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Talukder S, Murphy MO, Lyon A, Rosendahl AU. Metastasectomy of left atrial mesenchymal chondrosarcoma. Eur J Cardiothorac Surg 2020; 58:861-863. [PMID: 32413904 DOI: 10.1093/ejcts/ezaa116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Revised: 02/24/2020] [Accepted: 03/12/2020] [Indexed: 11/12/2022] Open
Abstract
Metastasis of chondrosarcoma of skeletal origin to the heart is uncommonly reported in the literature, with the majority of cases involving right atrial metastases. Surgical resection remains the mainstay of treatment, and the literature has shown improved median survival with this form of therapy, possibly by reducing thromboembolic risk in this patient population. We report the case of a patient with metastatic mesenchymal chondrosarcoma of the left atrium who underwent resection, following a lack of response to anticoagulation therapy. This is the first report of surgical resection of left atrial metastatic disease prior to the onset of thromboembolic sequelae.
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Affiliation(s)
| | - Michael O Murphy
- Department of Cardiac Surgery, Royal Brompton Hospital, London, UK
| | - Alexander Lyon
- Department of Cardio-Oncology, Royal Brompton Hospital, London, UK
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2
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Haslinger M, Dinges C, Granitz M, Klieser E, Hoppe UC, Lichtenauer M. Right Heart Failure Due to Secondary Chondrosarcoma in the Right Atrium. Circ Cardiovasc Imaging 2020; 13:e009824. [PMID: 32208737 DOI: 10.1161/circimaging.119.009824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Michael Haslinger
- Departments of Internal Medicine II (M.H., U.C.H., M.L.), Paracelsus Medical University, Salzburg, Austria
| | - Christian Dinges
- Cardiovascular Surgery (C.D.), Paracelsus Medical University, Salzburg, Austria
| | - Marcel Granitz
- Radiology (M.G.), Paracelsus Medical University, Salzburg, Austria
| | - Eckhard Klieser
- Pathology (E.K.), Paracelsus Medical University, Salzburg, Austria
| | - Uta C Hoppe
- Departments of Internal Medicine II (M.H., U.C.H., M.L.), Paracelsus Medical University, Salzburg, Austria
| | - Michael Lichtenauer
- Departments of Internal Medicine II (M.H., U.C.H., M.L.), Paracelsus Medical University, Salzburg, Austria
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3
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Goldberg AB, Lama von Buchwald C, Kalra DK, Rao AK. An Unusual Cardiac Metastasis: Right Atrial Chondrosarcoma Diagnosed With Multimodality Cardiac Imaging. ACTA ACUST UNITED AC 2019; 3:162-166. [PMID: 31468019 PMCID: PMC6710901 DOI: 10.1016/j.case.2019.03.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Metastatic cardiac tumors are about 20 times more common than primary cardiac tumors. Metastatic CS to the myocardium has only rarely been described in case reports. Cardiac masses are differentiated by clinical context, location, and imaging appearance. CMR is considered the gold standard in cardiac imaging, but TEE was key in this case.
