series of 124 cases of the French Sarcoma Group suggested a benefit of radiation therapy on progression-free survival. PATIENTS AND METHODS The dosimetric data of 12 patients were analyzed. RESULTS There was variety in radiotherapy modalities and definition of target volumes, doses and techniques are evolving more conformal plans. Irradiation appeared feasible with conventional fractionation with respect to toxicities (although probably underestimated due to short follow-up and dismal prognosis) and previously demonstrated benefit of radiotherapy for primitive cardiac sarcomas. CONCLUSION A scheme of 45Gy in 1.8Gy per fraction to a preoperative volume with an additional dose of 14Gy in 7 fractions on areas at risk or residual disease and margins 1cm, may be proposed based on the preliminary data of this study. Intensity modulated radiotherapy with daily cone-beam CT-scanner should be evaluated.
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Affiliation(s)
- J Thariat
- Département d'oncologie-radiothérapie, centre Antoine-Lacassagne, 227, avenue de la Lanterne, 06200 Nice, France; Université Nice Sophia-Antipolis, 06200 Nice, France.
| | - K Clément-Colmou
- Oncologie-radiothérapie, centre René-Gauducheau, institut de cancérologie de l'Ouest, 44805 Saint-Herblain, France
| | - G Vogin
- Oncologie-radiothérapie, centre Alexis-Vautrin, institut de cancérologie de Lorraine, 6, avenue de Bourgogne, 54519 Vandœuvre-lès-Nancy, France
| | - V Beckendorf
- Oncologie-radiothérapie, centre Alexis-Vautrin, institut de cancérologie de Lorraine, 6, avenue de Bourgogne, 54519 Vandœuvre-lès-Nancy, France
| | - A Ducassou
- Oncologie-radiothérapie, centre Claudius-Regaud, 20-24, rue du Pont-Saint-Pierre, 31300 Toulouse, France
| | - A M Ali
- Clinical oncology, Sohag University, Sohag, Égypte
| | - S Salas
- Oncologie médicale, CHU la Timone, AP-HM, 264, rue Saint-Pierre, 13005 Marseille, France
| | - E Saada
- Oncologie médicale, centre Antoine-Lacassagne, 227, avenue de la Lanterne, 06200 Nice, France
| | - A Thyss
- Oncologie médicale, centre Antoine-Lacassagne, 227, avenue de la Lanterne, 06200 Nice, France
| | - M Lapeyre
- Oncologie-radiothérapie, centre Jean-Perrin, 58, rue Montalembert, 63000 Clermont-Ferrand, France
| | - N Isambert
- Oncologie médicale, centre Georges-Francois-Leclerc, 1, rue du Professeur-Marion, 21000 Dijon, France
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Kośmider A, Jaszewski R, Marcinkiewicz A, Bartczak K, Knopik J, Ostrowski S. 23-year experience on diagnosis and surgical treatment of benign and malignant cardiac tumors. Arch Med Sci 2013; 9:826-30. [PMID: 24273564 PMCID: PMC3832829 DOI: 10.5114/aoms.2013.38677] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2010] [Revised: 12/15/2010] [Accepted: 01/31/2011] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Although myxoma is the most frequent cardiac tumor, other conditions should be taken into consideration in the differential diagnosis. Transthoracic echocardiography (TTE), followed by transesophageal echocardiography (TEE) remain the principal methods for cardiac tumor screening and visualizing. The aim of the study was to compare the diagnostics, surgical treatment and prognosis of malignant and benign cardiac tumors. MATERIAL AND METHODS From 1986 to 2009 there were 121 patients with cardiac tumors operated on in the Cardiac Surgery Clinic of the Medical University in Lodz. Patients were referred to surgery mainly on the basis of the TTE and TEE image. In 4 cases valvular prosthesis implantation or valve repair were carried out. Patients remained under long-term observation in the Cardiac Surgery Outpatient Clinic. RESULTS Myxoma was diagnosed in 114 cases. Malignancies were discovered in 7 cases. The left atrium was the most frequent localization. The echocardiographic image differed significantly in benign and malignant tumors. The postoperative period was complicated by embolic events or myocardial infarctions. Only malignant tumors were associated with mortality due to cardiovascular events. The survival for malignant tumors was significantly shorter. CONCLUSIONS Short and long-term results of operative treatment are very good for benign tumors in contrast to cardiac malignancies. The TTE and TEE image can be very significant in the final diagnosis.
