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Chen X, Chen Y, Xiao F, Liu M, Gu Z, Li Y, Hong M. Survival and analysis of prognostic factors for primary malignant cardiac tumors based on the SEER database. J Cancer Res Clin Oncol 2023; 149:15687-15696. [PMID: 37665405 DOI: 10.1007/s00432-023-05351-4] [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: 07/27/2023] [Accepted: 08/25/2023] [Indexed: 09/05/2023]
Abstract
PURPOSE The purpose of this study was to use the Surveillance, Epidemiology, and End Results (SEER) database to evaluate the survival rate of primary malignant cardiac tumors (PMCTs), assess the risk factors affecting survival, and calculate the number of PMCT cases in recent years. METHODS SEER 22 registries were used to calculate the number of cases PMCT. Data on age, sex, race, marital status, tumor size, the American Joint Committee on Cancer (AJCC) stage, lymph node involvement, metastasis, treatment, and survival were collected to analyze the survival and prognostic factors of SEER 17 registries. Using the Kaplan-Meier estimation method, a survival curve was obtained according to the influencing factors, and a multivariable Cox regression model was established. RESULTS In recent years, the average annual number of PMCT cases was 20.56 ± 7.12, significantly higher than the average before 2004 (P = 0.015; 95% CI 1.14-8.98). The 1-, 3-, and 5-year survival rates were 45.6%, 18.8%, and 11.2%, respectively. Multivariate analysis revealed that age (risk ratio [HR], 2.047; 95% CI 1.381-3.034), AJCC stage III (HR, 1.786; 95% CI 1.123-2.839), AJCC staging with distant metastasis (HR, 2.666; 95% CI 1.509-4.709), no chemotherapy (HR, 2.011; 95% CI 1.561-2.590), and tumor size larger than 99 mm (HR, 1.766; 95% CI 1.132-2.756) were independent risk factors for poor prognosis. Only age over 76 years and distant metastasis were independent risk factors for prognosis in the chemotherapy group. CONCLUSION In recent years, the annual number of patients with PMCT has increased significantly. Due to developments in chemotherapy, we should re-evaluate the traditional tumor staging and prognostic risk indicators to improve clinical applications.
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Affiliation(s)
- Xiaoxiao Chen
- The Second Affiliated Hospital of Nanjing Medical University, 121 Jiangjiayuan, Nanjing, China
| | - Yizhou Chen
- The Second Affiliated Hospital of Nanjing Medical University, 121 Jiangjiayuan, Nanjing, China
| | - Fangping Xiao
- The Second Affiliated Hospital of Nanjing Medical University, 121 Jiangjiayuan, Nanjing, China
| | - Meng Liu
- The Second Affiliated Hospital of Nanjing Medical University, 121 Jiangjiayuan, Nanjing, China
| | - Zhan Gu
- The Second Affiliated Hospital of Nanjing Medical University, 121 Jiangjiayuan, Nanjing, China
| | - Yi Li
- The Second Affiliated Hospital of Nanjing Medical University, 121 Jiangjiayuan, Nanjing, China
| | - Mei Hong
- The Second Affiliated Hospital of Nanjing Medical University, 121 Jiangjiayuan, Nanjing, China.
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2
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Abdul-Rahman DG, Hajisaeed SR, Othman YN, Anwar EO, Majeed ZS, Ali RK, Muhamad HN, Qadir OO. Patient with myelodysplastic syndrome presented with recurrent pericardial effusion diagnosed as epicardial hemangioma; Case report of a rare diagnosis with rare presentation. Radiol Case Rep 2023; 18:2253-2258. [PMID: 37123036 PMCID: PMC10130068 DOI: 10.1016/j.radcr.2023.03.028] [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: 01/20/2023] [Revised: 03/07/2023] [Accepted: 03/15/2023] [Indexed: 05/02/2023] Open
Abstract
Primary cardiac tumors are extremely rare and cardiac hemangiomas comprise less than 3% of them. Presentation of such disease with recurrent pericardial effusion is even rarer. Our patient is known case of myelodysplastic syndrome and up to our knowledge there are no reported case in which cardiac hemangioma was diagnosed in a patient with myelodysplastic syndrome. This 64 years male patient presented to our department with recurrent pericardial effusion, diagnosis was a query after extensive work he was found to suffer from a cardiac tumor based on the pulmonary artery and right ventricle. We performed surgery for him on cardiopulmonary bypass and did complete resection of the mass for him and result of biopsy showed mixed hemangioma. Recurrent pericardial effusion is most commonly a sign of a malignancy. Even with advancement of medical technology diagnoses of cardiac hemangiomas are still difficult. Treatment and definitive diagnosis is still complete surgical resection and histopathological examination.
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Affiliation(s)
| | - Shkar R. Hajisaeed
- Head of Cardiac Surgery Department, Open Heart Center, Slemany Teaching Hospital, Sulaimani, Iraq
- College of Medicine, University of Sulaimani, Sulaimani, Iraq
| | - Yad N. Othman
- Department of Thoracic and cardiovascular surgery Surgery PY3, Shar hospital, , Sulaimani DOH/KRG, Malik Mahmood Circle, Sulaimanyah, Iraq
- Corresponding author.
| | - Erfan Omer Anwar
- Cardiac surgery department, Open Heart Center, Slemany Teaching Hospital, Sulaimani, Iraq
| | - Zryan Salar Majeed
- Department of Thoracic and Cardiovascular Surgery PY4, Shar hospital, Sulaimani
| | - Razhan K. Ali
- Department of Thoracic and Cardiovascular Surgery, Shar hospital, Sulaimani DOH/KRG, Sulaimanyah, Iraq
| | - Han Nihad Muhamad
- Pathology department, University of Sulaimany, college of dentistiry, As-Sulaimaniyah, Kurdistan, Iraq
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3
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Rodrigues H, Ramalho AR, Correia I, Ferreira R, Santos L. Primary Cardiac Tumor in the Left Atrium: A Diagnostic Challenge. Cureus 2023; 15:e39443. [PMID: 37378158 PMCID: PMC10292095 DOI: 10.7759/cureus.39443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2023] [Indexed: 06/29/2023] Open
Abstract
An elderly man presented to the emergency department with shortness of breath, peripheral edema, and significant weight loss. Blood tests revealed anemia and elevated inflammatory markers, and chest imaging showed a massive left pleural effusion. During hospitalization, he developed subacute cardiac tamponade, and pericardiocentesis was performed. Further imaging revealed a primary malignant cardiac tumor with extensive infiltration of the cardiac tissue, and biopsy was deemed impossible due to the tumor's location. The most likely diagnosis was angiosarcoma. The cardiac surgery team evaluated the case and considered it inoperable due to the tumor's extensive infiltration. The patient is currently under the regular care of a palliative care team. This case underscores the difficulties of diagnosing primary cardiac tumors, particularly in elderly patients with comorbidities. Despite advances in imaging and surgical techniques, the prognosis for malignant cardiac tumors remains poor.
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Affiliation(s)
- Helena Rodrigues
- Internal Medicine Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, PRT
| | - Ana Rita Ramalho
- Internal Medicine Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, PRT
| | - Isabel Correia
- Internal Medicine Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, PRT
| | - Rogério Ferreira
- Internal Medicine Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, PRT
| | - Lèlita Santos
- Internal Medicine Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, PRT
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4
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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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5
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Thoddi Ramamurthy M, Kumar Balakrishnan V, Sunny S, Rajkumar A, Sundaram S, Krishnamurthy P, Boopathy Senguttuvan N, Murali A, Santhosham JDR, Periandavan K, Rajasekaran NS. Case report: Metastatic myxoid liposarcoma arising from the right atrium extends as cardiac tamponade-A rare case of atrial oncology. Front Cardiovasc Med 2023; 9:1046436. [PMID: 36776944 PMCID: PMC9909183 DOI: 10.3389/fcvm.2022.1046436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 12/20/2022] [Indexed: 01/27/2023] Open
Abstract
The reported incidence of liposarcomas in ~2,000 cases annually results in about 30% of myxoid liposarcomas. Cardiac myoxid liposarcomas are very rare; their presentation could be cardiac tamponade, due to direct compression of the tumor and/or pericardial effusion. In this report, we describe a patient who presented with pericardial effusion secondary to myoxid liposarcomas from the right atrium, an extremely rare presentation of liposarcomas in the heart. We also present non-invasive imaging through echocardiography, CECT thorax and FDG PET scans, followed by a CT-guided mass biopsy. Histopathology of the right atrial mass demonstrated myxoid liposarcoma positive for the S100 tumor marker.
