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Carreon CK, Sanders SP, Perez-Atayde AR, del Nido PJ, Walsh EP, Geva T, Alexander ME. Interdigitating Myocardial Tongues in Pediatric Cardiac Fibromas. JACC Clin Electrophysiol 2019; 5:563-575. [DOI: 10.1016/j.jacep.2019.01.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 01/16/2019] [Accepted: 01/31/2019] [Indexed: 10/27/2022]
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2
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Yuan SM. Fetal Primary Cardiac Tumors During Perinatal Period. Pediatr Neonatol 2017; 58:205-210. [PMID: 28043830 DOI: 10.1016/j.pedneo.2016.07.004] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Revised: 04/27/2016] [Accepted: 07/15/2016] [Indexed: 11/15/2022] Open
Abstract
Fetal primary cardiac tumors are rare, but they may cause complications, which are sometimes life threatening, including arrhythmias, hydrops fetalis, ventricular outflow/inflow obstruction, cardiac failure, and even sudden death. Among fetal primary cardiac tumors, rhabdomyomas are most common, followed by teratomas, fibromas, hemangiomas, and myxomas. Everolimus, a mammalian target of rapamycin inhibitor, has been reported to be an effective drug to cause tumor remission in three neonates with multiple cardiac rhabdomyomas. Neonatal cardiac surgery for the resection of primary cardiac tumors found by fetal echocardiography has been reported sporadically. However, open fetal surgery for pericardial teratoma resection, which was performed successfully via a fetal median sternotomy in one case report, could be a promising intervention to rescue these patients with large pericardial effusions. These recent achievements undoubtedly encourage further development in early management of fetal cardiac tumors. Owing to the rarity of fetal primary cardiac tumors, relevant information in terms of prenatal diagnosis, treatment, and prognosis remains to be clarified.
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Affiliation(s)
- Shi-Min Yuan
- Department of Cardiothoracic Surgery, The First Hospital of Putian, Teaching Hospital, Fujian Medical University, Putian 351100, Fujian Province, China.
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3
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Zhang Q, Wang T, Wang D, Liu J, Yu W, Liu X, Xiang X, Dong K, You F, Zhang G, Ju J, Zhu M, Duan W, Qiao B. Somatic copy number losses on chromosome 9q21.33q22.33 encompassing the PTCH1 loci associated with cardiac fibroma. Cancer Genet 2015; 208:615-20. [DOI: 10.1016/j.cancergen.2015.09.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Revised: 08/12/2015] [Accepted: 09/20/2015] [Indexed: 12/25/2022]
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4
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István K, Törő K, Kardos M, Imre C, György D, Ágnes N. Sudden Death Due to Infiltration of Left Bundle Branches by Interventricular Septal Cardiac Fibroma. J Forensic Sci 2012; 57:1669-74. [DOI: 10.1111/j.1556-4029.2012.02255.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2011] [Revised: 08/25/2011] [Accepted: 09/17/2011] [Indexed: 11/28/2022]
Affiliation(s)
- Kristóf István
- Department of Forensic and Insurance Medicine; Semmelweis University; Üllői út 93; 1091; Budapest; Hungary
| | - Klára Törő
- Department of Forensic and Insurance Medicine; Semmelweis University; Üllői út 93; 1091; Budapest; Hungary
| | - Magdolna Kardos
- 2nd Department of Pathology; Semmelweis University; Üllői út 93; 1091; Budapest; Hungary
| | - Czirják Imre
- Department of Forensic and Insurance Medicine; Semmelweis University; Üllői út 93; 1091; Budapest; Hungary
| | - Dunay György
- Department of Forensic and Insurance Medicine; Semmelweis University; Üllői út 93; 1091; Budapest; Hungary
| | - Nemeskéri Ágnes
- Department of Human Morphology and Developmental Biology; Semmelweis University; Tűzoltó u. 58; 1094; Budapest; Hungary
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5
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Abstract
Fibroblastic and myofibroblastic tumors in children and adolescents are a relatively common group of soft tissue proliferations that range from reactive to hamartomatous to neoplastic, with a full spectrum of benign, intermediate, and malignant neoplasms. These lesions are diagnostically challenging because of morphologic and immunohistochemical overlap, despite significant clinical, genetic, and prognostic differences. The fibromatoses are a major subgroup, and all types of fibromatoses can occur in the 1st 2 decades of life. Intermediate and malignant fibroblastic-myofibroblastic tumors are an important group that includes variants of fibrosarcoma and other tumors with recurrent cytogenetic or molecular genetic abnormalities and low metastatic potential. Pathologic examination is enhanced by adjunct techniques, such as immunohistochemistry, cytogenetics, and molecular genetics, although morphology provides the ultimate criteria for a specific diagnosis. This article reviews the clinicopathologic features of fibroblastic and myofibroblastic tumors with an emphasis on the unique aspects of these neoplasms in children and adolescents, the use of diagnostic adjuncts, and differential diagnoses.
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Affiliation(s)
- Cheryl M Coffin
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University, Nashville, TN, USA.
