1
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Farzin AO, Nejad SS. Cardiac angiosarcoma: a case report. J Int Med Res 2023; 51:3000605231211772. [PMID: 37987637 PMCID: PMC10664435 DOI: 10.1177/03000605231211772] [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: 09/06/2023] [Accepted: 10/17/2023] [Indexed: 11/22/2023] Open
Abstract
Angiosarcoma is the most invasive and malignant cardiac tumor and most commonly originates from the right atrium. Early diagnosis is essential, and echocardiography has an important role in diagnosis. This tumor grows aggressively, and metastases to other sites makes it difficult to control. Surgical treatment remains the best option for patients who do not respond to chemoradiotherapy. We herein report a case of a 17-year-old patient with cardiac angiosarcoma who presented with dyspnea, chest pain, dry cough, and fever. Although we considered the most probable diagnosis to be constrictive pericarditis, pathologic examination revealed a primary angiosarcoma originating from the pericardium. The patient underwent total pericardiectomy. However, despite receiving chemotherapy for 2 weeks postoperatively, she developed complications including leukopenia and eventually died of respiratory failure. Late diagnosis of angiosarcoma often occurs, resulting in progression to end-stage disease and a very poor prognosis. Therefore, a thorough understanding of this entity, knowledge of its pitfalls in management, and establishment of an accurate treatment guideline would help to develop a reliable and life-saving treatment approach for these patients.
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Affiliation(s)
- Alireza Omidi Farzin
- Assistant Professor of Cardiac Surgery, Department of Cardiovascular Surgery, Modarres Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shahrzad Shahrokhi Nejad
- Researcher, Department of Cardiovascular Surgery, Modarres Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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2
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Verbeek S, Sciot R, Debiec-Rychter M, Labarque V, Meyns B, Cools B. Case report: Cardiac intimal sarcoma in a young child. Front Pediatr 2023; 11:1238847. [PMID: 37818167 PMCID: PMC10560764 DOI: 10.3389/fped.2023.1238847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 09/11/2023] [Indexed: 10/12/2023] Open
Abstract
Undifferentiated mesenchymal tumors from the intimal layer (intimal sarcomas) are rare within the ventricles and exceptional in children. A rare case of an intimal sarcoma located in the right ventricle in a young child is presented with need for urgent surgical resection due to mechanical flow obstruction. Tumor cells showed amplification of MDM2 gene and a homozygous loss of CDKN2A on 9p21. A review of the literature regarding primary cardiac malignancies and intimal sarcoma in children is provided.
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Affiliation(s)
- Sanne Verbeek
- Department of Pathology, University Hospitals Leuven, Leuven, Belgium
| | - Raf Sciot
- Department of Pathology, University Hospitals Leuven, Leuven, Belgium
| | | | - Veerle Labarque
- Department of Pediatric Hematology and Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Bart Meyns
- Department of Cardiac Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Bjorn Cools
- Department of Pediatric and Congenital Cardiology, University Hospitals Leuven, Leuven, Belgium
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3
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Mubder M, Pour-Ghaz I, Al-Taweel O, Alhwarat B, Bond A, Choudhury AH, Mahmoud O, Alkhatib D. Primary Cardiac Sarcoma: Angiosarcoma Compressing the Right Coronary Artery. Cureus 2023; 15:e38360. [PMID: 37266054 PMCID: PMC10230120 DOI: 10.7759/cureus.38360] [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: 04/30/2023] [Indexed: 06/03/2023] Open
Abstract
Cardiac tumors are uncommon and can be classified as either primary benign, primary malignant, or metastatic. Cardiac tumors have a wide range of presentations, which can lead to delays in diagnosis and treatment. Primary cardiac tumors can also affect nearby structures, and there have been a few reported cases of coronary artery involvement with various underlying causes. In this case report, we describe a patient with a primary cardiac sarcoma (angiosarcoma) that had spread to other parts of the body and caused occlusion of the right coronary artery.
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Affiliation(s)
- Mohamad Mubder
- Internal Medicine, Kirk Kerkorian School of Medicine at University of Nevada, Las Vegas, Las Vegas, USA
| | - Issa Pour-Ghaz
- Cardiology, The University of Tennessee Health Science Center, Memphis, USA
| | - Omar Al-Taweel
- Cardiology, Kirk Kerkorian School of Medicine at University of Nevada, Las Vegas, Las Vegas, USA
| | | | - Addison Bond
- College of Medicine, The University of Tennessee Health Science Center, Memphis, USA
| | - Ahsan H Choudhury
- Cardiology, University Medical Center, Las Vegas, USA
- Cardiology, University of Nevada, Reno, USA
| | - Osama Mahmoud
- Cardiovascular Medicine, The University of Tennessee Health Science Center, Memphis, USA
| | - Deya Alkhatib
- Cardiovascular Medicine, The University of Tennessee Health Science Center, Memphis, USA
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4
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Luo Y, Gong K, Xie T, Liu R, Guo H, Wang L, Tan Z, Hu SJ, Yang Y, Xie L. Case Report: A Young Man With Giant Pericardial Synovial Sarcoma. Front Cardiovasc Med 2022; 9:829328. [PMID: 35155638 PMCID: PMC8829043 DOI: 10.3389/fcvm.2022.829328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 01/03/2022] [Indexed: 11/20/2022] Open
Abstract
Pericardial synovial sarcomas are sporadic tumors. Herein, we report a case of primary pericardial synovial sarcoma originating from the right pericardium. Missed diagnosis delayed surgical treatment. Eventually, the tumor occupied the almost entire pericardial cavity. The pericardial tumor was surgically removed as soon as possible after admission. In this paper, we aim to provide details that can help further understand the differing symptoms and presentations of pericardial synovial sarcoma and highlight the importance of consideration of this disease in similar cases where the etiology of pericardial effusion is unknown.
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Affiliation(s)
- Yong Luo
- Department of Cardiovascular Surgery, The Second Xiangya Hospital of Central South University, Central South University, Changsha, China
| | - Ke Gong
- Department of Cardiovascular Surgery, The Second Xiangya Hospital of Central South University, Central South University, Changsha, China
| | - Ting Xie
- Department of Cardiovascular Surgery, The Second Xiangya Hospital of Central South University, Central South University, Changsha, China
| | - Ruilin Liu
- Department of Cardiovascular Surgery, The Second Xiangya Hospital of Central South University, Central South University, Changsha, China
| | - Hui Guo
- Department of Cardiovascular Surgery, The Second Xiangya Hospital of Central South University, Central South University, Changsha, China
| | - Lei Wang
- Department of Cardiovascular Surgery, The Second Xiangya Hospital of Central South University, Central South University, Changsha, China
| | - Zhiping Tan
- The State Key Laboratory of Medical Genetics, The Clinical Center for Gene Diagnosis and Therapy, The Second Xiangya Hospital of Central South University, Central South University, Changsha, China
| | - Shi jun Hu
- Department of Cardiovascular Surgery, The Second Xiangya Hospital of Central South University, Central South University, Changsha, China
| | - Yifeng Yang
- Department of Cardiovascular Surgery, The Second Xiangya Hospital of Central South University, Central South University, Changsha, China
| | - Li Xie
- Department of Cardiovascular Surgery, The Second Xiangya Hospital of Central South University, Central South University, Changsha, China
- *Correspondence: Li Xie
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5
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Tumors of the cardiovascular system: heart and blood vessels. Cardiovasc Pathol 2022. [DOI: 10.1016/b978-0-12-822224-9.00015-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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6
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Gatti M, D’Angelo T, Muscogiuri G, Dell'aversana S, Andreis A, Carisio A, Darvizeh F, Tore D, Pontone G, Faletti R. Cardiovascular magnetic resonance of cardiac tumors and masses. World J Cardiol 2021; 13:628-649. [PMID: 34909128 PMCID: PMC8641001 DOI: 10.4330/wjc.v13.i11.628] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 07/19/2021] [Accepted: 10/27/2021] [Indexed: 02/06/2023] Open
Abstract
Cardiac masses diagnosis and treatment are a true challenge, although they are infrequently encountered in clinical practice. They encompass a broad set of lesions that include neoplastic (primary and secondary), non-neoplastic masses and pseudomasses. The clinical presentation of cardiac tumors is highly variable and depends on several factors such as size, location, relation with other structures and mobility. The presumptive diagnosis is made based on a preliminary non-invasive diagnostic work-up due to technical difficulties and risks associated with biopsy, which is still the diagnostic gold standard. The findings should always be interpreted in the clinical context to avoid misdiagnosis, particularly in specific conditions (e.g., infective endocarditis or thrombi). The modern multi-modality imaging techniques has a key role not only for the initial assessment and differential diagnosis but also for management and surveillance of the cardiac masses. Cardiovascular magnetic resonance (CMR) allows an optimal non-invasive localization of the lesion, providing multiplanar information on its relation to surrounding structures. Moreover, with the additional feature of tissue characterization, CMR can be highly effective to distinguish pseudomasses from masses, as well as benign from malignant lesions, with further differential diagnosis of the latter. Although histopathological assessment is important to make a definitive diagnosis, CMR plays a key role in the diagnosis of suspected cardiac masses with a great impact on patient management. This literature review aims to provide a comprehensive overview of cardiac masses, from clinical and imaging protocol to pathological findings.