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Affiliation(s)
- Alan B Goldberg
- Department of Internal Medicine, Division of Cardiology, Rush University Medical Center, Chicago, Illinois
| | - Claudia Lama von Buchwald
- Department of Internal Medicine, Division of Cardiology, Rush University Medical Center, Chicago, Illinois
| | - Dinesh K Kalra
- Department of Internal Medicine, Division of Cardiology, Rush University Medical Center, Chicago, Illinois
| | - Anupama K Rao
- Department of Internal Medicine, Division of Cardiology, Rush University Medical Center, Chicago, Illinois
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4
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CNS Metastases from Bone and Soft Tissue Sarcomas in Children, Adolescents, and Young Adults: Are They Really So Rare? BIOMED RESEARCH INTERNATIONAL 2017; 2017:1456473. [PMID: 28243595 PMCID: PMC5294350 DOI: 10.1155/2017/1456473] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Revised: 12/08/2016] [Accepted: 12/15/2016] [Indexed: 12/23/2022]
Abstract
Purpose. To check whether primary involvement of brain/spinal cord by bone/soft tissue sarcomas' metastases in children is as rare as described and to present various morphological forms of bone/soft tissue sarcomas' CNS metastases. Methods. Patients with first diagnosis in 1999–2014 treated at single center were included with whole course of disease evaluation. Brain/spinal canal magnetic resonance imaging (MRI)/computed tomography were performed in cases suspicious for CNS metastases. Extension from skull/vertebral column metastases was excluded. Results. 550 patients were included. MRI revealed CNS metastases in 19 patients (incidence 3.45%), 14 boys, aged 5–22 years. There were 12/250 osteosarcoma cases, 2/200 Ewing's sarcoma, 1/50 chondrosarcoma, 3/49 rhabdomyosarcoma (RMS), and 1/1 malignant mesenchymoma. There were 10 single metastases and 7 cases of multiple ones; in 2 RMS cases only leptomeningeal spread in brain and spinal cord was found. Calcified metastases were found in 3 patients and hemorrhagic in 4. In one RMS patient there were numerous solid, cystic, hemorrhagic lesions and leptomeningeal spread. Conclusions. CNS metastases are rare and late in children with bone/soft tissue sarcomas, although in our material more frequent (3.45%) than in other reports (0.7%). Hematogenous spread to brain and hemorrhagic and calcified lesions dominated in osteosarcoma. Ewing sarcoma tended to metastasize to skull bones. Soft tissue sarcomas presented various morphological forms.
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Shi X, Liang Z, Li J, Guo J, Shan Z, Wang Y. Radiofrequency ablation of metastatic chondrosarcoma-associated refractory ventricular tachycardia originating from the right ventricular outflow tract: A case report and literature review. Exp Ther Med 2016; 12:1803-1808. [PMID: 27588097 DOI: 10.3892/etm.2016.3529] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Accepted: 04/26/2016] [Indexed: 11/06/2022] Open
Abstract
Ventricular tachycardia (VT) and premature contraction originating from the right ventricular outflow tract (RVOT) usually appear in healthy individuals. Radiofrequency ablation (RFA) is highly effective at resolving this type of arrhythmia. Refractory VT of RVOT is uncommon and occasionally results from cardiac metastasis of extraskeletal mesenchymal chondrosarcomas (ESMC). ESMC is a rare malignant tumor arising from soft tissues. The current study presents the case of a 25-year-old male with severe VT arising from RVOT due to metastasis of an ESMC that originally occurred in the retroperitoneum. The diagnosis was confirmed following echocardiography and cardiac magnetic resonance. VT was eventually eliminated by RFA, and during the 8-month follow-up period the patient did not complain of any palpitations. Holter monitoring confirmed the absence of recurrence.
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Affiliation(s)
- Xiangmin Shi
- Department of Cardiology, The General Hospital of PLA, Beijing 100853, P.R. China
| | - Zhuo Liang
- Department of Cardiology, The General Hospital of PLA, Beijing 100853, P.R. China
| | - Jian Li
- Department of Cardiology, The General Hospital of PLA, Beijing 100853, P.R. China
| | - Jianping Guo
- Department of Cardiology, The General Hospital of PLA, Beijing 100853, P.R. China
| | - Zhaoliang Shan
- Department of Cardiology, The General Hospital of PLA, Beijing 100853, P.R. China
| | - Yutang Wang
- Department of Geriatric Cardiology, The General Hospital of PLA, Beijing 100853, P.R. China
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6
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Di Michele S, Mirabelli F, Galzerano D, Mankad S. An unusual myocardial infarction. Echo Res Pract 2014; 1:K9-K12. [PMID: 26693309 PMCID: PMC4676451 DOI: 10.1530/erp-14-0017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2014] [Accepted: 10/13/2014] [Indexed: 11/08/2022] Open
Abstract
UNLABELLED We present a 74-year-old male with a chondrosarcoma, who presented with chest pain. The history, electrocardiogram (ECG), and biomarkers established the diagnosis of myocardial infarction (MI); angiography did not show coronary atherosclerosis and, both initial transthoracic echocardiogram and chest computed tomography (CT), did not demonstrate any cardiac abnormalities. A second echocardiogram following a routine ECG showed presence of a mass involving the right ventricle and the cardiac apex that was confirmed by chest CT scan. We underline the importance of considering cardiac tumors in the clinical arena of MI management. LEARNING POINTS Cardiac tumors cause ECG changes similar to ischemic heart diseases.Keep in mind cardiac tumors when performing transthoracic echocardiogram (TTE) in the setting of suspected MI.TTE is the technique of choice in detecting cardiac tumors.