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Affiliation(s)
- Muralidharan Thoddi Ramamurthy
- Department of Cardiology, Sri Ramachandra Medical University and Research Institute, Chennai, Tamil Nadu, India,Muralidharan Thoddi Ramamurthy ✉
| | - Vinod Kumar Balakrishnan
- Department of Cardiology, Sri Ramachandra Medical University and Research Institute, Chennai, Tamil Nadu, India
| | - Sini Sunny
- Division of Molecular and Cellular Pathology, Department of Pathology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Abinayaa Rajkumar
- Department of Medical Biochemistry, University of Madras, Taramani Campus, Chennai, Tamil Nadu, India
| | - Sandhya Sundaram
- Department of Cardiology, Sri Ramachandra Medical University and Research Institute, Chennai, Tamil Nadu, India
| | - Preetam Krishnamurthy
- Department of Cardiology, Sri Ramachandra Medical University and Research Institute, Chennai, Tamil Nadu, India
| | | | - Arunan Murali
- Department of Radiology, Sri Ramachandra Medical University and Research Institute, Chennai, Tamil Nadu, India
| | - J. D. Roy Santhosham
- Department of Radiology, Sri Ramachandra Medical University and Research Institute, Chennai, Tamil Nadu, India
| | - Kalaiselvi Periandavan
- Department of Medical Biochemistry, University of Madras, Taramani Campus, Chennai, Tamil Nadu, India
| | - Namakkal S. Rajasekaran
- Division of Molecular and Cellular Pathology, Department of Pathology, University of Alabama at Birmingham, Birmingham, AL, United States,Division of Cardiovascular Medicine, Department of Medicine, University of Utah, Salt Lake City, UT, United States,*Correspondence: Namakkal S. Rajasekaran ✉
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6
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Rangashamaiah S, Jagadeesh HV, Rangan K, Ramegowda K, Nanjappa M. Clinicopathological correlation of cardiac myxoma- insights from a large volume tertiary cardiac center in South India. JOURNAL OF THE INDIAN ACADEMY OF ECHOCARDIOGRAPHY & CARDIOVASCULAR IMAGING 2023. [DOI: 10.4103/jiae.jiae_42_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
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7
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Zhu J, Zhang N, Ma Q, Jin L, Pan X. Intracardiac biopsy of cardiac tumors with echocardiographic guidance: Case report. Front Cardiovasc Med 2023; 10:1103918. [PMID: 37180777 PMCID: PMC10173306 DOI: 10.3389/fcvm.2023.1103918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 03/29/2023] [Indexed: 05/16/2023] Open
Abstract
Background Primary cardiac tumors are very rare, and about 20-30% of them are malignant tumors. Since early signs of cardiac tumors are non-specific, diagnosis can be challenging. There is a lack of the recommended guidelines or standardized strategies for diagnosis and optimal treatment for this disease. As the definite diagnoses of most tumors are made by pathologic confirmation, biopsied tissue is essential in determining the treatment for patients with cardiac tumors. Recently, intracardiac echocardiography (ICE) has been introduced to assist biopsy procedures of cardiac tumors and it provides high-quality imaging. Case Description Due to its low prevalence and variable presentation, cardiac malignant tumors usually are easily missed. Hereby, we report three cases of patients who presented with non-specific signs of cardiac disorder and was initially suspended diagnosis as lung infection or cancer. Under the guidance of ICE, cardiac biopsies were successfully on cardiac masses, giving critical data for diagnosis and treatment planning. No procedural complications were obtained in our cases. These cases are intended to highlight the clinical value and importance of ICE-guided biopsy of intracardiac mass. Conclusions The diagnosis of primary cardiac tumors relies on the histopathological results. In our experience, using ICE for biopsy of an intracardiac mass is an attractive tool to increase diagnostic results and reduce the risk of cardiac complications associated with inadequate targeting of the biopsy catheters.
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Affiliation(s)
- Jinyun Zhu
- Department of Cardiology, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Ning Zhang
- Department of Cardiology, the Affiliated Hangzhou First People’s Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Qunchao Ma
- Department of Cardiology, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Luhang Jin
- Department of Cardiology, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Xiaohong Pan
- Department of Cardiology, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- Correspondence: Xiaohong Pan
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8
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Incidental finding of a right ventricular mass: Fibroma or thrombosis? Radiol Case Rep 2022; 17:3754-3759. [PMID: 35965937 PMCID: PMC9363925 DOI: 10.1016/j.radcr.2022.07.026] [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: 06/16/2022] [Revised: 07/01/2022] [Accepted: 07/05/2022] [Indexed: 12/05/2022] Open
Abstract
Primary cardiac tumors are very rare and are often confused with other conditions due to clinical presentations or initial imaging. Here, we present a rare case of a 56-year-old male with right ventricular mass incidentally found on imaging. Appropriate testing should be conducted to rule out the possibility of a benign tumor. Asymptomatic patients with co-morbidities can be managed without surgery. More research is needed to devise guidelines for the management of these cases.
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9
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Sankarasubramanian S, Prabhakar P, Narasimhan MK. Genetic insights into cardiac tumors: a comprehensive review. MEDICAL ONCOLOGY (NORTHWOOD, LONDON, ENGLAND) 2022; 39:164. [PMID: 35972566 DOI: 10.1007/s12032-022-01761-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 05/31/2022] [Indexed: 11/24/2022]
Abstract
Cardiac neoplasms are rare, however, also a curable form of the disease once detected early. In recent years the viscus tumors have gained their highlights, due to the advancement in techniques like echocardiography both 2D and 3D, MRI, etc. These cardiac tumors are divided based on their benign and malignant nature and also as well as primary and secondary cardiac tumors. Largely the primary cardiac tumors are often than secondary cardiac tumors. The secondary tumor happens anywhere in the body involving the heart. The most common malignant tumors are sarcoma, some are angiosarcomas, fibromas, rhabdosarcoma, and leiomyosarcoma. The primary sarcoma affects both men and women at an equal rate with non-specific symptoms. These conditions led to high demand in genomic testing that helps in spot the mutation that leads to the particular type of cardiac neoplasm and it additionally helps to screen the mutated sequence and stop it from being inherited. Recent studies on cardiac tumors have revealed many genes that are involved in tumorigenesis and technologies have enabled the right screening of the tumor location within the heart and their histopathological studies were also studied. This review principally focuses on the understanding of the various forms of cardiac tumors, genetic variants involved and their influence, genetic testing, and different diagnostic approaches in cardiac tumors.
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Affiliation(s)
- Sivaramasundaram Sankarasubramanian
- Department of Genetic Engineering, School of Bioengineering, College of Engineering and Technology, SRM Institute of Science and Technology, SRM Nagar, Kattankulathur, Chennai, Tamil Nadu, 603203, India
| | - Prathiksha Prabhakar
- Department of Genetic Engineering, School of Bioengineering, College of Engineering and Technology, SRM Institute of Science and Technology, SRM Nagar, Kattankulathur, Chennai, Tamil Nadu, 603203, India
| | - Manoj Kumar Narasimhan
- Department of Genetic Engineering, School of Bioengineering, College of Engineering and Technology, SRM Institute of Science and Technology, SRM Nagar, Kattankulathur, Chennai, Tamil Nadu, 603203, India.
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10
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Ezzeddine FM, Haq IU, Pessanha BS, Pislaru SV, Bois MC, Kummer T, Stanich JA. Point-of-Care Ultrasound Diagnosis of a Giant Left Atrial Mass. CASE 2022; 6:243-246. [PMID: 36036056 PMCID: PMC9399556 DOI: 10.1016/j.case.2022.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Cardiac myxomas can cause cardiac, embolic, and/or constitutional symptoms. POCUS augments emergency care and assists in clinical decision-making. Multimodality imaging can help discern CMs from thrombi and other tumors.
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11
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Pournazari M, Assar S, Mohamadzadeh D, Mahdian M, Soltani S. Cardiac angiosarcoma: a case report of a young female with pulmonary metastasis. Egypt Heart J 2022; 74:40. [PMID: 35596835 PMCID: PMC9124257 DOI: 10.1186/s43044-022-00277-7] [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: 10/14/2021] [Accepted: 05/05/2022] [Indexed: 12/05/2022] Open
Abstract
Background Angiosarcoma is a malignant rare tumor that originates from vascular endothelial cells that cover lymphatic or blood vessels. Cardiac angiosarcoma is the most prevalent sarcoma entail the heart. It has low incidence rate and poor prognosis. Our effort through this report was raising awareness of uncommon manifestations of this disease and showing the importance of appropriate diagnosis and treatment. Case presentation We present a case of cardiac angiosarcoma in a young female whose symptoms included dyspnea and hemoptysis with a history of pericardial effusion and a past history of cardiac surgery for suspected atrial Myxoma. She had history of several hospitalizations and relapse of symptoms a few months after each hospital discharge. Conclusions The unspecific symptoms of cardiac angiosarcoma made it difficult to make in time diagnose and appropriate treatment. Awareness of unspecific presentations of cardiac angiosarcoma is necessary for proper diagnosis and treatment while delayed diagnosis may worsen the prognosis and even lead to death.
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Affiliation(s)
- Mehran Pournazari
- Rheumatology Department, Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shirin Assar
- Rheumatology Department, Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - Dena Mohamadzadeh
- Rheumatology Department, Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Maryam Mahdian
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Setareh Soltani
- Clinical Research Development Center, Taleghani and Imam Ali Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
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12
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Saef J, Jellis C, Unai S, Tan C, Dresing T, Ayoub C. Multimodality imaging evaluation of incidentally discovered intracardiac mass. Echocardiography 2022; 39:837-840. [PMID: 35505607 DOI: 10.1111/echo.15354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 03/28/2022] [Accepted: 04/06/2022] [Indexed: 11/27/2022] Open
Abstract
Incidentally discovered intracardiac masses often represent diagnostic dilemmas. No guideline-directed algorithm exists for evaluation and management in these cases. Understanding the utility and limitations of different imaging modalities expedites evaluation of differential diagnoses and management, particularly when there are discordant imaging findings. This case further demonstrates that benign cardiac tumors may grow rapidly, and that new and rapid emergence of an intracardiac mass does not necessarily correlate with a diagnosis of thrombus or malignancy. It also highlights the importance of a broad differential diagnosis and a systematic management approach in patients with intracardiac masses.