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Affiliation(s)
- Marco Gatti
- Radiology Unit, Department of Surgical Sciences, University of Turin, Turin 10126, Italy
| | - Tommaso D’Angelo
- Department of Biomedical Sciences and Morphological and Functional Imaging, “G. Martino” University Hospital Messina, Messina 98100, Italy
| | - Giuseppe Muscogiuri
- Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan 20149, Italy
| | | | | | - Andrea Carisio
- Radiology Unit, Department of Surgical Sciences, University of Turin, Turin 10126, Italy
| | - Fatemeh Darvizeh
- School of Medicine, Vita-Salute San Raffaele University, Milan 20121, Italy
| | - Davide Tore
- Radiology Unit, Department of Surgical Sciences, University of Turin, Turin 10126, Italy
| | - Gianluca Pontone
- Department of Cardiovascular Imaging, Centro Cardiologico Monzino, IRCCS, Milan 20138, Italy
| | - Riccardo Faletti
- Radiology Unit, Department of Surgical Sciences, University of Turin, Turin 10126, Italy
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7
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Maleszewski JJ, Basso C, Bois MC, Glass C, Klarich KW, Leduc C, Padera RF, Tavora F. The 2021 WHO Classification of Tumors of the Heart. J Thorac Oncol 2021; 17:510-518. [PMID: 34774791 DOI: 10.1016/j.jtho.2021.10.021] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 10/11/2021] [Accepted: 10/28/2021] [Indexed: 11/17/2022]
Affiliation(s)
- Joseph J Maleszewski
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota.
| | - Cristina Basso
- Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Melanie C Bois
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Carolyn Glass
- Department of Pathology, Duke University School of Medicine, Durham, North Carolina
| | - Kyle W Klarich
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
| | - Charles Leduc
- Department of Pathology and Cellular Biology, University of Montreal, Montreal, Quebec, Canada
| | - Robert F Padera
- Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Fabio Tavora
- Department of Pathology, Argos Laboratory/Messejana Heart and Lung Hospital, Fortaleza, Brazil
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8
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Spindel J, Mathbout MF, Huffman T, Ghafghazi S. Carney complex: left atrial myxoma in a patient with past pituitary microadenoma and lentiginosis. BMJ Case Rep 2021; 14:14/6/e241742. [PMID: 34167977 DOI: 10.1136/bcr-2021-241742] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
The Carney complex (CNC) is a rare autosomal dominant genetic complex that is characterised by multiple neoplasms consisting of neuroendocrine and cardiac tumours, with only 750 cases reported worldwide as of 2017. Cardiac tumours, in the context of the CNC, are of unique importance since the leading causes of death in patients with CNC are cardiac. To prevent sudden cardiac death and embolic events, a difficult diagnosis must be made and postdiagnostic screenings must be regular. We present a case of a 52-year-old man, with a medical history of pituitary microadenoma and facial lentiginosis, who presented with dyspnoea 2 months after suffering a cerebrovascular accident.
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Affiliation(s)
- Jeffrey Spindel
- Internal Medicine, University of Louisville, Louisville, Kentucky, USA
| | - Mohammad F Mathbout
- Cardiovascular Medicine, University of Louisville, Louisville, Kentucky, USA
| | - Travis Huffman
- Internal Medicine, University of Louisville, Louisville, Kentucky, USA
| | - Shahab Ghafghazi
- Cardiovascular Medicine, University of Louisville, Louisville, Kentucky, USA
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9
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Uemura K, Sano H, Takaoka H, Okita Y. Cardiac angiosarcoma in the right ventricle treated by surgical resection. BMJ Case Rep 2021; 14:14/3/e238736. [PMID: 33653836 PMCID: PMC7929840 DOI: 10.1136/bcr-2020-238736] [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] [Indexed: 11/03/2022] Open
Abstract
Cardiac angiosarcoma is a rare malignant neoplasm, the gold standard treatment is surgical resection. Our patient, an 81-year old Japanese woman, was admitted to hospital after chest pain over a month-long period. Transthoracic echocardiography (TTE) showed a heterogeneous and irregular mass-like lesion measuring approximately 45 mm and arising from the right ventricular free wall. Transesophageal echocardiography showed the lesion had a mobile portion. Considering the possibility of malignancy and a high risk of embolism and obstruction, we performed surgical resection of the tumour. Histological and immunohistochemical findings led to diagnosis of cardiac angiosarcoma. One year after surgery, TTE and CT showed no evidence of recurrence of angiosarcoma.
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Affiliation(s)
- Koya Uemura
- Division of Cardiovascular Medicine, Department of Internal Medicine, Aijinkai Takatsuki General Hospital, Takatsuki, Osaka, Japan
| | - Hiroyuki Sano
- Division of Cardiovascular Medicine, Department of Internal Medicine, Aijinkai Takatsuki General Hospital, Takatsuki, Osaka, Japan
| | - Hideyuki Takaoka
- Division of Cardiovascular Medicine, Department of Internal Medicine, Aijinkai Takatsuki General Hospital, Takatsuki, Osaka, Japan
| | - Yutaka Okita
- Division of Cardiovascular Surgery, Department of Surgery, Aijinkai Takatsuki General Hospital, Takatsuki, Osaka, Japan
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10
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Chen FF, Jiang SF, Dong C, Che Y, Du LY, Li ZY, Yang ZQ, Zhao YC, Liu Y. Case Report: Thromboembolism and Hemorrhagic Pericardial Effusion-The Janus Face of Primary Pericardial Angiosarcoma. Front Cardiovasc Med 2021; 7:618146. [PMID: 33521065 PMCID: PMC7843435 DOI: 10.3389/fcvm.2020.618146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 12/07/2020] [Indexed: 11/13/2022] Open
Abstract
Background: Primary cardiac angiosarcomas, especially those originating in the pericardium, are extremely rare and aggressive tumors with poor prognosis. These types of malignant tumors have diverse clinical presentations and are often masked by other comorbidities. Case Summary: Our hospital reported a 59-year-old woman who initially presented with pulmonary thromboembolism (PTE) and was subsequently treated with low-molecular-weight heparin. However, she experienced acute pericardial tamponade after anticoagulation therapy, where no obvious mass was primarily identified upon imaging, both in the pericardium or within the heart. Emergency pericardiocentesis and drainage were performed, where a total of 210 mL of bloody effusion was drained. Four months later, she was hospitalized with progressive hemoptysis and dyspnea. A large mixed mass occupying the right pericardium was later identified by coronary computed tomography angiography (CCTA). The mass was consistent with the right atrium, with heterogeneous thickened pericardium and localized moderate pericardial effusion. CCTA and positron emission tomography scans later showed metastases in both lungs and bilateral pleura. Nodules in hilar and mediastinal lymph nodes were also significant. Ultrasound-guided biopsy was performed, and the patient was ultimately diagnosed with an angiosarcoma based on final positive results for both CD31 and CD34 markers. The patient refused chemotherapy and passed away while waiting for her pathology results. The patient survived for 6 months since the first reported episode of PTE. Conclusions: Our case indicates that patients presenting with both embolism and hemorrhage should urgently be channeled to a clinical specialist to confirm any malignant etiology. This would be beneficial to confirm an early diagnosis and lengthen the duration of patient survival. However, the diagnosis of primary cardiac angiosarcoma is still challenging and requires multiple imaging modalities and biopsies in order to assist the accurate diagnosis of disease and achieve effective patient management.