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Affiliation(s)
- Sara Di Michele
- Department of Heart and Great Vessels 'A. Reale', La Sapienza University , Rome , Italy
| | - Francesca Mirabelli
- Department of Heart and Great Vessels 'A. Reale', La Sapienza University , Rome , Italy
| | | | - Sunil Mankad
- Department of Cardiovascular Disease, Mayo Clinic , Rochester, Minnesota , USA
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7
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Rodriguez A, Roubertie F, Thumerel M, Jougon J. Pulmonary metastatic chondrosarcoma with massive extension into left atrium and left ventricle: outcome of surgical management in emergency. Eur J Cardiothorac Surg 2013; 44:e341-2. [PMID: 23999561 DOI: 10.1093/ejcts/ezt426] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
We report a case of metastatic chondrosarcoma to the lung that invaded the right inferior pulmonary vein with massive cardiac extension and presented with an acute heart failure. CT scan showed a large mass of the right lower lobe which invaded and filled almost all the left atrium with an extension into left ventricle through the mitral valve. Surgical resection was performed in emergency. The patient is still alive 4 months after development of cardiac symptoms and surgery.
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Affiliation(s)
- Arnaud Rodriguez
- Department of Thoracic Surgery, University of Bordeaux, Pessac, France
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8
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Oizumi H, Tanaka R, Shimura H, Sasaki K, Koike H, Hattori N, Tanaka S. A case of cerebral embolism with metastatic chondrosarcoma in the left atrium. J Stroke Cerebrovasc Dis 2010; 20:79-81. [PMID: 20807491 DOI: 10.1016/j.jstrokecerebrovasdis.2009.10.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2009] [Revised: 10/14/2009] [Accepted: 10/14/2009] [Indexed: 12/01/2022] Open
Abstract
Cardiac tumor is a rare, but clinically important source of cerebral embolism. We report a case of metastatic chondrosarcoma in the left atrium with multiple cerebral emboli. A computed tomography scan of the chest revealed a large mass in the left atrium and pulmonary vein. The patient underwent heart surgery to remove the metastatic chondrosarcoma in the left atrium, to prevent the formation of further systemic emboli and possible sudden death. The cardiac tumor resection was successful, and the patient was discharged from the hospital without any handicap. This is a rare case of metastatic cardiac tumor that was a source of emboli into the brain and was eradicated.
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Affiliation(s)
- Hideki Oizumi
- Department of Neurology, Juntendo University Urayasu Hospital, Chiba, Japan
| | - Ryota Tanaka
- Department of Neurology, Juntendo University Urayasu Hospital, Chiba, Japan.
| | - Hideki Shimura
- Department of Neurology, Juntendo University Urayasu Hospital, Chiba, Japan
| | - Kumi Sasaki
- Department of Neurology, Juntendo University Urayasu Hospital, Chiba, Japan
| | - Hiroyuki Koike
- Department of Cardiosurgery, Juntendo University Urayasu Hospital, Chiba, Japan
| | - Nobutaka Hattori
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan
| | - Shigeki Tanaka
- Department of Neurology, Juntendo University Urayasu Hospital, Chiba, Japan
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9
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Izzo P, Ricci N, Capolupo R, Villani PC, Federici F, Roma F, Curcio C. A rare case of primary chondrosarcoma of the heart. J Cardiovasc Med (Hagerstown) 2007; 8:210-3. [PMID: 17312441 DOI: 10.2459/01.jcm.0000260842.68532.04] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
We describe a case of a rare primary chondrosarcoma of the heart in a 62-year-old woman who was referred to our institution with a diagnosis of left atrial undetermined mass. Despite utilization of transesophageal echocardiography and multislice computed tomography imaging, the definitive diagnosis of chondrosarcoma was achieved only with histology of the operative specimen. The tumor was extending from the left atrium to the left pulmonary veins causing obstruction of the venous drainage and a clinical and radiological picture of persistent respiratory infection. Surgery achieved only partial resection of the mass, including the removal of the obstruction to the pulmonary venous drainage. After surgery, a rapid healing of the respiratory infection was observed; however, 3 months later, the tumor was already regrowing rapidly.