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Affiliation(s)
- Anna Kośmider
- Military Teaching Hospital, Veterans Central Hospital, Medical University of Lodz, Poland
| | - Ryszard Jaszewski
- Cardiac Surgery Clinic, Chair of Cardiology and Cardiac Surgery, Medical University of Lodz, Poland
| | - Anna Marcinkiewicz
- Cardiac Surgery Clinic, Chair of Cardiology and Cardiac Surgery, Medical University of Lodz, Poland
| | - Karol Bartczak
- Cardiac Surgery Clinic, Chair of Cardiology and Cardiac Surgery, Medical University of Lodz, Poland
| | - Jerzy Knopik
- Cardiac Surgery Clinic, Chair of Cardiology and Cardiac Surgery, Medical University of Lodz, Poland
| | - Stanisław Ostrowski
- Cardiac Surgery Clinic, Chair of Cardiology and Cardiac Surgery, Medical University of Lodz, Poland
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Isambert N, Ray-Coquard I, Italiano A, Rios M, Kerbrat P, Gauthier M, Blouet A, Chaigneau L, Duffaud F, Piperno-Neumann S, Kurtz JE, Girard N, Collard O, Bompas E, Penel N, Bay JO, Guillemet C, Collin F, Blay JY, Le Cesne A, Thariat J. Primary cardiac sarcomas: a retrospective study of the French Sarcoma Group. Eur J Cancer 2013; 50:128-36. [PMID: 24135684 DOI: 10.1016/j.ejca.2013.09.012] [Citation(s) in RCA: 103] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Accepted: 09/19/2013] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Primary cardiac sarcomas (PCS) are rare tumours of dismal prognosis. METHODS Data of 124 patients with PCS referred to institutions of the French Sarcoma Group (FSG) from 1977 and 2010 were reviewed. RESULTS Median age was 48.8years. PCS were poorly-differentiated sarcomas (N=45, 36.3%), angiosarcomas (N=40, 32.3%), leiomyosarcomas (N=16, 12.9%) and others (N=23, 18.6%). At diagnosis, 100 patients (80.6%) were localised and 24 (19.4%) metastatic. Tumours were located in the right (N=47, 38.8%), left atrial cavities (N=45, 37.2%) or encompassed several locations in nine cases (7.4%). Surgery was performed in 81 cases (65.3%). Heart transplant was performed in five patients. Radiotherapy adjuvant (N=18, 14.5%) or alone (N=6, 4.8%) was performed in non-metastatic patients only (N=24, 19.4%). With a median follow-up of 51.2months, median overall survival (OS) was 17.2months for the entire cohort, 38.8months after complete resection versus 18.2 after incomplete resection and 11.2months in non-resected patients. Radiotherapy was associated with improved progression-free survival (PFS) on multivariate analysis. Chemotherapy was significantly associated with better OS only in non-operated patients but not in operated patients. In non-metastatic patients, surgery (hazard ratio [HR]=0.42, p<0.001), male gender (HR=0.56, p=.032) was associated with better OS and surgery (HR=0.61; p=.076), radiotherapy (HR=0.43; p=.004) and chemotherapy (HR=0.30, p=.003) improved PFS. CONCLUSION Only surgical resection is associated with a perspective of prolonged survival. Chemotherapy is associated with a better outcome in non-resected patients.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - Olivier Collard
- Institut de Cancérologie Lucien Neuwirth, Saint-Priest-en-Jarez, France
| | - Emmanuelle Bompas
- Institut de Cancérologie de l'Ouest René Gauducheau, Saint Herblain, France
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Motwani M, Kidambi A, Herzog BA, Uddin A, Greenwood JP, Plein S. MR imaging of cardiac tumors and masses: a review of methods and clinical applications. Radiology 2013; 268:26-43. [PMID: 23793590 DOI: 10.1148/radiol.13121239] [Citation(s) in RCA: 239] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Cardiac masses are usually first detected at echocardiography. In their further evaluation, cardiac magnetic resonance (MR) imaging has become a highly valuable technique. MR imaging offers incremental value owing to its larger field of view, superior tissue contrast, versatility in image planes, and unique ability to enable discrimination of different tissue characteristics, such as water and fat content, which give rise to particular signal patterns with T1- and T2-weighted techniques. With contrast material-enhanced MR imaging, additional tissue properties such as vascularity and fibrosis can be demonstrated. MR imaging can therefore contribute to the diagnosis of a cardiac mass as well as be used to detail its relationship to other cardiac and extracardiac structures. These assessments are important to plan therapy, such as surgical intervention. In addition, serial MR studies can be used to monitor tumor regression after surgery or chemotherapy. Primary cardiac tumors are very rare; metastases and pseudotumors (eg, thrombus) are much more common. This article provides an overview of cardiac masses and reviews the optimal MR imaging techniques for their assessment.