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Affiliation(s)
- Josh Saef
- Department of Cardiovascular Disease, Sydell & Arnold Miller Family Heart & Vascular Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Christine Jellis
- Department of Cardiovascular Disease, Sydell & Arnold Miller Family Heart & Vascular Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Shinya Unai
- Department of Thoracic and Cardiovascular Surgery, Sydell & Arnold Miller Family Heart & Vascular Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Carmela Tan
- Department of Anatomic Pathology, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Thomas Dresing
- Department of Cardiovascular Disease, Sydell & Arnold Miller Family Heart & Vascular Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Chadi Ayoub
- Department of Cardiovascular Disease, Mayo Clinic, Scottsdale, Arizona, USA
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13
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Heaton JN, Dhaduk N, Okoh AK, Dang-Ho KP, Tayal R, Salemi A, Waxman S. Author's reply: Characteristics, management, and outcomes among admissions for primary cardiac tumors: Results from The National Inpatient Sample. J Card Surg 2021; 36:4827. [PMID: 34585436 DOI: 10.1111/jocs.16037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 09/21/2021] [Indexed: 12/01/2022]
Affiliation(s)
- Joseph N Heaton
- Department of Medicine, The Brooklyn Hospital Center, Brooklyn, New York, USA.,Cardiovascular Research Unit, NBIMC, RWJ Barnabas Health, Newark, New Jersey, USA
| | - Nehal Dhaduk
- Cardiovascular Research Unit, NBIMC, RWJ Barnabas Health, Newark, New Jersey, USA
| | - Alexis K Okoh
- Cardiovascular Research Unit, NBIMC, RWJ Barnabas Health, Newark, New Jersey, USA
| | - Khoi P Dang-Ho
- Department of Medicine, The Brooklyn Hospital Center, Brooklyn, New York, USA
| | - Rajiv Tayal
- Cardiovascular Research Unit, NBIMC, RWJ Barnabas Health, Newark, New Jersey, USA
| | - Arash Salemi
- Cardiovascular Research Unit, NBIMC, RWJ Barnabas Health, Newark, New Jersey, USA
| | - Sergio Waxman
- Cardiovascular Research Unit, NBIMC, RWJ Barnabas Health, Newark, New Jersey, USA
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14
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Griborio-Guzman AG, Aseyev OI, Shah H, Sadreddini M. Cardiac myxomas: clinical presentation, diagnosis and management. Heart 2021; 108:827-833. [PMID: 34493547 DOI: 10.1136/heartjnl-2021-319479] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 08/24/2021] [Indexed: 11/04/2022] Open
Abstract
Cardiac myxomas (CM) are the most common type of primary cardiac tumours in adults, which have an approximate incidence of up to 0.2% in some autopsy series. The purpose of this review is to summarise the literature on CM, including clinical presentation, differential diagnosis, work-up including imaging modalities and histopathology, management, and prognosis. CM are benign neoplasms developed from multipotent mesenchyme and usually present as an undifferentiated atrial mass. They are typically pedunculated and attached at the fossa ovalis, on the left side of the atrial septum. Potentially life-threatening, the presence of CM calls for prompt diagnosis and surgical resection. Infrequently asymptomatic, patients with CM exhibit various manifestations, ranging from influenza-like symptoms, heart failure and stroke, to sudden death. Although non-specific, a classic triad for CM involves constitutional, embolic, and obstructive or cardiac symptoms. CM may be purposefully characterised or incidentally diagnosed on an echocardiogram, CT scan or cardiac MRI, all of which can help to differentiate CM from other differentials. Echocardiogram is the first-line imaging technique; however, it is fallible, potentially resulting in uncommonly situated CM being overlooked. The diagnosis of CM can often be established based on clinical, imaging and histopathology features. Definitive diagnosis requires macroscopic and histopathological assessment, including positivity for endothelial cell markers such as CD31 and CD34. Their prognosis is excellent when treated with prompt surgical resection, with postsurgical survival rates analogous to overall survival in the age-matched general population.
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Affiliation(s)
- Andres G Griborio-Guzman
- Division of Cardiology, Department of Internal Medicine, Thunder Bay Regional Health Sciences Centre, Thunder Bay, Ontario, Canada .,Department of Internal Medicine, Northern Ontario School of Medicine, Thunder Bay, Ontario, Canada
| | - Olexiy I Aseyev
- Department of Medical Oncology, Thunder Bay Regional Health Sciences Centre, Thunder Bay, Ontario, Canada.,Department of Oncology, Northern Ontario School of Medicine, Thunder Bay, Ontario, Canada
| | - Hyder Shah
- Division of Neurology, Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Masoud Sadreddini
- Division of Cardiology, Department of Internal Medicine, Thunder Bay Regional Health Sciences Centre, Thunder Bay, Ontario, Canada.,Department of Internal Medicine, Northern Ontario School of Medicine, Thunder Bay, Ontario, Canada
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15
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Cohen A, Donal E, Delgado V, Pepi M, Tsang T, Gerber B, Soulat-Dufour L, Habib G, Lancellotti P, Evangelista A, Cujec B, Fine N, Andrade MJ, Sprynger M, Dweck M, Edvardsen T, Popescu BA. EACVI recommendations on cardiovascular imaging for the detection of embolic sources: endorsed by the Canadian Society of Echocardiography. Eur Heart J Cardiovasc Imaging 2021; 22:e24-e57. [PMID: 33709114 DOI: 10.1093/ehjci/jeab008] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 01/07/2021] [Indexed: 12/28/2022] Open
Abstract
Cardioaortic embolism to the brain accounts for approximately 15-30% of ischaemic strokes and is often referred to as 'cardioembolic stroke'. One-quarter of patients have more than one cardiac source of embolism and 15% have significant cerebrovascular atherosclerosis. After a careful work-up, up to 30% of ischaemic strokes remain 'cryptogenic', recently redefined as 'embolic strokes of undetermined source'. The diagnosis of cardioembolic stroke remains difficult because a potential cardiac source of embolism does not establish the stroke mechanism. The role of cardiac imaging-transthoracic echocardiography (TTE), transoesophageal echocardiography (TOE), cardiac computed tomography (CT), and magnetic resonance imaging (MRI)-in the diagnosis of potential cardiac sources of embolism, and for therapeutic guidance, is reviewed in these recommendations. Contrast TTE/TOE is highly accurate for detecting left atrial appendage thrombosis in patients with atrial fibrillation, valvular and prosthesis vegetations and thrombosis, aortic arch atheroma, patent foramen ovale, atrial septal defect, and intracardiac tumours. Both CT and MRI are highly accurate for detecting cavity thrombosis, intracardiac tumours, and valvular prosthesis thrombosis. Thus, CT and cardiac magnetic resonance should be considered in addition to TTE and TOE in the detection of a cardiac source of embolism. We propose a diagnostic algorithm where vascular imaging and contrast TTE/TOE are considered the first-line tool in the search for a cardiac source of embolism. CT and MRI are considered as alternative and complementary tools, and their indications are described on a case-by-case approach.
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Affiliation(s)
- Ariel Cohen
- Assistance Publique-Hôpitaux de Paris, Saint-Antoine and Tenon Hospitals, Department of Cardiology, and Sorbonne University, Paris, France.,INSERM unit UMRS-ICAN 1166; Sorbonne-Université, Paris, France
| | - Erwan Donal
- University of Rennes, CHU Rennes, Inserm, LTSI - UMR 1099, F-35000 Rennes, France
| | - Victoria Delgado
- Department of Cardiology, Leiden University Medical Centre, Leiden, the Netherlands
| | - Mauro Pepi
- Centro Cardiologico Monzino, IRCCS, Via Parea 4, 20141, Milan, Italy
| | - Teresa Tsang
- Division of Cardiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Bernhard Gerber
- Service de Cardiologie, Département Cardiovasculaire, Cliniques Universitaires St. Luc, Division CARD, Institut de Recherche Expérimental et Clinique (IREC), UCLouvainAv Hippocrate 10/2803, B-1200 Brussels, Belgium
| | - Laurie Soulat-Dufour
- Assistance Publique-Hôpitaux de Paris, Saint-Antoine and Tenon Hospitals, Department of Cardiology, and Sorbonne University, Paris, France.,INSERM unit UMRS-ICAN 1166; Sorbonne-Université, Paris, France
| | - Gilbert Habib
- Aix Marseille Univ, IRD, MEPHI, IHU-Méditerranée Infection, APHM, La Timone Hospital, Cardiology Department, Marseille, France
| | - Patrizio Lancellotti
- University of Liège Hospital, GIGA Cardiovascular Sciences, Department of Cardiology, CHU SartTilman, Liège, Belgium.,Gruppo Villa Maria Care and Research, Maria Cecilia Hospital, Cotignola, and Anthea Hospital, Bari, Italy
| | - Arturo Evangelista
- Servei de Cardiologia. Hospital Universitari Vall d'Hebron-VHIR. CIBER-CV. Pº Vall d'Hebron 119. 08035. Barcelona. Spain
| | - Bibiana Cujec
- Division of Cardiology, University of Alberta, 2C2.50 Walter Mackenzie Health Sciences Center, 8440 112 St NW, Edmonton, Alberta, Canada T6G 2B7
| | - Nowell Fine
- University of Calgary, Libin Cardiovascular Institute, South Health Campus, 4448 Front Street Southeast, Calgary, Alberta T3M 1M4, Canada
| | - Maria Joao Andrade
- Maria Joao Andrade Cardiology Department, Hospital de Santa Cruz-Centro Hospitalar Lisboa Ocidental, Av. Prof. Dr. Reinaldo dos Santos 2790-134 Carnaxide, Portugal
| | - Muriel Sprynger
- Department of Cardiology-Angiology, University Hospital Liège, Liège, Belgium
| | - Marc Dweck
- British Heart Foundation, Centre for Cardiovascular Science, Edinburgh and Edinburgh Imaging Facility QMRI, University of Edinburgh, United Kingdom
| | - Thor Edvardsen
- Faculty of medicine, Oslo University, Oslo, Norway and Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Bogdan A Popescu
- Cardiology Department, University of Medicine and Pharmacy 'Carol Davila', Emergency Institute for Cardiovascular Diseases 'Prof. Dr. C. C. Iliescu', Sos. Fundeni 258, sector 2, 022328 Bucharest, Romania
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16
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Stougiannos P, Michas G, Leopoulou M, Evdoridis C, Mitropoulos F, Trikas A. Primary cardiac liposarcoma arising from the left atrium in an elderly female patient; the value of multimodality imaging. Hellenic J Cardiol 2021; 62:173-174. [DOI: 10.1016/j.hjc.2020.05.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 05/06/2020] [Accepted: 05/15/2020] [Indexed: 10/24/2022] Open
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Abstract
Every year, more than 795,000 people in the United States have a stroke, the vast majority of which are ischemic. Cardiac myxoma is an unusual cause of stroke and accounts for less than 1% of ischemic strokes. We present a case of a 56-year-old male with a history of hypertension, dyslipidemia, and type 2 diabetes mellitus, who presented with altered mental status, tinnitus, double vision, and diaphoresis. Due to concern for a cerebral vascular accident, a CT scan of the brain was obtained and showed no acute intracranial process. Brain MRI revealed multiple small acute infarcts involving bilateral posterior cerebral artery distribution. Further evaluation included transthoracic echocardiography that showed a large mobile mass in the left atrium measuring 3.5 x 2 cm intermittently projecting through the mitral valve. The patient underwent successful surgical resection of the left atrial mass. The pathology report confirmed the diagnosis of atrial myxoma. This case further highlights the importance of complete evaluation of stroke, including echocardiography, as well as the importance of careful surgical resection to prevent recurrence of systemic embolization and other complications of atrial myxoma.