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Affiliation(s)
- Paolo Izzo
- Divisione di Cardiologia e Dipartimento di Cardiochirurgia, Casa di Cura Villa Bianca, Città di Bari Hospital, Bari, Italy.
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10
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Yap CH, Hair C, Foy S, Sewak S, Francis M, Kenny JF. Resection of right atrial metastatic large-cell neuroendocrine carcinoma. Asian Cardiovasc Thorac Ann 2007; 15:e20-2. [PMID: 17244909 DOI: 10.1177/021849230701500131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The incidence of cardiac metastases is rising due to increasingly sensitive diagnostic investigations and longer patient survival as a result of improved treatment for malignancies. We report a rare case of right atrial metastasis from a large cell neuroendocrine carcinoma successfully resected with cardiopulmonary bypass. The surgical management of advanced cardiac malignancy is discussed. In appropriately selected cases surgical resection of cardiac metastases can be beneficial, allowing improvement in quality of life, and prolongation of life.
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Affiliation(s)
- Cheng-Hon Yap
- St. Vincent's Hospital, Melbourne, PO Box 2900, Fitzroy, Victoria 3065, Australia.
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11
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Sebire NJ, Ramsay AD, Malone M, Sheppard MN, Roebuck D, Elliott MJ. Massive cardiac chondroma presenting with heart failure and superior vena cava obstruction in a teenage boy. Fetal Pediatr Pathol 2004; 23:325-31. [PMID: 16137169 DOI: 10.1080/15227950490952460] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Histologically benign soft-tissue chondromas have been reported at many anatomical sites but are an uncommon cause of soft tissue mass lesions in childhood, accounting for less than 1% of cases. The most frequent sites for extraosseous soft-tissue chondromas are the hands and feet. For the extremely rare visceral chondromas, the site can be lung, where they may represent a component of Carney's syndrome of extra-adrenal paraganglioma, pulmonary chondroma, and epithelioid leiomyosarcoma of the gastrointestinal tract. Primary cardiac chondromas are exceptionally rare in patients of any age although cardiac chondrosarcoma, both primary and metastatic, is well reported. We present a case of a teenage boy with a fatal cardiac chondroma
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Affiliation(s)
- N J Sebire
- Department of Histopathology, Camelia Botnar Laboratories, Great Ormond Street Hospital, Great Ormond Street, London, UK WC1N 3JH.
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12
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Kase S, Nakamoto S, Miyasaka S, Moritani H, Akiyama T, Goto E, Adachi H, Ito H. Cardiac Chondrosarcoma Producing Parathyroid Hormone-Related Protein. Circ J 2004; 68:715-8. [PMID: 15226640 DOI: 10.1253/circj.68.715] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Chondrosarcoma is a malignant tumor characterized by the formation of cartilage. A case of primary cardiac chondrosarcoma of the left atrium developed in a middle-aged male. The preoperative serum concentrations of C-parathyroid hormone-related protein (PTHrP) and calcium were high (413.2 pmol/L and 12.2 mg/dl, respectively), but normalized after resection of the tumor, which measured 7 x 5 x 3.5 cm. The tumor was histopathologically diagnosed as chondrosarcoma, composed of outer atypical chondroid cells and inner pleomorphic and spindle mesenchymal cells mimicking malignant fibrous histiocytoma. Half of the cartilaginous tumor cells and a few pleomorphic cells showed cytoplasmic immunoreactivity for PTHrP. The tumor is a possible example of the functional pleiotropy of chondrosarcoma.