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Affiliation(s)
- Manish Motwani
- Multidisciplinary Cardiovascular Research Centre and Leeds Institute of Genetics, Health and Therapeutics, University of Leeds, Leeds LS2 9JT, England
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Wang JG, Li NN. Primary cardiac synovial sarcoma. Ann Thorac Surg 2013; 95:2202-9. [PMID: 23647858 DOI: 10.1016/j.athoracsur.2013.01.030] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2013] [Revised: 01/10/2013] [Accepted: 01/18/2013] [Indexed: 11/27/2022]
Abstract
Primary cardiac synovial sarcoma is an extremely rare entity. The clinical and pathologic characteristics are still poorly understood, and prognostic factors influencing overall survival are still unknown. In the present study, all characteristics of reported patients, including sex, age, clinical presentations, laboratory tests, electrocardiogram, imaging findings, pathology, location, therapy, and follow-up were carefully reviewed and survival analysis was performed. The present study has summarized some key features and may provide an effective consultation for the diagnosis and treatment of the tumor.
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Affiliation(s)
- Ji-Gang Wang
- Department of Pathology, The Affiliated Hospital of Medical College, Qingdao University, Qingdao, China.
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Primary intimal (spindle cell) sarcoma of the heart: a case report and review of the literature. Case Rep Med 2013; 2013:461815. [PMID: 23424592 PMCID: PMC3568891 DOI: 10.1155/2013/461815] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2012] [Accepted: 12/17/2012] [Indexed: 11/17/2022] Open
Abstract
Intimal (spindle cell) sarcomas of the left atrium are extremely rare primary cardiac tumours with three cases reported (Li et al. (2013), Cho et al. (2006), and Modi et al. (2009)). We present a 69-year-old man who first came to medical attention after experiencing abdominal discomfort. He had a 30 lb weight loss apparently due to dieting. He denied any other constitutional symptoms. His symptoms persisted despite a course of antibiotics for presumed diverticulitis. Laboratory values were within normal limits, though the haemoglobin was 131 g/L (normal: 140-180). Subsequent abdominal computed tomography (CT) scan revealed an abdominal wall mass and intracardiac lesion; the cardiac mass was further characterized by transesophageal echo (TEE), magnetic resonance imaging (MRI), and dedicated cardiac CT. TEE revealed a mass attached to the posterolateral wall of the left atrium above the mitral annulus, and the cardiac CT and MRI confirmed the TEE findings. The patient underwent extensive surgical resection and repair of the left side of the heart. Postoperatively, he developed acute renal failure requiring dialysis and reintubation for volume overload. He became acutely hypotensive, developed multiorgan failure, and succumbed to his illness. Histopathologic examination of the left atrial mass showed an intimal sarcoma.
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40
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Katalinic D, Stern-Padovan R, Ivanac I, Aleric I, Tentor D, Nikolac N, Santek F, Juretic A, Plestina S. Symptomatic cardiac metastases of breast cancer 27 years after mastectomy: a case report with literature review--pathophysiology of molecular mechanisms and metastatic pathways, clinical aspects, diagnostic procedures and treatment modalities. World J Surg Oncol 2013; 11:14. [PMID: 23343205 PMCID: PMC3562152 DOI: 10.1186/1477-7819-11-14] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2012] [Accepted: 01/13/2013] [Indexed: 01/06/2023] Open
Abstract
Metastases to the heart and pericardium are rare but more common than primary cardiac tumours and are generally associated with a rather poor prognosis. Most cases are clinically silent and are undiagnosed in vivo until the autopsy. We present a female patient with a 27-year-old history of an operated primary breast cancer who was presented with dyspnoea, paroxysmal nocturnal dyspnoea and orthopnoea. The clinical signs and symptoms aroused suspicion of congestive heart failure. However, the cardiac metastases were detected during a routine cardiologic evaluation and confirmed with computed tomography imaging. Additionally, this paper outlines the pathophysiology of molecular and clinical mechanisms involved in the metastatic spreading, clinical presentation, diagnostic procedures and treatment of heart metastases. The present case demonstrates that a complete surgical resection and systemic chemotherapy may result in a favourable outcome for many years. However, a lifelong medical follow-up, with the purpose of a detection of metastases, is highly recommended. We strongly call the attention of clinicians to the fact that during the follow-up of all cancer patients, such heart failure may be a harbinger of the secondary heart involvement.
