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Khalilian MR, Shamsian BS, Baghaei Tehrani R, Kharaz L, Talebian N. Inflammatory myofibroblastic tumor of the pericardium in an 11-month-old infant: A case report. Clin Case Rep 2023; 11:e6949. [PMID: 36789298 PMCID: PMC9913176 DOI: 10.1002/ccr3.6949] [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: 12/08/2021] [Revised: 01/04/2023] [Accepted: 01/23/2023] [Indexed: 02/12/2023] Open
Abstract
Primary cardiac tumors are very rare in infants. Here we present an 11-month-old infant with a pericardial inflammatory myofibroblastic tumor who presented with symptoms of respiratory distress and cardiac tamponade. The tumor was surgically removed, and the patient received medical treatment; the patient had no problem with follow-up.
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Affiliation(s)
- Mohammad Reza Khalilian
- Department of Pediatrics, School of Medicine, Modarres HospitalShahid Beheshti University of Medical SciencesTehranIran
| | - Bibi Shahin Shamsian
- Pediatric Congenital Hematologic Disorders Research Center, Research Institute for Childern's HealthShahid Beheshti University of Medical SciencesTehranIran
| | - Ramin Baghaei Tehrani
- Cardiac Surgery, Modarres Hospital, School of MedicineShahid Beheshti University of Medical sciencesTehranIran
| | - Ladan Kharaz
- Department of Pediatrics, School of MedicineShahid Beheshti University of Medical SciencesTehranIran
| | - Niki Talebian
- Department of Pediatrics, School of MedicineShahid Beheshti University of Medical SciencesTehranIran
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2
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Zhu W, Pan W, Li Z. Inflammatory myofibroblastic tumour of the mitral valve. J Paediatr Child Health 2022; 58:2104-2105. [PMID: 35838010 DOI: 10.1111/jpc.16086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 02/16/2022] [Accepted: 05/01/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Weiwei Zhu
- Department of Pediatrics, Peking University Third Hospital, Beijing, China
| | - Weiwei Pan
- Department of Pediatrics, Peking University Third Hospital, Beijing, China
| | - Zailing Li
- Department of Pediatrics, Peking University Third Hospital, Beijing, China
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Bilotta C, Perrone G, Maresi E, De Lisi G, Di Pasquale P, Piro E, Argo A, Zerbo S. Case Report: Unusual Clinical Presentation of a Rare Cardiac Inflammatory Myofibroblastic Tumor in Children: The Differential Diagnosis With Pediatric Emergencies. Front Pediatr 2021; 9:718157. [PMID: 34858900 PMCID: PMC8631727 DOI: 10.3389/fped.2021.718157] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Accepted: 10/04/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: There are still no guidelines about pediatric cardiac cancers. The purpose of this work is to provide new scientific data facilitating the differential diagnosis of a rare cardiac tumor with an unusual presentation, such as the cardiac inflammatory myofibroblastic tumor (IMT). Case Presentation: A 3-year-old male child presented with several symptoms including unconsciousness, vomiting, and drowsiness. A clinical and neurological examination revealed a unilateral (right) motor delay and positive unilateral Babinski sign. Electrocardiogram (ECG) was normal. Diagnostic Assessment: The total body computed tomography (CT) scans showed hypodensity in the left temporal-parietal lobe, a large hypodense area in the right frontal lobe, and a second area in the left frontal lobe were found with head CT. A magnetic resonance (MR) also noted cerebral areas of hypointensity. The echocardiographic images revealed an ovoid mass, adherent to the anterolateral papillary muscle. The histological exams, performed with hematoxylin-eosin, Masson's trichrome, Alcian blue PAS, Weigert and Van-Gieson stain, allowed observing the microscopic structure of the neoplastic mass. The immunohistochemical analysis was performed through subsequent antibodies: anti-vimentin, anti-actina, anti-ALK, anti-CD8, anti-CD3, anti-CD20, anti-kappa and lambda chains, and anti CD68 antibodies. The healthcare professionals diagnosed a cardiac IMT with brain embolism. Differential Diagnosis: The ventricular localization, observed through radiological exams, required a differential diagnosis with fibroma and rhabdomyoma, the presence of brain embolism with sarcoma, and its morphology with fibroma. Neurological symptoms might be attributed to encephalitis, primitive cerebral cancer, such as astrocytoma or neuroblastoma, cerebral metastases due to any malignancy, or embolic stroke. Conclusion: New studies are encouraged to better define IMT behavior and draw up guidelines confirming the crucial role of multidisciplinary approach and treatment protocol selected on the basis of the characteristics of the tumors, in the case of this rare type of cancer.