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Affiliation(s)
- Fei F Chen
- Department of Cardiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Shu F Jiang
- Department of Cardiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Chang Dong
- Department of Respiratory, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Ying Che
- Department of Ultrasonography, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Lin Y Du
- Department of Ultrasonography, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Zhi Y Li
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Zhi Q Yang
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Yi C Zhao
- Department of Cardiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Ying Liu
- Department of Cardiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
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11
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Abstract
Introduction: Primary cardiac tumors are exceedingly rare, with approximately 75% representing benign lesions. Sarcoma represents the most common primary cardiac malignancy, with a wide range of sarcoma histologies represented. Symptoms at diagnosis vary based on tumor location. Multidisciplinary treatment including chemotherapy, surgery, and occasionally radiation is often warranted. Despite aggressive treatment, the overall prognosis for primary cardiac sarcoma (PCS) remains poor with a median survival of approximately 1 year.Areas covered: A PubMed search for the key terms; 'cardiac sarcoma', 'primary cardiac sarcoma', and 'treatment' were conducted. Abstracts were reviewed for reports on presentation, treatments, and outcomes in PCS. Available data was limited to single-institution series, most of which were retrospective. Patterns of symptoms at diagnosis varied with tumor location (right vs. left vs. pericardium). Multimodality therapy, including chemotherapy and surgical resection was most commonly reported. Completely negative margin (R0) resection has the greatest impact on overall survival.Expert opinion: Given the rarity of PCS, patients should be referred to a high-volume sarcoma center for multidisciplinary evaluation. Neoadjuvant chemotherapy should be considered to aid in surgical resection. Due to the propensity for brain metastases in cardiac tumors, brain MRI at the time of diagnosis should be considered.
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Affiliation(s)
| | - Monika Leja
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Rashmi Chugh
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
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12
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Li X, Chen Y, Liu J, Xu L, Li Y, Liu D, Sun Z, Wen Z. Cardiac magnetic resonance imaging of primary cardiac tumors. Quant Imaging Med Surg 2020; 10:294-313. [PMID: 31956550 DOI: 10.21037/qims.2019.11.13] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Cardiac magnetic resonance (CMR) offers superior advantages in cardiac imaging due to supplying a greater field of view, excellent soft-tissue imaging, and multiplanar imaging capabilities. CMR imaging can evaluate the characteristics of cardiac tumors by visualizing the relationship between the tumor and surrounding tissues, and plays a vital role in assisting the formulation of the surgical plan, the assessment of tumor progression, and the monitoring of postoperative tumor recurrence and metastasis. In this review, we present the clinical manifestations and imaging features of different cardiac tumors. The superior performance of CMR in preoperative diagnosis, surgical treatment, and postoperative follow-up of patients with heart tumors are also highlighted.
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Affiliation(s)
- Xiaodan Li
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Yan Chen
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Jiayi Liu
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Lei Xu
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Yu Li
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Dongting Liu
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Zhonghua Sun
- Discipline of Medical Radiation Sciences, School of Molecular and Life Sciences, Curtin University, Perth, Australia
| | - Zhaoying Wen
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
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13
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Clinical characteristics associated with primary cardiac angiosarcoma outcomes: a surveillance, epidemiology and end result analysis. Eur J Med Res 2019; 24:29. [PMID: 31426842 PMCID: PMC6699122 DOI: 10.1186/s40001-019-0389-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 08/12/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Primary cardiac angiosarcoma (PCAS) is a rare type of tumour. Furthermore, descriptions of the demographic features and prognostic factors of PCAS patients have been poorly reported. METHODS A population cohort study was conducted using retrospectively extracted data from the SEER (Surveillance, Epidemiology and End Results) database for patients with histological diagnoses of PCAS; the extracted information included demographic, treatment and outcome data. RESULTS A total of 168 cases of PCAS from 1973 to 2013 were included. The mean age at diagnosis was 44.4 ± 15.5 years. PCAS was more prevalent in men than in women. The majority of PCAS patients were white (67.3%), while the incidence of PCAS in black individuals was relatively infrequent (19.0%). In addition, 87 cases were classified as distant stage, 44 as regional stage, and 33 as localized stage. The median disease-specific survival (DSS) was 7.22 months, and the 1-, 2- and 5-year DSS rate for PCAS patients was 34.7%, 14.3% and 10.2%, respectively. Further multivariate analyses showed that an age at (greater than or equal to) 45 years (HR 2.165), no radiotherapy (HR 1.629), tumour size > 5 cm (HR 3.182), and the summary stage was associated with worse PCAS-related survival. Cancer-directed surgery and radiotherapy significantly improved the DSS for patients with PCAS (P < 0.05). The C-index of the nomograms was 0.706 (95% CI 0.654-0.758), and the calibration curves showed good agreement between the nomogram prediction and actual observation. CONCLUSION PCAS is a rare cancer that is prone to have poor prognoses. To understand PCAS more thoroughly, more cases with adequate information are needed.
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14
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Guo GR, Wang X, Yang J, Chen L, Song JP, Wang LQ. Outcome and Pathological Characteristics of Primary Malignant Cardiac Tumors. Int Heart J 2019; 60:938-943. [PMID: 31308320 DOI: 10.1536/ihj.18-269] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The literature on malignant cardiac tumors is relatively limited because they are rare, especially among the Chinese population. We analyzed 14 patients diagnosed with malignant cardiac tumors in Fuwai Hospital and present the results of surgical treatments on the tumors. The mean age at tumor diagnosis was 47 years in a male-dominated cohort. There was a high frequency of pericardial effusion and coronary artery involvement in our group. We compared the survival times of patients who received different treatments and found that surgery improved prognosis of tumors, especially for patients who underwent orthotopic heart transplantation.
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Affiliation(s)
- Guang-Ran Guo
- Union Hospital, Tongji Medical College, Huazhong University of Science and Technology.,State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College
| | - Xin Wang
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College
| | - Ji Yang
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College
| | - Liang Chen
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College
| | - Jiang-Ping Song
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College
| | - Li-Qing Wang
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College
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15
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Burns EA, Ahmed A, Sunkara A, Khan U, Sharif R, Abdelrahim M, Reardon M, Trachtenberg B. Primary cardiac angiosarcoma diagnosed in the first trimester of pregnancy. Ecancermedicalscience 2019; 13:922. [PMID: 31281419 PMCID: PMC6546259 DOI: 10.3332/ecancer.2019.922] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Indexed: 11/06/2022] Open
Abstract
Primary cardiac angiosarcoma (PCAS) is a malignancy seldom seen in pregnancy. A 23-year-old G1P0 Chinese female was found to have PCAS during her first trimester when she presented with tamponade physiology. The transthoracic echocardiography (TTE) results did not indicate the presence of an intracardiac lesion, and pericardial fluid cytology analysis showed no evidence of malignancy. Cardiac magnetic resonance imaging (CMRI) exhibited a right atrial mass, and tissue biopsy indicated a high-grade angiosarcoma. MRI of the abdomen was suggestive of liver metastasis. She underwent an abortion and was started on combination chemotherapy, with a reduction in both the cardiac and liver masses. In cardiac angiosarcomas, advanced imaging modalities such as MRI should be utilised when there is high clinical suspicion or in the case of pregnancy when trying to minimise foetal harm. Prognosis is poor, and a standardised treatment protocol regardless of pregnancy continues to elude the medical community.
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Affiliation(s)
- Ethan A Burns
- Internal Medicine, Houston Methodist Hospital, Houston, TX 77030, USA
| | - Amna Ahmed
- Internal Medicine, Houston Methodist Hospital, Houston, TX 77030, USA
| | - Anusha Sunkara
- Houston Methodist DeBakey Heart and Vascular Center, Houston, TX 77030, USA
| | - Usman Khan
- Houston Methodist Cancer Center, Houston, TX 77030, USA
| | | | | | - Michael Reardon
- Houston Methodist DeBakey Heart and Vascular Center, Houston, TX 77030, USA
| | - Barry Trachtenberg
- Houston Methodist DeBakey Heart and Vascular Center, Houston, TX 77030, USA
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16
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Yu JF, Cui H, Ji GM, Li SQ, Huang Y, Wang RN, Xiao WF. Clinical and imaging manifestations of primary cardiac angiosarcoma. BMC Med Imaging 2019; 19:16. [PMID: 30764784 PMCID: PMC6375141 DOI: 10.1186/s12880-019-0318-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 01/31/2019] [Indexed: 11/24/2022] Open
Abstract
Background To investigate the CT manifestations of primary cardiac angiosarcoma. Methods The clinical and CT data for 9 patients with cardiac angiosarcoma were retrospectively analyzed. Results The lesions in all nine cases were located in the right atrium. In two cases, the involved lesion led downward to the tricuspid valve and right ventricle, and the dynamic cine showed that the lesion affected the opening and closing of the tricuspid valve. In three cases, the lesion involvement led to a thickened pericardium, accompanied by pericardial effusions. On CT plain scans, six patients showed homogeneous density, while three showed inhomogeneous density, two of which were associated with bleeding. On enhanced CT scans, seven patients showed heterogeneous centripetal enhancement, and some angiograms showed lesions with tortuous small blood vessels. The remaining two cases showed early stage rapid inhomogeneous enhancement. Five cases showed multiple metastatic nodules in the lungs at the time of initial diagnosis; four of these showed distinct sharp edges in multiple pulmonary nodules. Conclusions Cardiac angiosarcoma has a predilection site and is prone to invading adjacent structures, manifesting as malignant pericardial and pleural effusions. The CT enhancement manifestations are mostly inhomogeneous and centripetal with ground-glass opacity peripheral to the intrapulmonary metastases.