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Affiliation(s)
| | - Emad Kandah
- Internal Medicine, McLaren Health Care, Michigan State University, Flint, USA
| | - Basel Abdelazeem
- Internal Medicine, McLaren Health Care, Michigan State University, Flint, USA
| | - Saed Alnaimat
- Cardiology, McLaren Health Care, Michigan State University, Flint, USA
| | - Arvind Kunadi
- Internal Medicine, McLaren Health Care, Michigan State University, Flint, USA
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18
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Incidence, prognostic significance, and survival outcomes of primary cardiac sarcoma: An updated population-based retrospective study. Anatol J Cardiol 2020; 25:104-110. [PMID: 33583817 DOI: 10.14744/anatoljcardiol.2020.78107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE Primary cardiac sarcoma, a rare tumor with an aggressive course and imprecise prognosis, constitutes over 95% of all malignant cardiac tumors. Given the sparsely available evidence, there is a paucity of information regarding current knowledge on cardiac sarcoma. This study aimed to determine the incidence and incidence-based rates, patient characteristics, treatment modalities, and survival factors of cardiac sarcoma. METHODS A retrospective analysis of the incidence, incidence-based mortality rates and characteristics of cardiac sarcoma between 1975 and 2016 was carried out using the Surveillance, Epidemiology, and End Results (SEER) database. The National Cancer Institute's Joinpoint Regression program was used to calculate the Annual Percentage Changes (APC). Univariate and multivariate regression analysis were used to determine the survival characteristics. RESULTS A total 408 patients were identified for the incidence analysis, while 385 eligible patients were identified for the survival analysis. The mean age at diagnosis was 46.3±17.9 years. The incidence rate (per 100.000 per year) of cardiac sarcoma within the indicated years was 0.22, with an increased APC of 1.7 (p=0.013, 95% CI=0.5-2.9). A total of 251 (61.5%) patients underwent surgery, 93 (22.8%) patients received adjuvant radiotherapy, and 197 (50.2%) patients received chemotherapy. Surgical resection, chemotherapy, stage of tumor, and younger age significantly improved the survival outcomes (p<0.001). CONCLUSION Cardiac sarcoma is a rare type of soft tissue sarcomas with poor prognosis. Over the past 30 years, the incidence of cardiac sar-coma has been on the increase. Surgery remains the mainstay of management. Further studies are needed to compare different diagnostic and treatment modalities so as to ascertain the best treatment option that would enhance survival and prognosis of cardiac sarcoma.
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19
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Fibrolipoma of the left ventricle: an uncommon incidental autopsy finding. Forensic Sci Med Pathol 2019; 16:362-365. [PMID: 31776801 DOI: 10.1007/s12024-019-00197-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2019] [Indexed: 10/25/2022]
Abstract
Fibrolipoma of the heart is an unusual benign tumorous entity encountered, if present, during an ordinary imaging workout or at autopsy. It is often clinically silent but it can also be symptomatic depending on the size and location of the tumor. We report a case of an 82-year-old man with a medical history of malignant pleural mesothelioma. The decedent was referred to our department to undergo a forensic autopsy after a fall. Postmortem examination revealed a large encapsulated gelatinous, yellowish cardiac mass with its pedicle on the subendocardial region of the left ventricular anterior wall and interventricular septum, protruding into the left ventricular cavity. Histological examination confirmed the diagnosis of cardiac fibro-lipoma, a rare histologic variant of lipoma, irrelevant to the cause of death in the present case. The rarity of the occurrence of fibro-lipomas provides clinical implications for the inclusion of the entity in the differential diagnosis of a cardiac mass.
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20
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Giant Tricuspid Valve Fibroelastoma Incidentally Diagnosed During Routine Stress Testing. JACC Case Rep 2019; 1:564-568. [PMID: 34316879 PMCID: PMC8289157 DOI: 10.1016/j.jaccas.2019.08.016] [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: 04/25/2019] [Revised: 07/11/2019] [Accepted: 08/12/2019] [Indexed: 11/20/2022]
Abstract
Papillary fibroelastomas (PFEs) are the most common valvular tumor, typically occurring on left-sided valves. We describe the evaluation and treatment of a giant tricuspid PFE in a healthy 43-year-old police officer who was referred for evaluation of frequent premature ventricular contractions during job-related treadmill stress testing. (Level of Difficulty: Beginner.).
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21
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Orozco-Hernandez EJ, Argueta-Sosa EE, Mauchley D, Xie R, Mitchell CB, Self DM, Davies JE. Left ventricular myxoma: A contractile mass causing intracavitary obstruction and severe pulmonary hypertension. J Card Surg 2019; 34:1127-1129. [PMID: 31374579 DOI: 10.1111/jocs.14195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Cardiac myxomas can be fatal and left ventricular (LV) myxomas with papillary muscle and mitral valve (MV) involvement are rare. The following case is that of a 55-year-old woman who developed signs and symptoms of pulmonary hypertension. Imaging revealed a contractile mass in the LV that was in continuum with the papillary muscles and affected MV function. Her clinical course, radiologic, and hemodynamic findings are discussed. Finally, her surgical extraction technique is described in addition to potential complications encountered.
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Affiliation(s)
- Erik J Orozco-Hernandez
- Division of Cardiovascular Surgery, University of Alabama at Birmingham Hospital, Birmingham, Alabama
| | - Erwin E Argueta-Sosa
- Division of Cardiovascular Diseases, University of Alabama at Birmingham Hospital, Birmingham, Alabama
| | - David Mauchley
- Division of Cardiovascular Surgery, University of Alabama at Birmingham Hospital, Birmingham, Alabama
| | - Rongbing Xie
- Division of Cardiovascular Surgery, University of Alabama at Birmingham Hospital, Birmingham, Alabama
| | - Chace B Mitchell
- Division of Cardiovascular Surgery, University of Alabama at Birmingham Hospital, Birmingham, Alabama
| | - Dwight M Self
- Division of Cardiovascular Surgery, University of Alabama at Birmingham Hospital, Birmingham, Alabama
| | - James E Davies
- Division of Cardiovascular Surgery, University of Alabama at Birmingham Hospital, Birmingham, Alabama
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22
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Dénes S, Daron B, Behaeghe M, Seghaye MC. Cardiac papillary fibroelastoma of a bicuspid aortic valve in an adolescent: A case report. Clin Pract 2019; 9:1135. [PMID: 31579491 PMCID: PMC6766684 DOI: 10.4081/cp.2019.1135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 08/02/2019] [Indexed: 01/07/2023] Open
Abstract
Cardiac papillary fibroelastomas (CPFE) are exceptional primary benign cardiac tumours affecting the heart valves. We report here the case of a 15-year-old boy in whom echocardiography performed for non-specific chest pain during follow-up for bicuspid aortic valve showed as accidental finding the presence of a round mobile mass without stalk attached on the inferior side of the aortic valve. The mass did not cause any outflow tract obstruction or aortic insufficiency. Electrocardiogram-gated cardiac computed tomography and magnetic resonance imaging allowed to suspect CPFE. Although the patient was asymptomatic, open cardiac surgery with elective surgical resection of the tumour was performed to avoid systematic emboli. Histology confirmed the diagnosis of CPFE. This is an exceptional case of acquired CPFE in a young patient with bicuspid aortic valve. Due to the risk of systemic embolization, aortic or coronary ostium obstruction, elective excision of such lesions is recommended.