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Affiliation(s)
- Clio Bilotta
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Section of Legal Medicine, University of Palermo, Palermo, Italy
| | - Giulio Perrone
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Section of Legal Medicine, University of Palermo, Palermo, Italy
| | - Emiliano Maresi
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Section of Legal Medicine, University of Palermo, Palermo, Italy
| | - Giovanni De Lisi
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Section of Legal Medicine, University of Palermo, Palermo, Italy
| | - Pietro Di Pasquale
- Division of Cardiology, Paolo Borsellino, G. F. Ingrassia Hospital, Palermo, Italy
| | - Ettore Piro
- Department of Health Promotion, Maternal and Child Care, Internal Medicine and Medical Specialties "G. D'Alessandro", Neonatal Intensive Care Unit, University of Palermo, Palermo, Italy
| | - Antonina Argo
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Section of Legal Medicine, University of Palermo, Palermo, Italy
| | - Stefania Zerbo
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Section of Legal Medicine, University of Palermo, Palermo, Italy
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Monzón Díaz D, Cuerpo Caballero G, Irabien Ortiz A, Gonzalez Pinto Á. Inflammatory myofibroblastic tumour in the right ventricle of a 66-year-old man. Interact Cardiovasc Thorac Surg 2019; 29:967-968. [PMID: 31384927 DOI: 10.1093/icvts/ivz189] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 06/26/2019] [Accepted: 07/07/2019] [Indexed: 11/14/2022] Open
Abstract
Herein, we present the case of a 66-year-old man with an inflammatory myofibroblastic tumour. An inflammatory myofibroblastic tumour is an extremely rare entity, with only 60 cases having been reported to date in the literature. The origin of this type of tumour is unknown and the treatment of choice is surgical resection. We present the surgical technique of our case and a review of the literature regarding this tumour. This is the first case described in a man above 60 years of age with a tumour located in the right ventricle.
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Affiliation(s)
- Diego Monzón Díaz
- Cardiovascular Surgery Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | | | - Angela Irabien Ortiz
- Cardiovascular Surgery Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Ángel Gonzalez Pinto
- Cardiovascular Surgery Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain
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Syed AU, Al Mutairi MB, Al Muhaya M, Morsey M, Al Hujailey A, al Najjar A. Inflammatory myofibroblastic tumor of heart in a 4-month-old infant. Asian Cardiovasc Thorac Ann 2017; 26:47-49. [DOI: 10.1177/0218492317739474] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Primary tumors of heart are rare in infants. We report a case of inflammatory myofibroblastic tumor in a 4-month-old baby girl who presented with a massive pericardial effusion. She underwent complete surgical excision of the tumor. This is the first reported case from the Middle Eastern region. The clinical behavior and management of these rare infantile cardiac tumors are discussed briefly in this report.
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Affiliation(s)
- Aitizaz U Syed
- Pediatric Cardiac Services, Madinah Cardiac Center, Madinah Munawarrah, Saudi Arabia
| | - Mansour B Al Mutairi
- Pediatric Cardiac Services, Madinah Cardiac Center, Madinah Munawarrah, Saudi Arabia
| | - Mustafa Al Muhaya
- Pediatric Cardiac Services, Madinah Cardiac Center, Madinah Munawarrah, Saudi Arabia
| | - Mofeed Morsey
- Pediatric Cardiac Services, Madinah Cardiac Center, Madinah Munawarrah, Saudi Arabia
| | - Ahmed Al Hujailey
- Department of Pathology, King Fahad Hospital, Madinah Munawarrah, Saudi Arabia
| | - Abdulhameed al Najjar
- Pediatric Cardiac Services, Madinah Cardiac Center, Madinah Munawarrah, Saudi Arabia
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Nguyen J, Sethi S, Ahmed H, Prasad A. Myocardial Infarction Secondary to Inflammatory Myofibroblastic Tumor Obstruction of the Left Main: Treated With Primary PCI. Res Cardiovasc Med 2016; 5:e32619. [PMID: 27800457 PMCID: PMC5076383 DOI: 10.5812/cardiovascmed.32619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Accepted: 09/05/2015] [Indexed: 11/16/2022] Open
Abstract
Introduction Cardiac inflammatory myofibroblastic tumor is a rare tumor that can cause potentially fatal outcomes. Case Presentation We describe a case where the tumor originated on the mitral valve and extended through the left ventricular outflow tract and aortic valve and into the left main artery obstructing it. Due to the hemodynamic instability of the patient, we proceeded for cardiac catheterization with the intention to aspirate the mass but were forced to do percutaneous intervention to stabilize the patient and bridge him to surgery. Conclusions The patient underwent surgery several days later with complete resection of the tumor and coronary stent retrieval but his left ventricular ejection fraction remained poor after several months and he was referred for cardiac transplantation.