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Affiliation(s)
- Jin-Fen Yu
- Magnetic Resonance Room, Ji Nan Zhang Qiu District hospital of TCM, Shan Dong, 250200, China
| | - Hui Cui
- CT Diagnosis Room, Liao Cheng People's hospital, Shan Dong, 252000, China
| | - Guo-Min Ji
- Department of Radiology, Gu Cheng People's hospital, He Bei, 053000, China
| | - Shu-Qi Li
- Department of Ultrasonics, Lan Ling People's hospital, Shan Dong, 277799, China
| | - Yong Huang
- Department of Radiology, Shandong Tumor hospital, Ji Nan, 250117, China
| | - Ruo-Ning Wang
- Minimally Invasive Center, Tumor hospital, Sun Yat-Sen University, Guangzhou, 510060, China.
| | - Wen-Feng Xiao
- Magnetic Resonance Room, Sheng Li Oilfield Central Hospital, Shan Dong, 257034, China.
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17
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Gabani P, Fischer-Valuck BW, Robinson CG, Wilson DB, Michalski JM. Stereotactic Body Radiation Therapy for the Treatment of Primary Cardiac Angiosarcoma Causing Hemodynamic Instability. Pract Radiat Oncol 2019; 9:5-8. [PMID: 30611463 DOI: 10.1016/j.prro.2018.07.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 07/24/2018] [Accepted: 07/28/2018] [Indexed: 12/17/2022]
Affiliation(s)
- Prashant Gabani
- Department of Radiation Oncology, Washington University School of Medicine in Saint Louis, Saint Louis, Missouri
| | - Benjamin W Fischer-Valuck
- Department of Radiation Oncology, Washington University School of Medicine in Saint Louis, Saint Louis, Missouri
| | - Clifford G Robinson
- Department of Radiation Oncology, Washington University School of Medicine in Saint Louis, Saint Louis, Missouri
| | - David B Wilson
- Division of Pediatric Hematology and Oncology, Washington University School of Medicine in Saint Louis, Saint Louis, Missouri
| | - Jeff M Michalski
- Department of Radiation Oncology, Washington University School of Medicine in Saint Louis, Saint Louis, Missouri.
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18
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Abid N, Ltaief R, Sassi A, Lounissi T, Gheni R, Belfkih H, Mrad K, Barakett N. [Left atrial intimal sarcoma: A rare cause of acute heart failure]. Ann Cardiol Angeiol (Paris) 2018; 68:232-235. [PMID: 30290919 DOI: 10.1016/j.ancard.2018.08.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 08/23/2018] [Indexed: 11/29/2022]
Abstract
Primitive intimal sarcoma is a rare malignant cardiac tumor. Through the observation of a 41-year-old man who presented with an acute heart failure revealing a left atrial intimal sarcoma, we discuss different diagnostic and therapeutic modalities.
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Affiliation(s)
- N Abid
- Service de cardiologie, hôpital Taher Maamouri, Nabeul, Tunisie.
| | - R Ltaief
- Service de cardiologie, hôpital Taher Maamouri, Nabeul, Tunisie
| | - A Sassi
- Service d'anatomie et cytologie pathologiques, institut Salah Azaiez, Tunis, Tunisie
| | - T Lounissi
- Service de cardiologie, hôpital Taher Maamouri, Nabeul, Tunisie
| | - R Gheni
- Service de cardiologie, hôpital Taher Maamouri, Nabeul, Tunisie
| | - H Belfkih
- Service d'oncologie, hôpital Taher Maamouri, Nabeul, Tunisie
| | - K Mrad
- Service d'anatomie et cytologie pathologiques, institut Salah Azaiez, Tunis, Tunisie
| | - N Barakett
- Service de cardiologie, hôpital Taher Maamouri, Nabeul, Tunisie
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19
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Niclauss L, Montemurro M, Kirsch M, Prêtre R. Sarcoma of the heart: survival after surgery†. Interact Cardiovasc Thorac Surg 2018; 27:198-201. [DOI: 10.1093/icvts/ivy045] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Accepted: 01/09/2018] [Indexed: 12/15/2022] Open
Affiliation(s)
- Lars Niclauss
- Department of Cardiovascular Surgery, University Hospital of Lausanne (CHUV), Lausanne, Switzerland
| | - Michael Montemurro
- Department of Oncology, University Hospital of Lausanne (CHUV), Lausanne, Switzerland
| | - Matthias Kirsch
- Department of Cardiovascular Surgery, University Hospital of Lausanne (CHUV), Lausanne, Switzerland
| | - René Prêtre
- Department of Cardiovascular Surgery, University Hospital of Lausanne (CHUV), Lausanne, Switzerland
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20
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Wang JG, Li YJ, Liu H, Zhao P. Primary Cardiac Myxofibrosarcoma: A Case Report and Review of the Literature. TUMORI JOURNAL 2018. [DOI: 10.1177/030089161209800630] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Aims and background Primary myxofibrosarcoma of the heart is a rare malignancy. To the best of our knowledge, no more than 17 cases have been reported since 1963. Methods and study design We report the case of a 42-year-old man who presented with dyspnea and palpitation of one month's duration. Echocardiography and enhanced computed tomography revealed a large tumor in the left atrium. Results The patient underwent palliative excision of the tumor and histopathological analysis revealed it to be a low-grade myxofibrosarcoma. The patient developed a bone metastasis two years later and is still alive 26 months after the cardiac surgery. Conclusions Primary cardiac myxofibrosarcoma involves predominantly the left atrium and the most common symptom induced by the tumor is dyspnea. Disease outcome is often disappointing despite aggressive postoperative radiotherapy and chemotherapy.
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Affiliation(s)
- Ji-Gang Wang
- Department of Pathology, the Affiliated Hospital of Medical College, Qingdao University, Qingdao, Shandong Province, China
| | - Yu-Jun Li
- Department of Pathology, the Affiliated Hospital of Medical College, Qingdao University, Qingdao, Shandong Province, China
| | - Hui Liu
- Department of Pathology, the Affiliated Hospital of Medical College, Qingdao University, Qingdao, Shandong Province, China
| | - Peng Zhao
- Department of Pathology, the Affiliated Hospital of Medical College, Qingdao University, Qingdao, Shandong Province, China
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21
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Badaloni F, Pozzati E, Marucci G, Fiaschi P, Fioravanti A. Primary Cardiac High-grade Myxofibrosarcoma Presenting with Multiple Brain Metastases: A Case Report. Cureus 2017; 9:e1866. [PMID: 29375952 PMCID: PMC5773267 DOI: 10.7759/cureus.1866] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Herein we describe the case of a young patient who presented with a recent history of epilepsy due to multiple brain lesions; he did not complain about any cardiopulmonary impairments. The patient died as a consequence of hemorrhagic progression of brain metastatic disease. Regardless of a thorough investigation, the heart tumor remained occult. Primary cardiac tumors are very rare entities. Most of these are benign, but approximately 25% are malignant, and the majority of these are sarcomas. Myxofibrosarcoma and osteosarcoma are exceptionally rare. To date, we find only small series of cardiac myxofibrosarcoma, and to our knowledge, this one exceptionally presented with multiple brain metastatic lesions without cardiopulmonary symptoms.