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Affiliation(s)
- Sarah Dénes
- Pediatric Cardiology, Department of Pediatrics, University Hospital of Liège
| | - Benoît Daron
- Department of Pediatrics, Regional Hospital Verviers
| | - Marie Behaeghe
- Department of Anatomic Pathology, University Hospital of Leuven, Belgium
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23
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Beiras-Fernandez A, Kornberger A, El-Beyrouti H, Vahl CF. Giant right atrial myxoma: A rare cause of cardiovascular collapse. SAGE Open Med Case Rep 2019; 7:2050313X19841461. [PMID: 31057799 PMCID: PMC6452421 DOI: 10.1177/2050313x19841461] [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: 05/23/2018] [Accepted: 03/11/2019] [Indexed: 11/16/2022] Open
Abstract
We report the case of a patient with a giant right atrial myxoma that remained clinically silent until it almost completely obliterated the right atrium, prolapsed into the right ventricle and obstructed the tricuspid valve inflow. This case illustrates the importance of rapid surgical intervention in the setting of acute heart failure caused by tumor masses obliterating heart valves or cardiac chambers.
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Affiliation(s)
- Andres Beiras-Fernandez
- Department of Cardiothoracic and Vascular Surgery, University Hospital, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Angela Kornberger
- Department of Cardiothoracic and Vascular Surgery, University Hospital, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Hazem El-Beyrouti
- Department of Cardiothoracic and Vascular Surgery, University Hospital, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Christian-Friedrich Vahl
- Department of Cardiothoracic and Vascular Surgery, University Hospital, Johannes Gutenberg University Mainz, Mainz, Germany
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24
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Luo C, Zhu J, Bao C, Ding F, Mei J. Minimally invasive and conventional surgical treatment of primary benign cardiac tumors. J Cardiothorac Surg 2019; 14:76. [PMID: 30971259 PMCID: PMC6458600 DOI: 10.1186/s13019-019-0890-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Accepted: 04/01/2019] [Indexed: 01/14/2023] Open
Abstract
Background Primary cardiac tumors are rare and the majorities are benign. Conventional surgical treatment uses median sternotomy, while minimally invasive surgery from right anterolateral minithoracotomy has become an alternative method in recent years. In this study, we summarized the surgical outcomes of both approaches. Methods From January 2008 to August 2018, 50 patients with primary benign cardiac tumors underwent either conventional or minimally invasive surgery in our department. The baseline data were collected. The peri-operative data and follow up results were compared between the two groups. Results There were19 men and 31 women enrolled in this study with a mean age of 55.0 ± 17.5 years. The most common site of the tumor was left atrium (n = 40, 80%), followed by right atrium (n = 8, 16.0%), right ventricle (n = 1, 2.0%) and left ventricle (n = 1, 2.0%). All patients underwent surgery uneventfully, including 33 cases (66.0%) of median sternotomy and 17 cases (34.0%) of right anterolateral minithoracotomy. No significant differences were found between the two groups in terms of cardiopulmonary bypass time, aortic cross-clamp time, postoperative intubation time, intensive care unit days and length of the hospital stay. Patients with right anterolateral minithoracotomy had less post-operative chest drainage (536 ± 159 vs 773 ± 255 ml, P < 0.01) and transfusion rate (5.9% vs 33.3%, P = 0.033) than those who had sternotomy. There was no peri-operative death, and all the patients were alive and free of recurrence at the latest follow-up. Conclusions Surgical resection of primary benign cardiac tumors is safe, effective and durable. The right anterolateral minithoracotomy provides the same postoperative recovery as standard median sternotomy, but less transfusion. It can be considered as a promising alternative approach.
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Affiliation(s)
- Congcong Luo
- Department of Cardiothoracic Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China
| | - Jiaquan Zhu
- Department of Cardiothoracic Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China.
| | - Chunrong Bao
- Department of Cardiothoracic Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China
| | - Fangbao Ding
- Department of Cardiothoracic Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China
| | - Ju Mei
- Department of Cardiothoracic Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China
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25
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Primary Cardiac Angiosarcoma: Authors' Perspective Following Synthesis of Available Literature. REHABILITATION ONCOLOGY 2019. [DOI: 10.1097/01.reo.0000000000000147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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26
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Koza Y, Arslan U, Erkut B, Koza EA. Giant Right Ventricular Mass Protruding into the Pulmonary Artery during Systole. J Cardiovasc Echogr 2019; 29:68-70. [PMID: 31392123 PMCID: PMC6657459 DOI: 10.4103/jcecho.jcecho_11_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Myxomas are the most common primary cardiac tumors in adults and mainly originate in the left atrium with a slight female predominance. Only 3%–4% of myxomas are detected in the right ventricle. Although these tumors are histologically benign, they can lead to several catastrophic complications such as embolization or obstruction of blood flow at the mitral or tricuspid valve orifices. We report a rare case of right ventricular myxoma presented with near-syncope attacks and worsening dyspnea.
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Affiliation(s)
- Yavuzer Koza
- Department of Cardiology, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - Umit Arslan
- Department of Cardiovascular Surgery, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - Bilgehan Erkut
- Department of Cardiovascular Surgery, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - Enise Armagan Koza
- Department of Anesthesiology, Erzurum Regional Training and Research Hospital, Erzurum, Turkey
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27
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Hoeritzauer I, Carson AJ, Stone J. 'Cryptogenic Drop Attacks' revisited: evidence of overlap with functional neurological disorder. J Neurol Neurosurg Psychiatry 2018; 89:769-776. [PMID: 29436489 DOI: 10.1136/jnnp-2017-317396] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 01/04/2018] [Accepted: 01/07/2018] [Indexed: 11/04/2022]
Abstract
OBJECTIVE In their 1973 BMJ paper 'Cryptogenic Drop Attacks', Stevens and Matthews described 40, mostly middle-aged, female patients with drop attacks of unknown cause. Although clinically common, there has been little on this topic since. We aimed to determine clinical features, comorbidity and outcome of patients with drop attacks. METHODS We carried out a retrospective review of patients with cryptogenic drop attacks seen consecutively by one clinician (JS) between 2006 and 2016. Demographics, phenomenology, duration and frequency of attacks, attack description and comorbid diagnoses were recorded. Patients were followed up with a notes review. RESULTS 83 patients with cryptogenic drop attacks were predominantly female (89%, n=79), mean age 44 years. The majority (93%, n=77) could not remember the fall itself and almost half (43%, n=36) experienced prodromal dissociative symptoms. Mechanical trips or syncope preceded drop attacks, historically, in 24% (n=20) of cases. Persistent fatigue (73%, n=61), chronic pain (40%, n=33), functional limb weakness (31%,n=26) and dissociative (non-epileptic) attacks 28% (n=23) were common, with the latter usually preceding or emerging from drop attacks. At follow-up (88%, mean 38 months), 28% (n=23) had resolution of their drop attacks. Predisposing (but non-causative) disease comorbidity was found at baseline (n=12) and follow-up (n=5). CONCLUSIONS Cryptogenic drop attacks are associated with high frequency of comorbid functional somatic and functional neurological disorders. Patients commonly have prodromal dissociative symptoms and in some there was a clear relationship with prior or subsequent dissociative (non-epileptic) attacks. Some cryptogenic drop attacks may be best understood as phenomena on the spectrum of dissociative attacks.
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Affiliation(s)
- Ingrid Hoeritzauer
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Alan J Carson
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.,Department of Rehabilitation Medicine, NHS Lothian, Edinburgh, UK.,Department of Clinical Neuroscience, Western General Hospital, Edinburgh, UK
| | - Jon Stone
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.,Department of Clinical Neuroscience, Western General Hospital, Edinburgh, UK
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28
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Flint N, Siegel RJ, Bannykh S, Luthringer DJ. Bi-atrial cardiac myxoma with glandular differentiation: a case report with detailed radiologic-pathologic correlation. EUROPEAN HEART JOURNAL-CASE REPORTS 2018; 2:yty045. [PMID: 31020125 PMCID: PMC6177082 DOI: 10.1093/ehjcr/yty045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 04/03/2018] [Indexed: 11/29/2022]
Abstract
Introduction Myxoma is the most common cardiac benign tumour. While a typical myxoma is generally a straightforward diagnosis, some myxomas have unusual features that can make the diagnosis challenging. Glandular myxomas and metastatic adenocarcinomas, the most common type of metastatic carcinoma to the heart, can have very similar features. Case presentation We report a 60-year old man who presented with progressive shortness of breath on exertion. Echocardiography demonstrated a large heterogeneous, cystic left and right atrial mass. He was referred for surgery where a smooth and multilobulated left atrial mass was excised. Histopathological analysis with special stains revealed an unusual form of cardiac myxoma with extensive glandular differentiation. Discussion Cardiac myxomas can present with diverse clinical, radiological, and pathological features. Echocardiography is a modality of choice for diagnosis but can also miss small or multiple masses. Cardiac myxoma with glandular features is a rare type of myxoma. In our case, there was extensive glandular differentiation and the echocardiographic appearance provided clues for the unusual features of the tumour, suggesting a potential role for echocardiography in the detection and recognition of this morphologic histologic variation.