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Affiliation(s)
- Darko Katalinic
- Department of Oncology, University Hospital Centre (KBC Zagreb), University of Zagreb School of Medicine, Kispaticeva 12, Zagreb, Croatia.
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41
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Scott JP, Troshynski TJ, Clarke WR, Woods RK, Lal DR, Berens RJ, Tower RL. Case report: giant cardiac malignancy in a nine-year-old female. Can J Anaesth 2012; 59:1048-51. [PMID: 22936572 DOI: 10.1007/s12630-012-9780-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2012] [Accepted: 08/23/2012] [Indexed: 10/28/2022] Open
Abstract
PURPOSE To describe the management of a giant cardiac malignancy initially diagnosed as an anterior mediastinal mass. CLINICAL FEATURES A nine-year-old female with right facial swelling and chronic cough was diagnosed with a large right mediastinal mass. Intermittent ventricular and supraventricular arrhythmias were noted on admission electrocardiograms. Empiric corticosteroid and radiation therapy did not reduce the size of the tumour, and initial tissue biopsies were non-diagnostic. Due to worsening tamponade physiology and persistent arrhythmias, the patient was scheduled for tumour debulking with potential resection. Prior to surgery, a multidisciplinary team was assembled to delineate team member responsibilities and treatment algorithms. The procedure was performed under general anesthesia with spontaneous ventilation preserved during endotracheal intubation and invasive line placement. The team was prepared to provide extracorporeal mechanical support if needed. The child required inotropic and vasoactive medications after transitioning to positive pressure ventilation, but her hemodynamics improved with sternotomy. The lesion was identified as a malignant cardiac clear-cell tumour that was unresectable. Her sternum was left open, as attempted closure led to the re-creation of tamponade physiology. She underwent delayed sternal closure days later. After months of chemotherapy that resulted in significant tumour involution, she underwent successful surgical resection. CONCLUSION Giant primary cardiac tumours may present similarly to large anterior mediastinal masses. The care of patients with these lesions requires an understanding of the risks associated with mediastinal masses as well as those unique to cardiac tumours. A multidisciplinary approach is critical to providing safe and effective care throughout this process.
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Affiliation(s)
- John P Scott
- Section of Pediatric Anesthesia, Department of Anesthesiology, Medical College of Wisconsin, Children's Hospital of Wisconsin, 9000 W. Wisconsin Avenue, Milwaukee, WI, 53201, USA.
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Corradi D, Contini GA, Gherli T, Nicolini F. A left atrial myxomalike rhabdomyosarcoma. J Thorac Cardiovasc Surg 2012; 144:e7-10. [PMID: 22551770 DOI: 10.1016/j.jtcvs.2012.03.073] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2012] [Accepted: 03/30/2012] [Indexed: 11/13/2022]
Affiliation(s)
- Domenico Corradi
- Section of Pathology, Department of Pathology and Laboratory Medicine, University of Parma, Parma, Italy.
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Chhabra A, McClung JA, Kalapatapu S, Lafaro RJ, Fallon JT, Aronow WS. Giant myxoma causing heart failure symptoms. AMERICAN JOURNAL OF CASE REPORTS 2012; 13:29-32. [PMID: 23569480 PMCID: PMC3616051 DOI: 10.12659/ajcr.882593] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2012] [Accepted: 03/06/2012] [Indexed: 11/17/2022]
Abstract
BACKGROUND Myxomas arising from the eustachian valve are exceedingly rare. CASE REPORT A 72-year-old Jamaican-Chinese woman was evaluated for worsening dyspnea. The 2-dimensional and real time 3-dimensional transesophageal echocardiogram showed a 75 mm length × 44 mm width, multilobulated, mobile mass arising from the eustachian valve occupying the entire right atrial and right ventricular cavities extending into the coronary sinus, right ventricular outflow tract, and proximal inferior vena cava. The patient underwent successful resection of the mass and replacement of the tricuspid valve. Histopathologic examination confirmed the diagnosis of atrial myxoma. CONCLUSIONS This is the largest myxoma found on a Eustachian valve.