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Affiliation(s)
- Filippo Badaloni
- Department of Neurosurgery, IRCCS Institute of Neurological Sciences of Bologna, Bellaria Hospital, Bologna, Italy
| | - Eugenio Pozzati
- Department of Neurosurgery, IRCCS Institute of Neurological Sciences of Bologna, Bellaria Hospital, Bologna, Italy
| | - Gianluca Marucci
- Neuropathology Unit, IRCCS Foundation "carlo Besta" Neurological Institute, Milan, Italy
| | - Pietro Fiaschi
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
| | - Antonio Fioravanti
- Department of Neurosurgery, IRCCS Institute of Neurological Sciences of Bologna, Bellaria Hospital, Bologna, Italy
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Abstract
BACKGROUND Primary cardiac angiosarcoma is rare, but it is the most aggressive type of cardiac malignant tumor. When disease is confirmed it is often late in its stage resulting in a poor prognosis. CASE PRESENTATION We reported a 52-year-old woman who complained of dyspnea for 2 months and dry cough for 10 days. Computed tomography (CT), F-fluorodeoxyglucose (F-FDG), positron emission tomography-computed tomography (PET-CT), and transthoracic echocardiography showed a space-occupying lesion 7 cm × 5 cm × 5 cm in the right atrium. Malignant cells can be seen in pericardial fluid by pericardiocentesis in local hospital, but not be diagnosed definitely. We conducted CT-guided biopsy of the tumor and observed the necrotic tissues. An exploratory thoracotomy was performed and histological examination confirmed angiosarcoma. Unable to be surgical excision due to infiltrating widely, the patients received chemotherapy with docetaxel for 2 cycles and the disease was progressive. Antiangiogenesis-targeted therapy was combined with chemotherapy for 3 months. Unfortunately, the tumor was still in progress. She died of respiratory failure, survived for 10 months. CONCLUSION It is difficult to diagnose the primary cardiac angiosarcoma in early stage. Chemotherapy and target therapy are very limited in this case. Surgery remains the preferred treatment for patients with primary cardiac angiosarcoma. More efforts should be carried out on the effective diagnosis and multimodality treatment for this malignant disease.
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Affiliation(s)
| | - Lu Li
- Department of Thoracic Surgery
| | | | | | - Jihua Wu
- Department of Pathology, the 306th Hospital of PLA, Beijing, China
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23
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Zaidi S, Husain S, Barakah D. Primary leiomyosarcoma of the atrium with heterologous differentiation. Ann Saudi Med 2017; 37:403-405. [PMID: 28988256 PMCID: PMC6074192 DOI: 10.5144/0256-4947.2017.403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
UNLABELLED We report a case of a 47-year-old female who presented with breathlessness and palpitations for two weeks. On clinical evaluation, bilateral pedal edema was noticed. A CT pulmonary angiogram showed a mass in the left atrium causing significant obstruction to cardiovascular outflow. After extensive work-up, the mass was surgically resected. Histopathological findings from the acquired specimen revealed a high-grade leiomyosarcoma with extensive necrosis and heterologous (cartilaginous) differentiation. The early postoperative period was complicated by cardiac tamponade and the patient died on the second postoperative day due to ventricular arrhythmia, shock and multiorgan failure. SIMILAR CASES PUBLISHED No similar cases published.
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Affiliation(s)
- Shaesta Zaidi
- Correspondence: Dr. Shaesta Zaidi Department of Patholoy, King Saud University, Riyadh 11411, Saudi Arabia T: +966-54-202-8371 ORCID: http://orcid.org/000-0002-8441-3050
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24
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Wang H, Shi J, Liu H, Chen Y, Wang Y, Wang W, Zhang L. Clinical and diagnostic features of angiosarcoma with pulmonary metastases: A retrospective observational study. Medicine (Baltimore) 2017; 96:e8033. [PMID: 28885371 PMCID: PMC6392612 DOI: 10.1097/md.0000000000008033] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Angiosarcoma with pulmonary metastasis is a rare, fatal disease that often presents with multiple pulmonary nodules and diffuse alveolar hemorrhage. We herein review the detailed clinical characteristics of pulmonary metastatic angiosarcoma and determine a reasonable diagnostic strategy.The medical records of 11 patients with pulmonary angiosarcoma were reviewed.The mean age of the patients was 45.7 years (range, 30-71 years). All patients were male. The most common symptom was hemoptysis (8/11). Common initial misdiagnoses were tuberculosis (5/11), vasculitis (2/11), nontuberculous infectious disease (1/11), and constrictive pericarditis (1/11). Chest computed tomography (CT) of patients with hemoptysis showed bilateral, randomly distributed, variably shaped, and differently sized nodules, as well as ground-glass opacities (GGO) (8/11). The right heart was the most common primary tumor site (8/11), but the sensitivity of echocardiography was limited; CT angiography and cardiac magnetic resonance imaging (MRI) revealed more atrial masses. CT-guided needle biopsy was difficult to perform in most patients because of the small size of the nodules. The diagnosis was made by surgical biopsy of either the lung (3/9) or heart (6/9). The median overall survival of patients who underwent lung biopsy and those who underwent cardiac/pericardiac biopsy was 4.1 and 1.4 months, respectively (P = .098). The median overall survival of the 9 available patients was 5.0 months (95% confidence interval, 0.500-8.544).Angiosarcoma with pulmonary metastases should be considered in patients with hemoptysis and concurrent GGO and nodules on their chest CT scan. Careful cardiologic monitoring is necessary for these patients, even without any cardiac symptoms or signs, and enhanced cardiac MRI is the first recommendation. Surgical biopsy is reliable for histological diagnosis, but the safety of the lung biopsy should be carefully assessed. When primary cardiac tumors are identified, heart biopsy should be preferentially considered.
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Affiliation(s)
| | | | | | | | - Yining Wang
- Radiology Department, Peking Union Medical College Hospital, Dong Cheng District, Beijing, China
| | | | - Li Zhang
- Department of Respiratory Medicine
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25
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Pomoni A, Sotiriadis C, Gay F, Jouannic AM, Qanadli SD. Percutaneous endovascular biopsy of intravascular masses: efficacy and safety in establishing pre-therapy diagnosis. Eur Radiol 2017; 28:301-307. [DOI: 10.1007/s00330-017-4983-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 04/28/2017] [Accepted: 07/10/2017] [Indexed: 12/20/2022]
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26
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Di Franco A, Gaudino M, Weinsaft JW, Pun SC, Narula N, Khan SA, Malik ZM, Ohmes LB, Skubas NJ, Girardi LN. “Second” Primary Cardiac Sarcoma in a Patient With Ewing Sarcoma. Always Expect The Unexpected. Ann Thorac Surg 2017; 103:e131-e133. [DOI: 10.1016/j.athoracsur.2016.07.063] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Revised: 07/09/2016] [Accepted: 07/20/2016] [Indexed: 10/20/2022]
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27
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Leduc C, Jenkins SM, Sukov WR, Rustin JG, Maleszewski JJ. Cardiac angiosarcoma: histopathologic, immunohistochemical, and cytogenetic analysis of 10 cases. Hum Pathol 2017; 60:199-207. [DOI: 10.1016/j.humpath.2016.10.014] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2016] [Revised: 09/20/2016] [Accepted: 10/14/2016] [Indexed: 02/07/2023]
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28
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Kukla P, Pleva L, Porzer M, Brát R, Handlos P, Buzrla P, Plášek J, Mrozek J, Homza M. Inferior vena cava leiomyosarcoma with right atrium tumorous mass presenting as heart failure in a 70-year-old man: A case report. COR ET VASA 2016. [DOI: 10.1016/j.crvasa.2015.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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29
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Machado I, Arana E, Cruz J, Brotons S, Vendrell J, Escriba I, Chust ML, Martínez-Banaclocha N, Lavernia J, Llombart-Bosch A. Malignant Peripheral Nerve Sheath Tumor With Osseous Heterologous Differentiation in Uncommon Locations (Heart and Retropharynx). Int J Surg Pathol 2016; 24:456-462. [DOI: 10.1177/1066896916632908] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
Abstract
We report two cases of malignant peripheral nerve sheath tumor (MPNST) in an uncommon location (heart and retropharynx) both with divergent osseous heterologous differentiation. We present the pathological and immunohistochemical studies that confirmed the neurogenic origin. The histopathology of the tumor arising in the retropharynx showed a transition from a neurofibroma to MPNST, making this a new report of an MPNST arising from a plexiform neurofibroma without neurofibromatosis. Primary cardiac MPNST with osseous differentiation has never been reported before. In conclusion, the histology of MPNSTs is very heterogeneous, showing no specific diagnostic immunoprofile or genetic alteration. Thus, it is important to rule out other histologically similar tumors, particularly in cases arising in uncommon locations or tumors with divergent heterologous differentiation.