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Affiliation(s)
- Nir Flint
- Heart Institute, Cedars-Sinai Medical Center, 127 S San Vincente Blvd, Los Angeles, CA, USA.,Department of Cardiology, Tel-Aviv Sourasky Medical Center affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, 6 Weizmann st., Tel-Aviv, Israel
| | - Robert J Siegel
- Heart Institute, Cedars-Sinai Medical Center, 127 S San Vincente Blvd, Los Angeles, CA, USA
| | - Serguei Bannykh
- Department of Pathology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
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29
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Amao-Ruiz E, Correa-Fernández AM, Viqueira-Rodríguez I. Atrioventricular block due to papillary fibroelastoma. Med Clin (Barc) 2017; 149:504-505. [PMID: 28942946 DOI: 10.1016/j.medcli.2017.07.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2017] [Revised: 07/17/2017] [Accepted: 07/27/2017] [Indexed: 11/24/2022]
Affiliation(s)
- Elvis Amao-Ruiz
- Servicio de Cardiología, Hospital Clínico de Valladolid, Valladolid, España.
| | - Ana María Correa-Fernández
- Unidad de Insuficiencia Cardiaca, Servicio de Cardiología, Hospital Clínico de Valladolid, Valladolid, España
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30
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Pirzada A, Connors S, Harris S, Adams C. Primary Cardiac T Cell Lymphoma Mimicking ST-Elevation Myocardial Infarction. Cardiology 2017; 138:259-263. [PMID: 28950259 DOI: 10.1159/000479676] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 07/24/2017] [Indexed: 11/19/2022]
Abstract
Primary cardiac T cell lymphoma is an extremely rare condition with only a handful of biopsy-proven cases worldwide. We present a 62-year-old female presenting with nonspecific chest discomfort, shortness of breath, and anterolateral ST-elevation on electrocardiogram mimicking a ST-elevation myocardial infarction. Imaging revealed a cardiac mass and cardiac catheterization showed diffuse noncritical coronary disease with an occluded 2nd diagonal branch. Biopsy via minimally invasive cardiac surgery showed a pathologically proven diagnosis of primary cardiac T cell lymphoma. To our knowledge, this is the first documented case worldwide of primary cardiac T cell lymphoma that has resulted in ST-elevation mimicking a myocardial infarction.
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Affiliation(s)
- Ashar Pirzada
- Department of Internal Medicine, Memorial University, St. John's, NL, Canada
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Mo R, Mi L, Zhou Q, Wang D. Outcomes of surgical treatment in 115 patients with primary cardiac tumours: a 15-year experience at a single institution. J Thorac Dis 2017; 9:2935-2941. [PMID: 29221265 DOI: 10.21037/jtd.2017.08.04] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Background Primary cardiac tumours are rare, and few studies have examined large samples. The aim of this study was to review a single institution's 15 years of experience with primary cardiac tumours. Methods We conducted a retrospective analysis of 119 consecutive patients admitted to the Nanjing Drum Tower Hospital from April 2002 to January 2017. Five patients declined surgery due to illness or for financial reasons, and one patient underwent a second operation due to tumour recurrence 10 years after the first operation. In total, 115 patients underwent surgery. The surgeons used median sternotomy and a right atrial approach to complete the gross total resection. The patients were separated into three groups according to their tumour pathology (myxomas, other benign tumours, or malignant tumours). A total of 84 patients were followed up for an average of 34.8±31.2 months (range 2-141 months). Results The sites of the cardiac tumours included the left atrium (n=93, 80.1%), right atrium (n=14, 14.0%), left ventricle (n=2, 1.7%), valves (n=7, 6.0%), and other sites (n=1, 0.8%). According to the postoperative pathology, 99 (86.0%) tumours were classified as myxomas, 8 (7.0%) were other types of benign tumours, and 8 (7.0%) were malignant tumours. Patients with malignant tumours had a longer surgical time (P=0.035) and postoperative hospitalization time (P=0.009). Patients with myxoma tumours exhibited better 5-year survival than patients with malignant tumours (95.7% vs. 57.1%, P<0.001). Conclusions In the Chinese population, the incidence of primary cardiac tumours is mainly attributable to myxomas. Gross total resection is a safe and effective treatment for both benign and malignant tumours. Long-term survival is satisfactory for benign tumours but low for malignant tumours, and a risk of recurrence exists. Postoperative chemotherapy or radiotherapy may be needed to achieve better outcomes.
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Affiliation(s)
- Ran Mo
- Department of Cardiothoracic Surgery, Nanjing Drum Tower Hospital, the Affiliated Hospital of Medical School of Nanjing University, Nanjing 210008, China
| | - Lin Mi
- Department of Cardiothoracic Surgery, Nanjing Drum Tower Hospital, the Affiliated Hospital of Medical School of Nanjing University, Nanjing 210008, China
| | - Qing Zhou
- Department of Cardiothoracic Surgery, Nanjing Drum Tower Hospital, the Affiliated Hospital of Medical School of Nanjing University, Nanjing 210008, China
| | - Dongjin Wang
- Department of Cardiothoracic Surgery, Nanjing Drum Tower Hospital, the Affiliated Hospital of Medical School of Nanjing University, Nanjing 210008, China
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Bowman JN, Treece JM, Bhattad PB, Bochis M, Bajaj K. Giant Left Atrial Myxoma Masquerading as Cough-Syncope Syndrome. J Investig Med High Impact Case Rep 2017; 5:2324709617724177. [PMID: 28815190 PMCID: PMC5546641 DOI: 10.1177/2324709617724177] [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: 05/21/2017] [Revised: 06/28/2017] [Accepted: 07/08/2017] [Indexed: 11/24/2022] Open
Abstract
Left atrial myxomas are the most common type of benign primary cardiac tumor. Patients can present with generalized symptoms, such as fatigue, symptoms from obstruction of the myxoma, or even embolization of the myxoma causing distal thrombosis. We describe a case with several-month duration of syncopal episodes that occurred after coughing and with exertion. Computed tomography of the chest showed a 6.1 cm by 4.5 cm mass in the left atrium, later evaluated with an echocardiogram. Cardiothoracic surgery removed the mass, and it was determined to be an atrial myxoma. It is important for an internist to be able to diagnose an atrial myxoma because of the risks associated with embolization and even sudden death as myxoma can block blood supply from atrium to ventricle.
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Affiliation(s)
- Jennifer N Bowman
- East Tennessee State University and James H. Quillen College of Medicine, Johnson City, TN, USA
| | - Jennifer M Treece
- East Tennessee State University and James H. Quillen College of Medicine, Johnson City, TN, USA
| | | | - Melania Bochis
- East Tennessee State University and James H. Quillen College of Medicine, Johnson City, TN, USA
| | - Kailash Bajaj
- East Tennessee State University and James H. Quillen College of Medicine, Johnson City, TN, USA
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Abstract
In the past, cardiac tumors were a just clinical curiosity and the prognosis was poor. Surgical management became possible after the advent of cardiopulmonary bypass, and more recently, preoperative diagnosis was greatly improved by the development of echocardiography, computed tomography, and magnetic resonance imaging. The value of echocardiography for diagnosing cardiac mass lesions has become well established. Numerous advances have occurred in the last 5 decades, and the evolution of echocardiography involves the development of its many modalities. This review is intended to help echocardiologists and forensic pathologists in providing good medical practice when faced with the challenge of investigating unexpected clinical signs, particularly in young people, or unexpected postmortem findings.
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Duncan MD, Swinburne AJ, Sahni S, Zuckerman JE, Hacobian M. Small Cell Lung Cancer Presenting as a Cardiac Mass with Embolic Phenomena. Am J Med 2017; 130:e55-e57. [PMID: 27637599 DOI: 10.1016/j.amjmed.2016.08.028] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Revised: 08/24/2016] [Accepted: 08/24/2016] [Indexed: 01/06/2023]
Affiliation(s)
- Mark D Duncan
- Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, Calif.
| | - Alec J Swinburne
- Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, Calif
| | - Sheila Sahni
- Division of Cardiology, David Geffen School of Medicine at UCLA, Los Angeles, Calif
| | - Jonathan E Zuckerman
- Department of Pathology, David Geffen School of Medicine at UCLA, Los Angeles, Calif
| | - Melkon Hacobian
- Division of Cardiology, David Geffen School of Medicine at UCLA, Los Angeles, Calif
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Nantha YS, Malek SA. Silent Left Large Atrial Myxoma: A Patient with Serial Electrocardiogram Variation. Korean J Fam Med 2017; 38:229-232. [PMID: 28775814 PMCID: PMC5541172 DOI: 10.4082/kjfm.2017.38.4.229] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Revised: 08/24/2016] [Accepted: 09/09/2016] [Indexed: 11/25/2022] Open
Abstract
Cardiac myxoma is often discovered as an incidental finding and presents with various subtle symptoms and signs. Electrocardiographic findings are mostly non-specific. Atrial flutter or conduction abnormalities are known to be rare. We report a case of large left atrial myxoma that was diagnosed by transthoracic echocardiography at a primary care clinic. An asymptomatic, 71-year-old woman presented with serial abnormal electrocardiogram changes during a routine consultation. A diagnosis of left atrial myxoma was obtained through transthoracic echocardiography. We report this case with a review of literature on cardiac myxoma associated with arrhythmia.