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Affiliation(s)
- James Nguyen
- Bradenton Cardiology Center, University of Texas Health Science Center, San Antonio, United States
| | - Salil Sethi
- Bradenton Cardiology Center, University of Texas Health Science Center, San Antonio, United States
| | - Hinan Ahmed
- Bradenton Cardiology Center, University of Texas Health Science Center, San Antonio, United States
| | - Anand Prasad
- Bradenton Cardiology Center, University of Texas Health Science Center, San Antonio, United States
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Pang R, Merritt NH, Shkrum MJ, Tijssen JA. Febrile Illness in an Infant With an Intracardiac Inflammatory Myofibroblastic Tumor. Pediatrics 2016; 137:e20143544. [PMID: 26798044 DOI: 10.1542/peds.2014-3544] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/14/2015] [Indexed: 12/12/2022] Open
Abstract
We report a case of a child with a right ventricular inflammatory myofibroblastic tumor (IMT) who presented with fever, viral symptoms, and abdominal discomfort. Including this case, 49 intracardiac tumors have been previously reported in all age groups. The majority of intracardiac IMTs occur in pediatric patients, with approximately half presenting in children aged <12 months. Intracardiac IMTs are generally described as benign tumors; however, depending on their location, the initial presentation may involve heart failure or sudden death.(1) In addition to cardiac signs and symptoms, the clinical presentation of IMTs may also include constitutional signs such as fever, anemia, and elevated inflammatory markers. This case report reviews the diagnosis and management of IMTs, as well as the histopathologic features of this rare tumor type. Clinicians should be aware of their clinical presentation because early diagnosis and treatment can significantly reduce morbidity and mortality.
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Affiliation(s)
- Renée Pang
- Department of Pediatrics, Children's Hospital, London Health Sciences Centre, London, Ontario, Canada; and University of Western Ontario, London, Ontario, Canada
| | - Neil H Merritt
- Department of Pediatrics, Children's Hospital, London Health Sciences Centre, London, Ontario, Canada; and University of Western Ontario, London, Ontario, Canada
| | - Michael J Shkrum
- University of Western Ontario, London, Ontario, Canada University Hospital, London Health Sciences Centre, London, Ontario, Canada; and
| | - Janice A Tijssen
- Department of Pediatrics, Children's Hospital, London Health Sciences Centre, London, Ontario, Canada; and University of Western Ontario, London, Ontario, Canada
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Eilers AL, Nazarullah AN, Shipper ES, Jagirdar JS, Calhoon JH, Husain SA. Cardiac Inflammatory Myofibroblastic Tumor. World J Pediatr Congenit Heart Surg 2014; 5:556-64. [DOI: 10.1177/2150135114546203] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Although inflammatory myofibroblastic tumors (IMTs) can be found in virtually every major organ, cardiac origin is rare. After recently providing care to a child who presented with a significant myocardial infarction, interest in this rare tumor was piqued. We describe a comprehensive review of cardiac IMT, including information on nomenclature, epidemiology, clinical features, pathogenesis, gross/histological features, immunohistochemical profile, diagnosis, treatment, and prognosis. Fifty-seven cases were identified in the literature. Interestingly, our case represents the seventh case of coronary artery involvement reported. Moreover, it was found that an initial presentation of sudden death most commonly involves the coronary arteries.
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Affiliation(s)
- Amanda L. Eilers
- Department of Cardiothoracic Surgery, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Alia N. Nazarullah
- Department of Pathology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Edward S. Shipper
- Department of Surgery, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Jaishree S. Jagirdar
- Department of Pathology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - John H. Calhoon
- Department of Cardiothoracic Surgery, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - S. Adil Husain
- Department of Cardiothoracic Surgery, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
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Xu B, Fraser RS, Renaud C, Youssef S, Gottesman RD, Bernard C. Inflammatory myofibroblastic tumor of the aortic valves causing sudden cardiac death: a case report and review of the literature. Pediatr Dev Pathol 2014; 17:231-9. [PMID: 24649800 DOI: 10.2350/13-12-1414-cr.1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Cardiac inflammatory myofibroblastic tumor (IMT) is a rare entity affecting predominantly infants, children, and young adults. Although most tumors have a benign clinical course after complete surgical resection, some have significant clinical effects. We report the case of a 9-year-old girl who had sudden cardiac death as a result of occlusion of the left circumflex coronary artery. A review of 57 cases of cardiac IMTs reported in the literature in terms of epidemiology, clinical presentation, histologic and immunohistologic features, and outcome is presented. Recognition of this rare abnormality is important in order to initiate prompt surgical intervention.