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Affiliation(s)
| | | | - Julia Cruz
- Instituto Valenciano de Oncología, Valencia, Spain
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30
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Thyagarajan B, Unnikrishnan D, Patel S, Alagusundaramoorthy SS. Intracardiac metastasis of high-grade sarcoma of the neck causing right ventricular outflow obstruction. BMJ Case Rep 2016; 2016:bcr-2016-215455. [PMID: 27251603 DOI: 10.1136/bcr-2016-215455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
| | - Dileep Unnikrishnan
- Department of Internal Medicine, Monmouth Medical Center, Long Branch, New Jersey, USA
| | - Shil Patel
- Department of Internal Medicine, Monmouth Medical Center, Long Branch, New Jersey, USA
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31
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Jang Y, Kim J, Shim JW, Kim EY, Moon J, An J, Jeon YB, Lee KC, Ahn HK. Primary cardiac angiosarcoma: a prolonged response to surgical resection followed by concurrent chemoradiotherapy with docetaxel. SPRINGERPLUS 2016; 5:648. [PMID: 27330914 PMCID: PMC4870531 DOI: 10.1186/s40064-016-2248-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Accepted: 04/28/2016] [Indexed: 12/05/2022]
Abstract
Introduction Primary cardiac cancer is a very rare disease, among which primary cardiac angiosarcoma is one of the most frequent type and is characterized by extremely poor prognosis without established optimal treatment. Case description Here we report a case of primary cardiac angiosarcoma with hemorrhagic pericardial effusion who achieved a durable response with tumor excision followed by concurrent chemoradiotherapy with docetaxel. A sixty year old man was presented with dyspnea and was diagnosed with primary cardiac angiosarcoma with hemorrhagic pericardial effusion. After surgical excision of primary tumor with microscopic residual disease followed by concurrent chemoradiotherapy with docetaxel, the patient showed durable response of progression free survival of 12 months. Discussion and evaluation This case shows benefit of concurrent chemoradiotherapy with taxane. Further investigation of aggressive multimodal treatment strategy is warranted for primary cardiac angiosarcoma with pauci-metastasis even when achievement of complete resection seems unlikely.
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Affiliation(s)
- Youngwoo Jang
- Department of Internal Medicine, Gachon University Gil Medical Center, 1198 Guwol-dong, Namdong-gu, Incheon, 405-760 Republic of Korea
| | - Joonhwan Kim
- Department of Internal Medicine, Gachon University Gil Medical Center, 1198 Guwol-dong, Namdong-gu, Incheon, 405-760 Republic of Korea
| | - Jung Woo Shim
- Department of Internal Medicine, Gachon University Gil Medical Center, 1198 Guwol-dong, Namdong-gu, Incheon, 405-760 Republic of Korea
| | - Eun Young Kim
- Department of Radiology, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Jungkeun Moon
- Department of Internal Medicine, Gachon University Gil Medical Center, 1198 Guwol-dong, Namdong-gu, Incheon, 405-760 Republic of Korea
| | - Jungsuk An
- Department of Pathology, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Yang Bin Jeon
- Department of Thoracic and Cardiovascular Surgery, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Kyu Chan Lee
- Department of Radiation Oncology, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Hee Kyung Ahn
- Department of Internal Medicine, Gachon University Gil Medical Center, 1198 Guwol-dong, Namdong-gu, Incheon, 405-760 Republic of Korea
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32
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Vatankulu B, Dirlik Serim B, Sonmezoglu K, Vatankulu MA. Right Ventricle Metastasis of Pleomorfic Undifferentiated Sarcoma Detected by FDG PET/CT and Three-Dimensional Echocardiography. Echocardiography 2016; 33:1103-4. [PMID: 27109261 DOI: 10.1111/echo.13241] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Affiliation(s)
- Betül Vatankulu
- Cerrahpasa Faculty of Medicine, Department of Nuclear Medicine, Istanbul University, Istanbul, Turkey
| | - Burcu Dirlik Serim
- Cerrahpasa Faculty of Medicine, Department of Nuclear Medicine, Istanbul University, Istanbul, Turkey
| | - Kerim Sonmezoglu
- Cerrahpasa Faculty of Medicine, Department of Nuclear Medicine, Istanbul University, Istanbul, Turkey
| | - Mehmet A Vatankulu
- Faculty of Medicine, Department of Cardiology, Bahcelievler Medical Park Hospital, Istanbul, Turkey
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34
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Primary Left Cardiac Angiosarcoma with Mitral Valve Involvement Accompanying Coronary Artery Disease. Case Rep Surg 2015; 2015:810306. [PMID: 26649221 PMCID: PMC4663746 DOI: 10.1155/2015/810306] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Accepted: 11/04/2015] [Indexed: 11/17/2022] Open
Abstract
We report here on a 43-year-old female patient presenting with non-ST elevation myocardial infarction, severe mitral regurgitation, and mild mitral stenosis secondary to encroachment of the related structures by a primary cardiac angiosarcoma. A coronary angiography revealed significant stenosis in the left main and left circumflex arteries and at exploration, the tumour was arising from posterior left atrial free wall, invading the posterior mitral leaflet, and extending into all of the pulmonary veins and pericardium. Therefore, no further intervention was performed, except for left internal mammarian artery to left anterior descending artery anastomosis and biopsy. As far as we know, this case is unique with respect to its presentation.
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35
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Kupsky DF, Newman DB, Kumar G, Maleszewski JJ, Edwards WD, Klarich KW. Echocardiographic Features of Cardiac Angiosarcomas: The Mayo Clinic Experience (1976-2013). Echocardiography 2015; 33:186-92. [PMID: 26460068 DOI: 10.1111/echo.13060] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE Cardiac angiosarcoma is the most common primary malignant cardiac tumor. The dismal prognosis and nonspecific symptomatology underscore the need for an accurate and cost-effective approach to the identification and characterization of this rare tumor. METHODS Mayo Clinic tissue registry archives were queried for all histologically confirmed cases of cardiac angiosarcoma (1976-2013) with available imaging data. Echocardiograms were retrospectively reviewed. RESULTS Thirty-three cases of cardiac angiosarcoma were identified; of these, 17 had echocardiograms available (mean age, 46 years; six men). Transthoracic echocardiography (TTE) as the initial diagnostic test had 75% sensitivity for visualizing primary cardiac angiosarcoma (9/12 patients). Tumor extension into the pericardium was common and pericardial effusion was present in 15 patients (88%); however, pericardial fluid cytology was negative for malignancy in all tested patients (n = 15). Left ventricular ejection fraction (LVEF) was preserved in 16 patients (94%) (average LVEF, 62%). Right ventricular function was mildly reduced in two patients (12%) at initial presentation. Tricuspid valve obstruction was present in three patients (18%; mean diastolic gradient, 6.3 mmHg [range, 3-11 mmHg]). CONCLUSION The sensitivity of TTE as the first diagnostic imaging modality compared favorably with computed tomography. Pericardial effusion was common, but pericardial fluid cytology was negative in all patients who underwent pericardiocentesis. The absence of a stalk was a universal finding that may help distinguish angiosarcoma from benign, primarily pedunculated tumors such as myxoma and papillary fibroelastoma.
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Affiliation(s)
- Daniel F Kupsky
- Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | - Darrell B Newman
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota
| | - Gautam Kumar
- Division of Cardiology, Emory University School of Medicine/Atlanta VA Medical Center, Atlanta, Georgia
| | - Joseph J Maleszewski
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota.,Division of Anatomic Pathology, Mayo Clinic, Rochester, Minnesota
| | | | - Kyle W Klarich
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota
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36
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Thway K, Jordan S, Fisher C, Nicholson AG. Updates in the approach to intrathoracic sarcomas. Histopathology 2015; 67:755-70. [DOI: 10.1111/his.12771] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Khin Thway
- Sarcoma Unit; Royal Marsden Hospital; London UK
| | - Simon Jordan
- Department of Surgery; Royal Brompton Hospital; London UK
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37
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Lestuzzi C, De Paoli A, Baresic T, Miolo G, Buonadonna A. Malignant cardiac tumors: diagnosis and treatment. Future Cardiol 2015; 11:485-500. [DOI: 10.2217/fca.15.10] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Primary malignant cardiac tumors are represented by sarcomas and non-Hodgkin lymphomas. They are rare, affect mostly patients in the fourth decade of life and have a severe prognosis. Both the diagnosis and the treatment require a multidisciplinary approach, and the cardiologist plays a central role both in the diagnosis and in the follow-up. The prognosis may be improved by a careful planning of surgery and by the use of multimodality treatment, including complementary chemotherapy and radiation therapy. A strict follow-up must be planned even after apparently complete cure.