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Affiliation(s)
- Amit Chhabra
- Cardiology Division, Department of Medicine, Westchester Medical Center/New York Medical College, Valhalla, NY, U.S.A
| | - John A. McClung
- Cardiology Division, Department of Medicine, Westchester Medical Center/New York Medical College, Valhalla, NY, U.S.A
| | - Srirama Kalapatapu
- Cardiology Division, Department of Medicine, Westchester Medical Center/New York Medical College, Valhalla, NY, U.S.A
| | - Rocco J. Lafaro
- Cardiology Division, Department of Medicine, Westchester Medical Center/New York Medical College, Valhalla, NY, U.S.A
| | - John T. Fallon
- Cardiology Division, Department of Medicine, Westchester Medical Center/New York Medical College, Valhalla, NY, U.S.A
| | - Wilbert S. Aronow
- Cardiology Division, Department of Medicine, Westchester Medical Center/New York Medical College, Valhalla, NY, U.S.A
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Yusuf SW, Bathina JD, Qureshi S, Kaynak HE, Banchs J, Trent JC, Ravi V, Daher IN, Swafford J. Cardiac tumors in a tertiary care cancer hospital: clinical features, echocardiographic findings, treatment and outcomes. Heart Int 2012; 7:e4. [PMID: 22690297 PMCID: PMC3366300 DOI: 10.4081/hi.2012.e4] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2011] [Accepted: 01/09/2012] [Indexed: 11/25/2022] Open
Abstract
Cardiac tumors are a rare entity, comprised of tumors with diverse histology and natural history. We report the clinical characteristics, echocardiograhic findings, therapy and outcome of 59 patients with primary and metastatic cardiac tumors. Our institutional echocardiogram data base from 1993 through 2005 was reviewed to identify patients diagnosed with intra-cardiac tumor. A total of 59 patients with cardiac tumors were identified and included in the study. The patients' characteristics, presenting symptoms, diagnostic tests, location, histology of the tumor, treatment and the one year survival rate of this population was collected from the medical records. Of the 59 cardiac tumor cases, 16 (27%) were primary cardiac tumors and 43 (73%) were secondary cardiac tumors. The most common primary tumor was sarcoma affecting 13 (81%) of the 16 cases. Of these, 5 patients were angiosarcoma, 5 unclassified sarcoma, one myxoid sarcoma and 2 malignant fibrous histiocytoma. The mean age at presentation was 41.1 years, and the most common location was right atrium affecting 6 cases (37.5%). The most common symptom of dyspnea was present in 10 (62.5%) cases. Eleven (25.6%) of the 43 secondary cardiac tumors were metastasis from renal cell carcinoma. The mean age at presentation was 55.4 years. Right atrium was the most frequent location affecting 18 (42%) of the 43 patients. The most common presenting symptom was dyspnea in 15 (35%) cases. For both primary and secondary tumors, dyspnea was the most common symptom and right atrium was most frequently involved. Sarcoma was the most common primary cardiac tumor while metastasis from renal cell carcinoma was the most common secondary tumor.