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6
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Torimitsu S, Nemoto T, Wakayama M, Okubo Y, Yokose T, Kitahara K, Ozawa T, Nakayama H, Shinozaki M, Sasai D, Ishiwatari T, Takuma K, Shibuya K. Literature survey on epidemiology and pathology of cardiac fibroma. Eur J Med Res 2012; 17:5. [PMID: 22472419 PMCID: PMC3351722 DOI: 10.1186/2047-783x-17-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2011] [Accepted: 03/27/2012] [Indexed: 11/10/2022] Open
Abstract
Background Although cardiac fibroma has been regarded as benign tumor, it presents various symptoms and may lead to death. Unfortunately, only a few studies have reported the epidemiology, embryology, and histopathology of the tumor, and the factors predicting poorer outcome are still obscured. Methods In July 2011 we searched for English and Japanese cases of cardiac fibroma using the PubMed and IgakuChuoZasshi databases. We then extracted and sampled raw data from the selected publications in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) style as much as was possible. Results Details of a total of 178 patients with cardiac fibroma were retrieved. The mean age was 11.4 years (median: 2.8 years). Tumor sizes ranged from 8.0 to 150.0 mm (mean 53.1 mm). The left ventricle was found to be the most common site associated with the tumor at a rate of 57.3%, followed by the right ventricle, and interventricular septum. The highest mortality was found in patients with septal involvement (58.6%). In all, 111 patients survived among the 160 patients with a recorded outcome. A younger age of the patient at the time of diagnosis was associated with a decreased survival rate. In addition, a significant positive association was found between ages for patients younger than 17 years of age and the diameter of the tumor at the time of diagnosis (r = 0.341, P = 0.006). Conclusions Both the younger age of patients at the time of diagnosis and septal involvement can be regarded as factors significantly indicating a poor prognosis. Furthermore, our statistical analyses support the following hypotheses. First, the high ratio of tumor-to-heart size may generate low cardiac output and therefore lead to poor outcome. Second, the ratio of the sites where cardiac fibroma occurred corresponds with the ratio of the muscular weight of the cardiac chamber. Third, cardiac fibroma involving the interventricular septum more frequently induces conduction system disease.
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Affiliation(s)
- Suguru Torimitsu
- Department of Surgical Pathology, Toho University School of Medicine, 6-11-1 Omori-Nishi, Ota-Ku, Tokyo 143-8541, Japan
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7
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Jain D, Maleszewski JJ, Halushka MK. Benign cardiac tumors and tumorlike conditions. Ann Diagn Pathol 2010; 14:215-30. [DOI: 10.1016/j.anndiagpath.2009.12.010] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2009] [Accepted: 12/22/2009] [Indexed: 10/19/2022]
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8
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Bell DM, Dekmezian RH, Husain SA, Luna MA. Oral calcifying fibrous pseudotumor: case analysis and review. Head Neck Pathol 2008; 2:343-7. [PMID: 20614307 PMCID: PMC2807574 DOI: 10.1007/s12105-008-0083-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2008] [Accepted: 08/11/2008] [Indexed: 10/21/2022]
Abstract
Calcifying fibrous pseudotumor (CFT) is a rare distinct soft-tissue lesion characterized histologically by lymphoplasmacytic aggregates in a rich collagenized background with abundant psammomatous and dystrophic calcifications. Occurring most often in children and young adults, CFTs are clinically benign lesions that can form over a broad anatomic distribution, including in subcutaneous and deep soft tissues, as well as in serosal and visceral locations. The cause and mechanisms of pathogenesis of CFT are unknown. Simple excision with a margin of normal tissue is the treatment of choice. The risk for local recurrence is low. In this article, we describe a case of CFT in a 29-year-old woman with a 7-cm mass on the right upper gingiva and hard palate, discuss the differential diagnosis with other oral spindle cell lesions, such as, desmoid fibromatosis, nodular fasciitis, inflammatory myofibroblastic tumors, solitary fibrous tumor and also review the recent literature on this rare benign entity.