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Affiliation(s)
| | - Shadidah Abdul Malek
- Non-Communicable Disease Department, Seremban Primary Care Clinic, Seremban, Malaysia
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Yüksel A, Saba D, Velioğlu Y, Ener S, Özkan H. Biatrial Approach Provides Better Outcomes in the Surgical Treatment of Cardiac Myxomas. Braz J Cardiovasc Surg 2016; 31:309-317. [PMID: 27849304 PMCID: PMC5094423 DOI: 10.5935/1678-9741.20160066] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2016] [Accepted: 05/30/2016] [Indexed: 11/20/2022] Open
Abstract
Objective We aimed to present clinical features, surgical approaches, importance of surgical technique and long-term outcomes of our patients with cardiac myxoma who underwent surgery. Methods We retrospectively collected data of patients with cardiac myxoma who underwent surgical resection between February 1990 and November 2014. Biatrial approach is the preferred surgical method in a large proportion of patients that are operated due to left atrial myxoma because it provides wider exposure than the uniatrial approach. To prevent recurrence during surgical resection, a large excision is made so as to include at least 5 mm of normal area from clean tissue around the tumor. Moreover, special attention is paid to the excision that is made as a whole, without digesting the fragment of tumor with gentle dissections. Results Forty-three patients (20 males, mean age of 51.7±8.8 years) were included. Most common symptom was dyspnea (48.8%). Tumor was located in the left atrium in 37 (86%) patients. Resections were achieved via biatrial approach in 34 patients, uniatrial approach in 8 patients, and right atriotomy with right ventriculotomy in 1 patient. One patient died due to low cardiac output syndrome in the early postoperative period. Mean follow-up time was 102.3±66.5 months. Actuarial survival rates were 95%, 92% and 78% at five, 10 and 15 years, respectively. Recurrence was observed in none of the patients during follow-up. Conclusion Although myxomas are benign tumors, due to embolic complications and obstructive signs, they should be treated surgically as soon as possible after diagnosis. To prevent recurrence, especially in cardiac myxomas which are located in left atrium, preferred biatrial approach is suggested for wide resection of the tumor and to avoid residual tumor.
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Affiliation(s)
- Ahmet Yüksel
- Uludag University Faculty of Medicine, Bursa, Turkey
| | - Davit Saba
- Uludag University Faculty of Medicine, Bursa, Turkey
| | - Yusuf Velioğlu
- Abant Izzet Baysal University Faculty of Medicine, Bolu, Turkey
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Isogai T, Yasunaga H, Matsui H, Tanaka H, Hisagi M, Fushimi K. Factors affecting in-hospital mortality and likelihood of undergoing surgical resection in patients with primary cardiac tumors. J Cardiol 2016; 69:287-292. [PMID: 27341740 DOI: 10.1016/j.jjcc.2016.05.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2015] [Revised: 04/29/2016] [Accepted: 05/16/2016] [Indexed: 02/05/2023]
Abstract
BACKGROUND Previous studies on primary cardiac tumors were mainly based on small case series collected from a limited number of institutions. Contemporary data of patients with primary cardiac tumors treated with or without surgery in a nationwide clinical setting are limited. METHODS Using the Diagnosis Procedure Combination database, we retrospectively identified 1317 patients hospitalized with a primary cardiac tumor (1023 myxomas, 63 non-myxomas, 72 sarcomas, 41 malignant lymphoma, 118 unspecified tumors) at 486 hospitals in Japan from July 2010 to March 2013. The outcome was overall in-hospital mortality, defined as in-hospital death occurring during the initial hospitalization or during rehospitalization. We examined the associations of baseline factors with overall in-hospital mortality and undergoing surgical resection using multivariable logistic regression analyses. RESULTS Overall, 914 (69.4%) patients underwent surgery and 403 (30.6%) did not. The surgery group was younger (median age, 67 years vs. 71 years, p<0.001) and was more likely to be treated at an academic hospital (38.9% vs. 27.8%, p<0.001) than the no-surgery group. The surgery group also had a higher Barthel index and a higher conscious level and showed a lower frequency of extracardiac malignancies than the no-surgery group. The likelihood of undergoing surgery was associated with coexisting cerebral infarction [adjusted odds ratio (95% confidence interval), 1.96 (1.23-3.12)] and academic hospital [1.58 (1.20-2.09)]. Patients with lower Barthel index and coexisting extracardiac malignancies were less likely to undergo surgery. Overall in-hospital mortality was 2.1% and 13.4% in the surgery and non-surgery groups, respectively. Older age, lower Barthel index, lower consciousness level, coexisting metastatic extracardiac malignancy [2.95 (1.24-7.01)], and sarcoma [21.04 (8.28-53.42)] were associated with higher overall in-hospital mortality, while academic hospital [0.41 (0.20-0.84)] and surgical resection [0.39 (0.20-0.74)] were associated with lower mortality. CONCLUSIONS Several background factors were associated with prognosis and surgery in patients hospitalized with primary cardiac tumors.
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Affiliation(s)
- Toshiaki Isogai
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan; Department of Cardiology, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan.
| | - Hideo Yasunaga
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Hiroki Matsui
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Hiroyuki Tanaka
- Department of Cardiology, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan
| | - Motoyuki Hisagi
- Department of Cardiovascular Surgery, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan
| | - Kiyohide Fushimi
- Department of Health Policy and Informatics, Graduate School of Medicine, Tokyo Medical and Dental University, Tokyo, Japan
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du Toit-Prinsloo L, van Niekerk ECA, Cronjé CM, Dinkel J. Sudden death in an adolescent due to primary angiosarcoma of the right atrium. Forensic Sci Med Pathol 2016; 12:376-9. [PMID: 27108450 DOI: 10.1007/s12024-016-9779-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Lorraine du Toit-Prinsloo
- Department of Forensic Medicine, University of Pretoria, Private Bag X323, Arcadia, 0007, South Africa.
| | - Egbert C A van Niekerk
- Department of Forensic Medicine, University of Pretoria, Private Bag X323, Arcadia, 0007, South Africa
| | - Christien M Cronjé
- Tshwane Academic Division, Department of Anatomical Pathology, Faculty of Health Sciences, National Health Laboratory Service, University of Pretoria, Private Bag X323, Arcadia, 0007, South Africa
| | - Jurgen Dinkel
- Tshwane Academic Division, Department of Anatomical Pathology, Faculty of Health Sciences, National Health Laboratory Service, University of Pretoria, Private Bag X323, Arcadia, 0007, South Africa
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40
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Sun BJ, Lee JH. Intracardiac echocardiography for guiding biopsy of cardiac tumors: a novel noninvasive technique. Interv Cardiol 2015. [DOI: 10.2217/ica.15.42] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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41
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Kawabata T, Kasahara S, Ohtsuki SI, Kuroko Y, Kotani Y, Fujii Y, Yoshizumi K, Arai S, Sano S. Left Ventricular Myxoma Occluding the Suprarenal Abdominal Aorta in an Infant. Ann Thorac Surg 2015; 100:309-11. [PMID: 26140776 DOI: 10.1016/j.athoracsur.2014.08.066] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Revised: 08/14/2014] [Accepted: 08/29/2014] [Indexed: 11/25/2022]
Abstract
Myxoma is the most common primary cardiac tumor in adults; however, it is extremely rare in infants. Acute occlusion of the abdominal aorta by a cardiac myxoma is also rare. We report the case of an infant with acute occlusion of the suprarenal abdominal aorta by a left ventricular myxoma. The patient underwent successful catheter embolectomy of the abdominal aorta and surgical resection of the cardiac myxoma. This is a very rare case report of the combination of infantile left ventricular myxoma and acute occlusion of the abdominal aorta.
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Affiliation(s)
- Takuya Kawabata
- Department of Cardiovascular Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
| | - Shingo Kasahara
- Department of Cardiovascular Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Shin-ichi Ohtsuki
- Department of Pediatric Cardiology of Okayama University Hospital, Okayama, Japan
| | - Yosuke Kuroko
- Department of Cardiovascular Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yasuhiro Kotani
- Department of Cardiovascular Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yasuhiro Fujii
- Department of Cardiovascular Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Ko Yoshizumi
- Department of Cardiovascular Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Sadahiko Arai
- Department of Cardiovascular Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Shunji Sano
- Department of Cardiovascular Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
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Jalalian R, Naghshvar F, Habibi V, Hakakian V, Namazi M. Primary Cardiac Angiosarcoma in a Middle Aged Woman. IRANIAN RED CRESCENT MEDICAL JOURNAL 2015; 17:e23067. [PMID: 26328065 PMCID: PMC4553020 DOI: 10.5812/ircmj.23067v2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Revised: 11/11/2014] [Accepted: 03/15/2015] [Indexed: 11/26/2022]
Abstract
Introduction: Primary cardiac angiosarcoma is the most common primary sarcoma in adults between the 3rd and 4th decades of life. Nearly 90% of angiosarcomas occur in the right atrium, which is responsible for the late onset of symptoms. Case Presentation: We presented a 56-year-old woman admitted to our center with lung emboli symptoms. Transthoracic and transesophageal echocardiography (TTE and TEE) demonstrated very large size (more than 10 cm diameter) multilobulated mass with mobile particles extended from the right atrium to the right ventricle and the right ventricular outflow tract which destructed the right atrium (RA) wall and penetrated to the pericardial space. Conclusions: Unfortunately the tumor was unresectable and just an incisional biopsy was performed. She received chemotherapy as palliative care.