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Affiliation(s)
- Bin Xu
- 1 Department of Pathology, Montreal Children's Hospital, McGill University Health Centre, Montreal, QC H3H 1P3, Canada
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10
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Abstract
Tumours originating from cardiac tissues are rarely encountered during childhood, and fortunately most of these tumours are benign in nature. Inflammatory myofibroblastic tumour, which has unique clinical, pathological, and molecular characteristics, is a relatively new entity compared with previously mentioned tumoural processes originating from the heart. Most of the cardiac intima-media thickness patients are in the age group of 4 months to 17 years. This rarely seen tumoural process has not been subject of any specific research and the prognosis is not well known. Here we present the case of a 3-month-old child who was admitted to our outpatient clinic with massive pericardial effusion and who has shown excellent progress after surgical resection of over 1 year.
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Inflammatory myofibroblastic tumor of the right atrium. Case Rep Med 2010; 2010. [PMID: 20886029 PMCID: PMC2945675 DOI: 10.1155/2010/695216] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2010] [Revised: 07/02/2010] [Accepted: 08/11/2010] [Indexed: 12/02/2022] Open
Abstract
Cardiac inflammatory myofibroblastic tumor (IMT) is a rare entity and is associated with distinct clinical, pathological and molecular features. The clinical behavior, natural history, biological potential, management and prognosis of such tumors are unclear. We present herewith an adolescent girl who presented with similar entity involving the junction of the right atrium and the inferior vena cava (IVC) in association with thrombocytosis and IVC thrombosis leading to obstruction of blood flow. Diagnostic tools included imaging and immuno-histopathology studies. Surgical management included resection of the tumor and thrombo-embolectomy of the IVC under cardiopulmonary bypass. This case is unique due to association of complete obstruction of IVC caused by the strategic location of the tumor, thrombosis of vena cava and association of thrombocytosis. These features have not been reported yet in relation to the cardiac IMT. This report will help in better understanding and management of similar cases in terms of planning cannulation of femoral veins or application of total hypothermic circulatory arrest during cardiopulmonary bypass and prompt us to look for recurrence or metastasis during follow up using echocardiography and laboratory investigations. The possibility of IMT should be kept in the differential diagnosis of cardiac tumors especially in children and adolescents.
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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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Echogenic mass in the right atrium after surgical ventricular septal defect closure: thrombus or tumour? Cardiol Young 2010; 20:86-8. [PMID: 20067662 DOI: 10.1017/s1047951109990746] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
We describe a neonate who presented with an echogenic mass in the right atrium 8 weeks after closure of ventricular and atrial septal defects. On a routine post operative check up after discharge, a mass was detected in the right atrium on echocardiography. As a thrombotic formation was suggested, lysis was started, in combination with the administration of unfractioned heparin. As there was no change in echogenicity or size of the mass, it was surgically excised. Histopathological examination revealed a myofibroblastic inflammatory tumour.
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Di Maria MV, Campbell DN, Mitchell MB, Lovell MA, Pietra BA, Miyamoto SD. Successful Orthotopic Heart Transplant in an Infant With an Inflammatory Myofibroblastic Tumor of the Left Ventricle. J Heart Lung Transplant 2008; 27:792-6. [DOI: 10.1016/j.healun.2008.03.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2007] [Revised: 03/06/2008] [Accepted: 03/12/2008] [Indexed: 11/16/2022] Open
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Pucci A, Valori A, Muscio M, Garofalo L, Ferroni F, Abbruzzese PA. Asymptomatic inflammatory myofibroblastic tumor of the heart: immunohistochemical profile, differential diagnosis, and review of the literature. Cardiovasc Pathol 2008; 18:187-90. [PMID: 18436455 DOI: 10.1016/j.carpath.2008.03.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2007] [Revised: 01/08/2008] [Accepted: 03/04/2008] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Inflammatory myofibroblastic tumor (IMT) is an uncommon lesion, mainly occurring in children and young adults and extremely rare in the heart. IMTs are composed of differentiated myofibroblastic cells accompanied by inflammatory cells. Cardiac IMTs are considered biologically benign, but they may have fatal consequences depending upon the peculiarity of site. Because of their rarity in the heart, most knowledge is based on extracardiac lesions that have uncertain behaviour. METHODS AND RESULTS We investigated the morphologic features and the immunohistochemical profile of an intracardiac IMT, arising in the right outflow tract of an asymptomatic 11-month-old boy, by using a large panel of antibodies, many of them previously reported in extracardiac IMTs only. Results were compared with data of literature. After complete surgical excision of the tumor, the patient is disease-free at 1 year of follow-up. CONCLUSIONS The present case showed morphologic and immunohistochemical features characteristic of IMT. Immunohistochemistry was helpful for characterization and differential diagnosis. The immunoreactivity pattern (including calponin expression) was similar to that of extracardiac IMTs except for anaplastic lymphoma kinase 1 immunoreactivity, lacking in this benign intracardiac IMT but usually associated to favourable prognosis in extracardiac IMTs.
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Affiliation(s)
- Angela Pucci
- Department of Pathology, Regina Margherita Hospital, ASO OIRM-S Anna, Turin, Italy.
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