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Affiliation(s)
- Diana M. Bell
- Department of Pathology, Unit 85, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX 77030 USA
| | | | | | - Mario A. Luna
- Department of Pathology, Unit 85, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX 77030 USA
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Scanlan D, Radio SJ, Nelson M, Zhou M, Streblow R, Prasad V, Reyes C, Perry D, Fletcher S, Bridge JA. Loss of the PTCH1 gene locus in cardiac fibroma. Cardiovasc Pathol 2007; 17:93-7. [PMID: 18329553 DOI: 10.1016/j.carpath.2007.08.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2007] [Revised: 07/23/2007] [Accepted: 08/08/2007] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Cardiac fibroma (CF) is a rare benign tumor that is poorly characterized genetically. CF is more commonly encountered in patients with Gorlin syndrome (3%) than the general population. Mutations of the tumor suppressor gene PTCH1 are the underlying cause of Gorlin syndrome. METHODS Conventional cytogenetic analysis was performed on a peripheral blood and a CF sample from a 2-week-old male. In addition, fluorescence in situ hybridization (FISH) studies were performed to assess the copy number of the PTCH1 gene locus (9q22.3) on metaphase and interphase cells from these same specimens using yeast artificial protein (YAC) probe 891G1 and on representative paraffin-embedded tissue sections of two additional CFs (one arising in a 2-month-old female and the other in a 13-week-old male). None of the patients had Gorlin syndrome. RESULTS Karyotypically, the following abnormal chromosomal complement was detected in the 2-week-old male's CF: 46,XY,del(9)(q22q34)[15]. FISH studies revealed homozygous loss of the PTCH1 locus in the cytogenetically analyzed CF and in the CF arising in the 13-week-old male. Heterozygous loss of this locus was identified in the remaining CF from the 2-month-old female. A mutational mechanism other than deletion may be responsible for PTCH1 inactivation on the other locus in this latter patient. Conventional cytogenetic and FISH studies of the peripheral blood sample from the 2-week-old male were normal. CONCLUSION These data support a tumor suppressor gene role for PTCH1 in nonsyndromic or sporadic CFs.
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Affiliation(s)
- David Scanlan
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE 68198-8135, USA
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Stainback RF, Hamirani YS, Cooley DA, Buja LM. Tumors of the Heart. CARDIOVASCULAR MEDICINE 2007. [DOI: 10.1007/978-1-84628-715-2_110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
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12
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Viswanathan S, Gibbs JL, Roberts P. Clonal translocation in a cardiac fibroma presenting with incessant ventricular tachycardia in childhood. Cardiol Young 2003; 13:101-2. [PMID: 12691295 DOI: 10.1017/s1047951103000167] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
MESH Headings
- Biopsy, Needle
- Chromosome Aberrations
- Chromosomes, Human, Pair 1
- Chromosomes, Human, Pair 5
- Chromosomes, Human, Pair 9
- Diagnosis, Differential
- Female
- Fibroma/diagnosis
- Fibroma/genetics
- Fibroma/surgery
- Heart Neoplasms/diagnosis
- Heart Neoplasms/genetics
- Heart Neoplasms/surgery
- Humans
- Immunohistochemistry
- Infant
- Tachycardia, Ventricular/diagnosis
- Tachycardia, Ventricular/therapy
- Translocation, Genetic
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Vougiouklakis T, Goussia A, Ioachim E, Peschos D, Agnantis N. Cardiac fibroma. A case presentation. Virchows Arch 2001; 438:635-6. [PMID: 11469699 DOI: 10.1007/s004280100442] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Araoz PA, Mulvagh SL, Tazelaar HD, Julsrud PR, Breen JF. CT and MR imaging of benign primary cardiac neoplasms with echocardiographic correlation. Radiographics 2000; 20:1303-19. [PMID: 10992020 DOI: 10.1148/radiographics.20.5.g00se121303] [Citation(s) in RCA: 234] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Benign primary cardiac neoplasms are rare but may cause significant morbidity and mortality. However, they are usually treatable and can often be diagnosed with echocardiography, computed tomography (CT), or magnetic resonance (MR) imaging. Myxomas typically arise from the interatrial septum from a narrow base of attachment. Fibroelastomas are easily detected at echocardiography as small, mobile masses attached to valves by a short pedicle. Cardiac fibromas manifest as a large, noncontractile, solid mass in a ventricular wall at echocardiography and as a homogeneous mass with soft-tissue attenuation at CT. They are usually homogeneous and hypointense on T2-weighted MR images and isointense relative to muscle on T1-weighted images. Paragangliomas usually appear as large, echogenic left atrial masses at echocardiography and as circumscribed, heterogeneous masses with low attenuation at CT. These tumors are usually markedly hyperintense on T2-weighted MR images and iso- or hypointense relative to myocardium on T1-weighted images. Cardiac lipomas manifest at CT as homogeneous, low-attenuation masses in a cardiac chamber or in the pericardial space and demonstrate homogeneous increased signal intensity that decreases with fat-saturated sequences at T1-weighted MR imaging. Cardiac lymphangiomas manifest as cystic masses at echocardiography and typically demonstrate increased signal intensity at T1- and T2-weighted MR imaging. Familiarity with these imaging features and with the relative effectiveness of these modalities is essential for prompt diagnosis and effective treatment.
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Affiliation(s)
- P A Araoz
- Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA.
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Abstract
Calcifying fibrous pseudotumor is a rare lesion of uncertain histogenesis that has a unique histologic appearance. We report herein a case of a 24-year-old woman with a mass on the right posterior side of the neck. Magnetic resonance imaging with contrast showed a well-circumscribed mass between the right splenius and semispinalis cervicis muscles; the study suggested high collagen content. Simple excision was performed. The histologic findings were diagnostic of calcifying fibrous pseudotumor. Our review of 19 previously reported cases suggests that a good outcome is expected when a diagnosis of calcifying fibrous pseudotumor is made.
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Affiliation(s)
- H Hoffmann
- Department of Pathology and Laboratory Medicine, University of Texas Medical School, Houston 77030, USA
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