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Affiliation(s)
| | | | | | | | | | - Jonathan C. Trent
- Department of Sarcoma Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Vinod Ravi
- Department of Sarcoma Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Pacini D, Careddu L, Pantaleo A, Berretta P, Leone O, Marinelli G, Gargiulo G, Di Bartolomeo R. Primary benign cardiac tumours: long-term results. Eur J Cardiothorac Surg 2011; 41:812-9. [PMID: 22219403 DOI: 10.1093/ejcts/ezr067] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Primary heart tumours are rare lesions with variegated histological types. We reviewed our 35 years experience with a significant number of primary benign cardiac tumour cases. METHODS The patient database at University of Bologna was searched to identify patients with primary cardiac tumours between 1974 and 2009. Benign tumours were classified as myxomas and non-myxomas. Ninety-four were myxomas (mean age of 59.1 ± 15.6), and 13 were benign non-myxomas tumours (mean age of 39.7 ± 24.9; P = 0.0001). Complete resection of the masses was performed in all cases except in one. RESULTS In-hospital mortality was 3% in the myxoma group and 8% in the non-myxoma group. The mean follow-up was 15.1 and 7.4 years for the myxoma and non-myxoma groups, respectively. The long-term survival of discharged patients was 68 ± 7% for the myxoma group and 100% for the non-myxoma group at 20 years, respectively. Recurrence of a tumour occurred only in the myxoma group (four cases) after 1, 3, 5 and 8 years, respectively. Twenty patients had an extracardiac tumour that was diagnosed before operation in 12 (11 in the myxoma group) and during the follow-up in 8 patients (only in the myxoma group). CONCLUSIONS Primary cardiac tumours can be surgically treated with good short- and long-term results. Mortality and morbidity are mainly due to the status of preoperative patients'. An accurate follow-up is mandatory in order to detect the recurrence of a cardiac tumour such as to exclude the presence or the development of extracardiac tumours that we found frequently associated with the myxoma.
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Affiliation(s)
- Davide Pacini
- Department of Cardiac Surgery, S Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
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Kumar N, Agarwal S, Ahuja A, Das P, Airon B, Ray R. Spectrum of cardiac tumors excluding myxoma: Experience of a tertiary center with review of the literature. Pathol Res Pract 2011; 207:769-74. [DOI: 10.1016/j.prp.2011.09.014] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2011] [Revised: 09/07/2011] [Accepted: 09/24/2011] [Indexed: 11/27/2022]
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Onan B, Haydin S, Onan IS, Akdeniz C, Odemis E, Bakir I. Giant tumor of the right atrium in infancy. Ann Thorac Surg 2011; 92:737-40. [PMID: 21801937 DOI: 10.1016/j.athoracsur.2011.02.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2011] [Revised: 01/24/2011] [Accepted: 02/07/2011] [Indexed: 11/29/2022]
Abstract
Cardiac hemangiomas can occur at any age, but they are extremely rare when they occur early after birth. We describe the case of a 5-month-old infant who had a giant right atrial capillary hemangioma associated with massive pericardial effusion. The tumor was incidentally diagnosed during routine clinical follow-up. The hemangioma was removed successfully under cardiopulmonary bypass, and the patient's postoperative course was uneventful. The occurrence of giant capillary hemangioma in infancy represents an unusual event in the relevant literature. Herein, we discuss the clinical features and surgical management of this rare primary tumor of infancy.
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Affiliation(s)
- Burak Onan
- Department of Cardiovascular Surgery, Pediatric Cardiac Surgery Division, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education & Research Hospital, Istanbul, Turkey
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Delays in diagnostics and treatment of cardiac tumors are unacceptable. Int J Cardiol 2011; 147:157-8. [DOI: 10.1016/j.ijcard.2010.05.054] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2010] [Accepted: 05/30/2010] [Indexed: 11/21/2022]
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Hrabak-Paar M, Hübner M, Štern-Padovan R, Lušić M. Hemangioma of the Interatrial Septum: CT and MRI Features. Cardiovasc Intervent Radiol 2010; 34 Suppl 2:S90-3. [DOI: 10.1007/s00270-010-0062-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2010] [Accepted: 11/19/2010] [Indexed: 10/18/2022]
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50
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Kwon HY, Cho KI, Kim SM, Lee HG, Hwang CS, Kim HJ, Kang JH, Kim MJ, Jang KT, Kim TI. A rare case with primary undifferentiated carcinoma of pericardium. J Cardiovasc Ultrasound 2010; 18:104-7. [PMID: 20967159 DOI: 10.4250/jcu.2010.18.3.104] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2010] [Revised: 07/21/2010] [Accepted: 08/17/2010] [Indexed: 11/22/2022] Open
Abstract
A primary pericardial tumor is very rare. A 77-year-old woman was admitted to our hospital with chief complaint of exertional dyspnea due to large amount of pericardial effusion. She was finally diagnosed as pericardial undifferentiated carcinoma without definite histopathologial, immunochemistry feature. Despite palliative radiation therapy, the patient died of multiple organ failure. The prognosis of primary pericardial undifferentiated carcinoma is known to be very poor, especially in old people.
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Affiliation(s)
- Hyuk Yong Kwon
- Division of Cardiology, Department of Internal Medicine, Maryknoll Medical Center, Busan, Korea
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