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Affiliation(s)
- Chiara Lestuzzi
- Cardiology Unit, Oncology Department, CRO, National Cancer Institute (IRCCS), Aviano (PN), Italy
| | - Antonino De Paoli
- Radiation Oncology Department, CRO, National Cancer Institute (IRCCS), Aviano (PN), Italy
| | - Tanja Baresic
- Nuclear Medicine Unit, CRO, National Cancer Institute (IRCCS), Via F Gallini 2, 33081, Aviano (PN), Italy
| | - Gianmaria Miolo
- Medical Oncology, Oncology Department, CRO, National Cancer Institute (IRCCS), Aviano (PN), Italy
| | - Angela Buonadonna
- Medical Oncology, Oncology Department, CRO, National Cancer Institute (IRCCS), Aviano (PN), Italy
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Huo Z, Lu H, Mao Q, Jin Z, Wu H, Feng X, Xiao Y, Wang Y, Guo L. Primary synovial sarcoma of the right heart involving the tricuspid valve in an elderly Chinese woman: a case report. Diagn Pathol 2015; 10:80. [PMID: 26112006 PMCID: PMC4482032 DOI: 10.1186/s13000-015-0300-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2014] [Accepted: 05/12/2015] [Indexed: 12/13/2022] Open
Abstract
Described herein is a 51-year-old woman with abdominal discomfort who was found to have a pericardial effusion and a large mass in her right heart by computed tomography scan and who then underwent tumour resection surgery. The tumour was so extensive that it involved the right atrium, the right ventricle and the tricuspid valve, and encompassed the right coronary artery. The patient had no significant medical history, and no tumour was found at any other site. The morphology of the tumour mimicked carcinosarcoma, exhibiting mixed epithelioid and spindle elements and it was difficult to differentiate the diagnosis even by immunohistochemical stains. Then, the final diagnosis of primary biphasic synovial sarcoma of the heart was established based on the finding of SS18 rearrangement. This is a highly intriguing rare case that may represent a diagnostic pitfall, particularly regarding frozen section. The patient will receive chemotherapy, and we will pursue follow-up.
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MESH Headings
- Biomarkers, Tumor/analysis
- Biomarkers, Tumor/genetics
- Chemotherapy, Adjuvant
- China
- Diagnosis, Differential
- Female
- Frozen Sections
- Gene Rearrangement
- Heart Neoplasms/chemistry
- Heart Neoplasms/complications
- Heart Neoplasms/genetics
- Heart Neoplasms/pathology
- Heart Neoplasms/surgery
- Humans
- Immunohistochemistry
- In Situ Hybridization, Fluorescence
- Middle Aged
- Paraffin Embedding
- Pericardial Effusion/etiology
- Predictive Value of Tests
- Proto-Oncogene Proteins/genetics
- Repressor Proteins/genetics
- Sarcoma, Synovial/chemistry
- Sarcoma, Synovial/complications
- Sarcoma, Synovial/genetics
- Sarcoma, Synovial/pathology
- Sarcoma, Synovial/surgery
- Tomography, X-Ray Computed
- Tricuspid Valve/chemistry
- Tricuspid Valve/pathology
- Tricuspid Valve/surgery
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Affiliation(s)
- Zhen Huo
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No.1Shuaifuyuan, Wangfujing Street, Dongcheng District, Beijing, 100730, China.
| | - Haizhen Lu
- Department of Pathology, Cancer Hospital/Institute, Chinese Academy of Medical Sciences, Beijing, 100021, China.
| | - Qi Mao
- Department of Cardiac Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China.
| | - Zhengyu Jin
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China.
| | - Huanwen Wu
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No.1Shuaifuyuan, Wangfujing Street, Dongcheng District, Beijing, 100730, China.
| | - Xiaoli Feng
- Department of Pathology, Cancer Hospital/Institute, Chinese Academy of Medical Sciences, Beijing, 100021, China.
| | - Yu Xiao
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No.1Shuaifuyuan, Wangfujing Street, Dongcheng District, Beijing, 100730, China.
| | - Yining Wang
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China.
| | - Lina Guo
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No.1Shuaifuyuan, Wangfujing Street, Dongcheng District, Beijing, 100730, China.
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Waness A, Batoon AA, Mirza I, Al Mahmeed W. Elusive Cardiac Angiosarcoma in a Young Pregnant Female: Rare Presentation With Fatal Outcome. Cardiol Res 2015; 6:292-296. [PMID: 28197244 PMCID: PMC5295525 DOI: 10.14740/cr402w] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/25/2015] [Indexed: 12/15/2022] Open
Abstract
Heart tumors are rare occurrences. They can present diagnostic challenges and severe complications especially in pregnant women. We report a rare case of angiosarcoma (AS) cordis of the right atrium in a young healthy pregnant female. Her diagnosis remained elusive for some time until development of advanced disease symptomatology. The diagnosis was unfortunately clinched when her tumor grew to be detected by imaging modalities. An emergency cesarean section was performed delivering a healthy baby. The patient was aggressively treated with chemotherapy to no avail. She passed away 2 months after her diagnosis was established. Only few cases of the occurrence of aggressive cardiac AS and human pregnancy are documented. The course of this disastrous combination is usually marked by severe complications, difficult therapeutic options and ultimately fast demise. Physicians need to be more aware of such diagnosis and diligently try to diagnose it as early as possible.
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Affiliation(s)
- Abdelkarim Waness
- Obstetrics and Gynecology Department, Sidra Medical and Research Center, Doha, Qatar
| | - Amal A Batoon
- Department of Medicine, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
| | - Imran Mirza
- Department of Pathology, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
| | - Wael Al Mahmeed
- Department of Cardiology, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
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Wang JG, Cui L, Jiang T, Li YJ, Wei ZM. Primary cardiac leiomyosarcoma: an analysis of clinical characteristics and outcome patterns. Asian Cardiovasc Thorac Ann 2015; 23:623-30. [PMID: 25740020 DOI: 10.1177/0218492315574197] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Primary cardiac leiomyosarcoma is an extremely rare entity. There is no accumulated knowledge about the clinical characteristics and therapeutic strategies for this tumor. This study aimed to systematically review the available literature to investigate the clinicoradiologic and clinicopathologic characteristics, treatment, and outcomes in patients with primary cardiac leiomyosarcoma. METHODS We identified 79 instances derived from 72 unique reports and carefully analyzed all clinical presentations, imaging, pathology, treatments, and outcomes. RESULTS The mean age at onset was 48 years. A symptom of obstruction was the most frequent complaint at diagnosis. Routine imaging methods such as echocardiography, computed tomography, and magnetic resonance imaging had high sensitivity in diagnosis. The tumor has a poorer life expectancy than its counterparts in other sites. The 5-year overall survival and recurrence-free survival rates were 25.4% and 14.7%, respectively. Overall survival was affected by age, surgery, and adjunctive chemotherapy or radiotherapy. CONCLUSIONS Our findings suggest that primary cardiac leiomyosarcomas tend to be biologically more aggressive compared to their counterparts in other sites. However, complete resection and adjunctive chemotherapy or radiotherapy may help to increase the life expectancy.
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Affiliation(s)
- Ji-Gang Wang
- Department of Pathology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Li Cui
- Department of Nephrology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Tao Jiang
- Department of Oncology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yu-Jun Li
- Department of Pathology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Zhi-Min Wei
- Department of Pathology, The Affiliated Hospital of Qingdao University, Qingdao, China
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Glaoui M, Benbrahim Z, Belbaraka R, Naciri S, Errihani H, Lescene A. An uncommon long-term survival case of primary cardiac leiomyosarcoma. World J Surg Oncol 2014; 12:338. [PMID: 25385248 PMCID: PMC4289262 DOI: 10.1186/1477-7819-12-338] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2013] [Accepted: 10/20/2014] [Indexed: 11/10/2022] Open
Abstract
Primary cardiac sarcoma is a rare aggressive entity. It constitutes the second most common type of primary cardiac neoplasms. Its management has largely been guided by small retrospective series with a median survival of 6 months. Here, we discuss a unique case of 8-year survival cardiac leiomyosarcoma managed by surgical and adjuvant therapy.
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Affiliation(s)
| | - Zineb Benbrahim
- Gustave Roussy Institute, 114 Rue Édouard Vaillant, 94805 Villejuif, France.
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Anvari MS, Naderan M, Eslami Shahr Babaki A, Shoar S, Boroumand MA, Abbasi K. Clinicopathologic review of non-myxoma cardiac tumors: a 10-year single-center experience. Cardiology 2014; 129:199-202. [PMID: 25342027 DOI: 10.1159/000365916] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2014] [Accepted: 07/14/2014] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To report the prevalence, clinical presentation and histological characteristics of non-myxoma cardiac tumors in a major tertiary heart center. METHOD Review of the medical profiles of 36,930 patients admitted to our hospital between 2003 and 2013 yielded a total of 86 cases of cardiac tumors (63 cases of myxomas and 23 cases of non-myxoma tumors). Clinical presentations and histological features were presented exclusively for primary and secondary tumors. RESULTS Of 23 enrolled patients with non-myxoma tumors, 5 had primary tumors and 18 had secondary or metastatic tumors. The most frequent origins of the secondary tumors were breast cancer, lymphoma, leukemia and lung cancer. Most secondary tumors had pericardial involvement, and only one tumor involved the left atrium. Sarcomas, including spindle-cell sarcoma and liposarcoma, comprised the majority of the primary malignant tumors. None of these tumors had pericardial involvement, and, except for one case, all were confined to the left side of the heart. All patients were symptomatic on admission, with dyspnea being the most frequent presenting symptom. CONCLUSION Metastatic cardiac tumors were more prevalent than the primary ones, with fibromas constituting the largest proportion of the primary tumors and breast cancer being the prevalent cause of metastasis.