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Affiliation(s)
- Rozita Jalalian
- Department of Cardiology, Mazandaran University of Medical Sciences, Sari, IR Iran
- Corresponding Author: Rozita Jalalian, Department of Cardiology, Mazandaran University of Medical Sciences, Sari, IR Iran. Tel: +98-1512224002, Fax: +98-1512224002, E-mail:
| | - Farshad Naghshvar
- Department of Pathology, Mazandaran University of Medical Sciences, Sari, IR Iran
| | - Valiollah Habibi
- Department of Cardiothoracic Surgery, Mazandaran University of Medical Sciences, Sari, IR Iran
| | - Vahid Hakakian
- Department of Cardiology, Mazandaran University of Medical Sciences, Sari, IR Iran
| | - Morteza Namazi
- Department of Cardiology, Mazandaran University of Medical Sciences, Sari, IR Iran
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Acute Mesenteric Ischemia Caused by Rare Cardiac Tumor Embolus. ACG Case Rep J 2015; 2:27-9. [PMID: 26157897 PMCID: PMC4435340 DOI: 10.14309/crj.2014.74] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Accepted: 09/25/2014] [Indexed: 12/21/2022] Open
Abstract
Acute mesenteric ischemia (AMI) is a rare vascular emergency associated with a high mortality rate. The most common cause of AMI is cardiac emboli from thrombi associated with atrial fibrillation or following myocardial infarction. We present a case of AMI caused by a unique source of emboli, confirmed as an embolization of a cardiac sarcoma to the small bowel by matching biopsies obtained from the superior mesenteric artery (SMA) and the embolic source.
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44
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Roever L, Casella-Filho A, Dourado PMM, Resende ES, Chagas ACP. Cardiac tumors: a brief commentary. Front Public Health 2014; 2:264. [PMID: 25538934 PMCID: PMC4257081 DOI: 10.3389/fpubh.2014.00264] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Accepted: 11/14/2014] [Indexed: 11/13/2022] Open
Abstract
Patients with cardiac tumors may present with cardiovascular related or constitutional symptoms, but more often than not a cardiac mass is discovered incidentally during an imaging examination performed for an unrelated indication. Cardiac myxoma is generally considered to be a surgical emergency. Echocardiography, including the transesophageal approach, is the most important means of diagnosis; computed tomography and magnetic resonance imaging. The clinical presentation has changed, and the management of cardiac myxoma now needs to be reviewed.
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Affiliation(s)
- Leonardo Roever
- Heart Institute (InCor), University of São Paulo Medical School , São Paulo , Brazil ; Federal University of Uberlândia , Uberlândia , Brazil
| | - Antonio Casella-Filho
- Heart Institute (InCor), University of São Paulo Medical School , São Paulo , Brazil
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Bhat SPS, Gowda SL G, Chikkatur R, Nanjappa MC. Lipomatous hamartoma of mitral valve. Asian Cardiovasc Thorac Ann 2014; 24:34-5. [DOI: 10.1177/0218492314534249] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Primary cardiac tumors are very rare, and tumors arising from cardiac valves are extremely rare. We present a case of lipomatous hamartoma of the mitral valve in a young female. This is the 6th case of lipomatous hamartoma of the mitral valve to be reported. We discuss the operative and histopathological findings.
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Affiliation(s)
- Seetharama PS Bhat
- Department of Cardiothoracic and Vascular Surgery, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, India
| | - Girish Gowda SL
- Department of Cardiothoracic and Vascular Surgery, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, India
| | - Raghavendra Chikkatur
- Department of Cardiothoracic and Vascular Surgery, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, India
| | - Manjunath C Nanjappa
- Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, India
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46
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Ederhy S, Soulat-Dufour L, Ileana E, Mir O, Haddour N, Boccara F, Soria JC, Cohen A. Apport de l’imagerie dans l’évaluation des masses et métastases cardiaques. ONCOLOGIE 2014. [DOI: 10.1007/s10269-014-2394-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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47
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Guo Y, Wang Y, Kong D, Shu X. Automatic classification of intracardiac tumor and thrombi in echocardiography based on sparse representation. IEEE J Biomed Health Inform 2014; 19:601-11. [PMID: 24691169 DOI: 10.1109/jbhi.2014.2313132] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Identification of intracardiac masses in echocardiograms is one important task in cardiac disease diagnosis. To improve diagnosis accuracy, a novel fully automatic classification method based on the sparse representation is proposed to distinguish intracardiac tumor and thrombi in echocardiography. First, a region of interest is cropped to define the mass area. Then, a unique globally denoising method is employed to remove the speckle and preserve the anatomical structure. Subsequently, the contour of the mass and its connected atrial wall are described by the K-singular value decomposition and a modified active contour model. Finally, the motion, the boundary as well as the texture features are processed by a sparse representation classifier to distinguish two masses. Ninety-seven clinical echocardiogram sequences are collected to assess the effectiveness. Compared with other state-of-the-art classifiers, our proposed method demonstrates the best performance by achieving an accuracy of 96.91%, a sensitivity of 100%, and a specificity of 93.02%. It explicates that our method is capable of classifying intracardiac tumors and thrombi in echocardiography, potentially to assist the cardiologists in the clinical practice.
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48
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Ostrowski S, Marcinkiewicz A, Kośmider A, Jaszewski R. Sarcomas of the heart as a difficult interdisciplinary problem. Arch Med Sci 2014; 10:135-48. [PMID: 24701226 PMCID: PMC3953983 DOI: 10.5114/aoms.2014.40741] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2010] [Revised: 01/10/2011] [Accepted: 03/20/2011] [Indexed: 12/17/2022] Open
Abstract
Cardiac tumors are assumed to be a rare entity. Metastases to the heart are more frequent than primary lesions. Sarcomas make up the majority of cardiac malignant neoplasms. Among them angiosarcoma is the most common and associated with the worst prognosis. Malignant fibrous histiocytoma comprises the minority of cardiac sarcomas and has uncertain etiology as well as pathogenesis. Transthoracic echocardiography remains the widely available screening examination for the initial diagnosis of a cardiac tumor. The clinical presentation is non-specific and the diagnosis is established usually at an advanced stage of the disease. Sarcomas spread preferentially through blood due to their immature vessels without endothelial lining. Surgery remains the method of choice for treatment. Radicalness of the excision is still the most valuable prognostic factor. Adjuvant therapy is unlikely to be effective. The management of cardiac sarcomas must be individualized due to their rarity and significant differences in the course of disease.
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Affiliation(s)
- Stanisław Ostrowski
- Department of Cardiac Surgery, Chair of Cardiology and Cardiac Surgery, Medical University of Lodz, Poland
- Military Teaching Hospital – Veterans Central Hospital, Lodz, Poland
| | - Anna Marcinkiewicz
- Department of Cardiac Surgery, Chair of Cardiology and Cardiac Surgery, Medical University of Lodz, Poland
- Military Teaching Hospital – Veterans Central Hospital, Lodz, Poland
| | - Anna Kośmider
- Military Teaching Hospital – Veterans Central Hospital, Lodz, Poland
| | - Ryszard Jaszewski
- Department of Cardiac Surgery, Chair of Cardiology and Cardiac Surgery, Medical University of Lodz, Poland
- Military Teaching Hospital – Veterans Central Hospital, Lodz, Poland
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49
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Beh P, Byard RW. Cardiac tumors and sudden death. Forensic Sci Med Pathol 2014; 10:269-71. [PMID: 24435953 DOI: 10.1007/s12024-013-9526-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/21/2013] [Indexed: 10/25/2022]
Affiliation(s)
- Philip Beh
- Department of Pathology, The University of Hong Kong, Pokfulam, Hong Kong
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Liu Y, Maureira P, Selton-Suty C, Folliguet T, Marie PY, Mandry D, Villemot JP, Tran N, Cahn V. Small cardiac hemangioma: a challenge for diagnosis and dilemma for management. Ann Thorac Surg 2014; 97:e11-3. [PMID: 24384214 DOI: 10.1016/j.athoracsur.2013.07.104] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Revised: 07/08/2013] [Accepted: 07/22/2013] [Indexed: 11/28/2022]
Abstract
A small cardiac tumor in the left ventricle was discovered incidentally in a 53-year-old patient by echocardiography and was further confirmed by magnetic resonance imaging. A clinical diagnosis of "fibroelastoma or myxoma with an atypical location?" was made, and an uneventful surgical resection was carried out in consideration of the potential embolic risk. The histologic analysis revealed a capillary hemangioma. A posteriori, we reviewed the coronary angiography performed 2 years earlier and found a typical "tumor blush" sign. We discuss the diagnostic features of this case and the alternative approaches that could have been chosen, including a conservative approach with close follow-up.
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Affiliation(s)
- Yihua Liu
- Department of Cardiovascular Surgery and Heart Transplantation, CHU-Nancy, Nancy, France; Universite de Lorraine, Nancy, France
| | - Pablo Maureira
- Department of Cardiovascular Surgery and Heart Transplantation, CHU-Nancy, Nancy, France; Universite de Lorraine, Nancy, France.
| | | | - Thierry Folliguet
- Department of Cardiovascular Surgery and Heart Transplantation, CHU-Nancy, Nancy, France; Universite de Lorraine, Nancy, France
| | - Pierre-Yves Marie
- Universite de Lorraine, Nancy, France; Department of Medical Imaging, CHU-Nancy, Nancy, France
| | - Damien Mandry
- Universite de Lorraine, Nancy, France; Department of Medical Imaging, CHU-Nancy, Nancy, France
| | - Jean-Pierre Villemot
- Department of Cardiovascular Surgery and Heart Transplantation, CHU-Nancy, Nancy, France; Universite de Lorraine, Nancy, France
| | | | - Virginie Cahn
- Department of Anatomo-Pathology, CHU-Nancy, Nancy, France
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