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Affiliation(s)
- Satoru Kase
- Department of Laboratory Medicine, Tottori Perfectual Central Hospital, Tottori, Japan
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13
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Hoekstra HJ, Pras B, Mooyaart EL, van Ginkel R, Molenaar WM. Pelvic girdle chondrosarcoma and inferior vena cava thrombosis. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 1997; 23:577-9. [PMID: 9484938 DOI: 10.1016/s0748-7983(97)93589-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Pelvic girdle chondrosarcomas in children and adolescents are extremely rare. These high grade malignant chondrosarcomas with a locally aggressive growth pattern have a high tendency for thrombus formations in the afferent tumour vessels, associated with an increased risk of inferior vena cava thrombosis, pulmonary embolism and metastatic spread to the lungs. This tumour location is generally non-resectable for cure and, since adjuvant chemotherapy is ineffective, patients die from the tumour thrombus formation causing tumour emboli and metastatic disease to the lungs. Effective local tumour control can be achieved with high-dose hyperfractionated radiation therapy.
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Affiliation(s)
- H J Hoekstra
- Department of Surgical Oncology, Groningen University Hospital, The Netherlands
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14
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Miwa S, Konishi Y, Matsumoto M, Minakata K. Primary cardiac chondrosarcoma--a case report. JAPANESE CIRCULATION JOURNAL 1997; 61:795-7. [PMID: 9293411 DOI: 10.1253/jcj.61.795] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
We report a case of chondrosarcoma of the heart that was managed surgically. As chondrosarcoma of cardiac origin is extremely rare, this case is described with a brief comment.
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Affiliation(s)
- S Miwa
- Department of Cardiovascular Surgery, Japanese Red Cross Society Wakayama Medical Center, Japan
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15
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Khoo V, Ngan S, Guiney M, Lim-Joon D. Acute vascular embolus resulting from metastatic endocardial involvement with synovial sarcoma: report of a case and review of the literature. AUSTRALASIAN RADIOLOGY 1997; 41:49-52. [PMID: 9125069 DOI: 10.1111/j.1440-1673.1997.tb00469.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
A rare case of metastatic soft tissue sarcoma (STS) involving the endocardium of the left ventricle of the heart is described. A 57-year-old man with a previously resected synovial sarcoma of the anterior abdominal wall presented 5 years later with an acute ischaemic arm resulting from tumour embolus. The treatment and outcome of the patient are outlined. Metastatic STS cardiac involvement and management of this complication are reviewed.
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Affiliation(s)
- V Khoo
- Peter MacCallum Cancer Institute, Melbourne, Victoria, Australia
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16
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Dickens P, Poon CS, Wat MS. Sudden death associated with solitary intracavitary right atrial metastatic tumour deposit. Forensic Sci Int 1992; 57:169-73. [PMID: 1473808 DOI: 10.1016/0379-0738(92)90010-t] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
We report a case of cardiac metastasis of primary adrenal cortical carcinoma to the endocardium of the right atrium resulting in an intracavitary mass which we believe caused sudden death by blocking the tricuspid valve orifice. We have been unable to find a similar case previously reported although primary atrial myxoma is well known to be a rare cause of sudden cardiac death by the same mechanism. Modern non-invasive imaging techniques have facilitated recognition of intracavitary cardiac metastases, and with surgical intervention, when feasible, the risk of sudden cardiac death can be reduced.
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Affiliation(s)
- P Dickens
- Department of Pathology, University of Hong Kong
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17
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Affiliation(s)
- A Jallu
- Department of Neursociences, and Orthopedics, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
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18
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Giuliano CT, Kauffman WM, Haller JO, Fletcher BD, Rao SP. Inferior vena cava--right atrial tumor thrombus in malignant pelvic bone tumors in children. Pediatr Radiol 1992; 22:206-8. [PMID: 1508591 DOI: 10.1007/bf02012497] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Two patients with IVC and right atrial tumor thrombus associated with malignant bone tumors are described. Other tumors such as Wilms', renal cell CA, testicular adrenal and hepatic neoplasms have also been reported to invade the IVC. Ultrasound, CT and MRI are helpful in evaluating the presence of vascular thrombosis as well as its longitudinal extent, and intracardiac involvement.
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Affiliation(s)
- C T Giuliano
- Department of Radiology, State University of New York Downstate Medical Center, Brooklyn
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