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Affiliation(s)
- Maryam Sotoudeh Anvari
- Department of Surgical and Clinical Pathology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
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43
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Coskun U, Sinan UY, Calpar I, Yildizeli B, Yanartas M, Filinte D, Kucukoglu MS. Pulmonary artery sarcoma masquerading as chronic pulmonary thromboembolism. Tex Heart Inst J 2014; 41:518-22. [PMID: 25425987 DOI: 10.14503/thij-13-3598] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
We describe the case of a 60-year-old woman who presented with pulmonary artery sarcoma, a very rare tumor of the cardiovascular system. Her tumor was initially misdiagnosed as chronic pulmonary thromboembolism, and she underwent pulmonary endarterectomy. Early diagnosis of primary pulmonary artery sarcoma is crucial. That alternative should always be considered before settling on a diagnosis of pulmonary embolism. Suspicion should be aroused by the failure of anticoagulant treatment to alleviate pulmonary perfusion abnormalities and systemic symptoms. Surgical resection of the tumor-preferably by pulmonary endarterectomy, followed by reconstruction as needed-is currently the most promising treatment for pulmonary artery sarcoma.
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Prognostic analysis for survival after resections of localized primary cardiac sarcomas: a single-institution experience. Ann Thorac Surg 2014; 97:1379-85. [PMID: 24565404 DOI: 10.1016/j.athoracsur.2013.12.030] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2013] [Revised: 11/22/2013] [Accepted: 12/09/2013] [Indexed: 11/23/2022]
Abstract
BACKGROUND Primary cardiac sarcomas are rare diseases with a poor prognosis. This study aims to provide a prognostic analysis after different levels of resections of cardiac sarcomas. METHODS Twenty-nine patients undergoing resections of primary cardiac sarcomas at the Zhongshan Hospital from September 1995 to July 2012 were retrospectively reviewed. RESULTS There were 15 women and 14 men. The mean age was 41.0 years. The most common histologic type was angiosarcoma (28%). The median survival for the entire cohort was 17 months (range, 5 to 216 months). Patients with microscopically negative margin (R0) resections had a better median survival than those with microscopically positive margin (R1) resections (58 months versus 11 months; p<0.001). The median survival after an R1 resection was not different from that after a partial resection (12 months; p=0.81). The median local recurrence-free survival after an R0 resection was longer than that after an R1 resection (36 months versus 6 months; p<0.001). Five patients who underwent R0 resections and repeated resections of local recurrences or metastases had the longest median survival of 72 months. None of the patients with R0 resections received adjuvant therapy. Multimodality treatment after R1 and partial resections slightly increased the survival. CONCLUSIONS For nonmetastatic and localized primary cardiac sarcoma, an R0 surgical resection of cardiac sarcomas should be performed. Aggressive surgical treatment or radiation therapy for local recurrence or metastasis prolongs the survival. Multimodality treatment is recommended after incomplete resections of cardiac sarcomas. The role of adjuvant chemotherapy after R0 resections is unclear.
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Bezerra SG, Brandão AA, Albuquerque DC, Militão RC, Hadlich MS, Azevedo CF. Pericardial synovial sarcoma: case report and literature review. Arq Bras Cardiol 2014; 101:e103-6. [PMID: 24522279 PMCID: PMC4106819 DOI: 10.5935/abc.20130235] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Sabrina Godoy Bezerra
- Instituto D'Or de Pesquisa e Ensino (IDOR), Rio de Janeiro, RJ
- Rede Labs D'Or - Grupo Fleury, Rio de Janeiro, RJ - Brazil
| | | | - Denilson Campos Albuquerque
- Instituto D'Or de Pesquisa e Ensino (IDOR), Rio de Janeiro, RJ
- Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ
| | - Rochelle Coppo Militão
- Instituto D'Or de Pesquisa e Ensino (IDOR), Rio de Janeiro, RJ
- Rede Labs D'Or - Grupo Fleury, Rio de Janeiro, RJ - Brazil
| | - Marcelo Souza Hadlich
- Instituto D'Or de Pesquisa e Ensino (IDOR), Rio de Janeiro, RJ
- Rede Labs D'Or - Grupo Fleury, Rio de Janeiro, RJ - Brazil
| | - Clerio Francisco Azevedo
- Instituto D'Or de Pesquisa e Ensino (IDOR), Rio de Janeiro, RJ
- Rede Labs D'Or - Grupo Fleury, Rio de Janeiro, RJ - Brazil
- Mailing address: Clerio Francisco Azevedo Instituto D'Or de Pesquisa e
Ensino - Rua Diniz Cordeiro 30, Botafogo. Postal Code 22281-100, Rio de Janeiro, RJ,
Brazil E-mail: ,
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46
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Bhattacharyya S, Khattar RS, Gujral DM, Senior R. Cardiac tumors: the role of cardiovascular imaging. Expert Rev Cardiovasc Ther 2013; 12:37-43. [PMID: 24345096 DOI: 10.1586/14779072.2014.872031] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Evaluation of cardiac tumors with cardiovascular imaging aims to establish aetiology, identify complications of tumor and help define management strategy. 2D echocardiography remains the primary diagnostic modality. Additional use of newer echocardiographic techniques such as 3D, strain and contrast echocardiography better characterise tumor morphology, tissue characteristics and vascularity respectively. Cardiac MRI and computed tomography provide complementary information and are able to identify extra-cardiac infiltration and also provide further tissue characterisation. This review explores the non-invasive diagnostic approach to evaluation of cardiac tumors.
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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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48
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Oh SJ, Yeom SY, Kim KH. Clinical implication of surgical resection for the rare cardiac tumors involving heart and great vessels. J Korean Med Sci 2013; 28:717-24. [PMID: 23678263 PMCID: PMC3653084 DOI: 10.3346/jkms.2013.28.5.717] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2012] [Accepted: 02/27/2013] [Indexed: 11/20/2022] Open
Abstract
This study aimed to investigate the clinical implication of surgical resection for the malignancies of heart and great vessels. Between January 2001 and May 2011, a retrospective review of the results in 12 patients was conducted. There were 6 patients with primary cardiac tumor including leiomyosarcoma, angiosarcoma, undifferentiated type sarcoma and malignant fibrous histiocytoma. The remaining 6 patients had the metastatic tumors or adjacent invasion to the heart and great vessels. Six of seven patients who underwent complete resection had no evidence of recurrence. However, four of five patients who underwent incomplete resection or biopsy showed local recurrence or distant metastasis of residual tumor, and one of them required reoperation for recurred tumor. In-hospital mortality was 8.3% and the mean survival of all patients was 22.2 ± 6.1 months. Survival of the incomplete resection group, except for the two biopsy cases, was 25.9 ± 7.9 months, and there was no mortality in the complete resection group. Therefore, clinical outcomes in patients who had malignancies of the heart and great vessels may be improved when the aggressive and complete resection, or possible debulking for palliation, was performed. Moreover, adjuvant multimodality therapy may be imperative to prevent recurrence or metastasis, and to provide improved survival.
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Affiliation(s)
- Se Jin Oh
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Sang Yoon Yeom
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Kyung-Hwan Kim
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
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Cutaneous metastases can be the initial presenting sign of a cardiac sarcoma. Am J Dermatopathol 2013; 35:286-7. [PMID: 23542718 DOI: 10.1097/dad.0b013e318267faa3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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50
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Ruptured cardiac angiosarcoma with pulmonary metastases: a rare disease with a common (mis)diagnosis! Indian Heart J 2012; 64:603-6. [PMID: 23253417 DOI: 10.1016/j.ihj.2012.07.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2012] [Revised: 06/20/2012] [Accepted: 07/17/2012] [Indexed: 11/23/2022] Open
Abstract
In Indian settings pulmonary tuberculosis remains the most common diagnosis in a patient presenting with constitutional symptoms, hemoptysis and lung opacities. We describe a case report of a fifty-year-old woman who was receiving empirical anti-tubercular drugs for a metastatic illness to lungs arising from a primary angiosarcoma in the right atrium. This rare entity was misdiagnosed and typical echocardiographic findings suggested this diagnosis.
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