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Karigyo CJT, Pessoa BMS, Nicacio SP, Terwilliger E, Costa P, dos Santos PR, Ernani V, Seetharam M, Murakami AN, Batalini F. Cardiac Tumors: Review. Braz J Cardiovasc Surg 2024; 39:e20230405. [PMID: 39038269 PMCID: PMC11262154 DOI: 10.21470/1678-9741-2023-0405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 02/12/2024] [Indexed: 07/24/2024] Open
Abstract
Cardiac tumors are rare and encompass a variety of presentations. Clinica symptoms are usually nonspecific, but they can present as obstructive, embolic, or constitutional symptoms. Treatment options and prognosis vary highly depending on the subtype, tumor size, and location. Surgical resection is usually the first-line therapy, except for cardiac lymphomas, and provides favorable long-term prognosis in most benign tumors. Cardiac sarcomas, however, are usually diagnosed in advanced stages, and the treatment relies on a multimodal approach with chemotherapy and radiotherapy. Metastatic cardiac tumors are usually related to advanced disease and carry an overall poor prognosis.
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Affiliation(s)
- Carlos J. T. Karigyo
- Engineering Center for Circulatory Assistance, Instituto Dante
Pazzanese de Cardiologia, São Paulo, São Paulo, Brazil
- Postgraduate Program in Medicine/Technology and Intervention in
Cardiology, Universidade de São Paulo, São Paulo, São Paulo,
Brazil
| | | | | | - Emma Terwilliger
- Mayo Clinic College of Medicine and Science, Rochester, Minnesota,
United States of America
| | - Philippos Costa
- Division of Hematology and Oncology, Yale University Yale Cancer
Center, New Haven, Connecticut, United States of America
| | - Pedro Reck dos Santos
- Division of Cardiothoracic Surgery, Mayo Clinic Arizona, Phoenix,
Arizona, United States of America
| | - Vinicius Ernani
- Division of Oncology, Mayo Clinic Arizona, Phoenix, Arizona, United
States of America
| | - Mahesh Seetharam
- Division of Oncology, Mayo Clinic Arizona, Phoenix, Arizona, United
States of America
| | | | - Felipe Batalini
- Division of Oncology, Mayo Clinic Arizona, Phoenix, Arizona, United
States of America
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2
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AlRasheed MM. Genetics of Cardiac Tumours: A Narrative Review. Heart Lung Circ 2024; 33:639-647. [PMID: 38161083 DOI: 10.1016/j.hlc.2023.11.005] [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: 04/27/2023] [Revised: 10/09/2023] [Accepted: 11/13/2023] [Indexed: 01/03/2024]
Abstract
Cardiac tumours can occur in association with genetic syndromes. Rhabdomyomas have been reported in association with tuberous sclerosis, myxomas with Carney's complex, cardiac fibromas with Gorlin syndrome, and paragangliomas with multiple endocrine neoplasm syndrome. The presentation and prognosis of cardiac tumours associated with genetic syndromes differ compared with sporadic cases. Knowledge about the associated syndromes' genetic features and extracardiac manifestations is essential for the diagnosis, prognosis, and management of cardiac neoplasms. Moreover, identifying genetic mutations in benign and malignant cardiac tumours is needed to personalise management and improve treatment outcomes. Thus, this review discusses the genetic abnormalities associated with cardiac tumours, the current genetic screening recommendations, and the effect of those genetic mutations on the outcomes.
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Affiliation(s)
- Maha M AlRasheed
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia.
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3
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Hawryszko M, Sławiński G, Jankowska H, Dorniak K, Kochańska A, Daniłowicz-Szymanowicz L, Lewicka E. Coexistence of Left Atrial Tumor and Lung Cancer-The Key Role of an Individualized Approach. Diagnostics (Basel) 2024; 14:133. [PMID: 38248011 PMCID: PMC10814791 DOI: 10.3390/diagnostics14020133] [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: 12/13/2023] [Revised: 01/01/2024] [Accepted: 01/04/2024] [Indexed: 01/23/2024] Open
Abstract
During the diagnostic work-up in oncology, it is exceedingly rare to assume a concomitant presence of two cancers, a benign one and a malignant one, in a single patient. A 61-year-old man was admitted to the cardiology department for cardiac evaluation prior to planned radical treatment of non-small cell (NSCLC) left lung cancer (cT3N1M0). Echocardiography revealed a prominent, unpedunculated structure, measuring 17 × 14 mm, located in the left atrium (LA) near the fossa ovalis. The tumor was confirmed via cardiac magnetic resonance (CMR) imaging, which showed the radiological features of an atrial myxoma. The patient consulted with the Cardiac Surgery Department and was deemed ineligible for surgical treatment of a lesion with mucinous features; thus, no definitive histopathologic confirmation of the tumor present was possible. He was then successfully treated with radical radiochemotherapy and immunotherapy. During the 2-year follow-up, regular echocardiography and CMR were performed, which documented a stable LA tumor size.
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Affiliation(s)
- Maja Hawryszko
- Department of Cardiology and Electrotherapy, Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland; (M.H.); (A.K.); (L.D.-S.); (E.L.)
| | - Grzegorz Sławiński
- Department of Cardiology and Electrotherapy, Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland; (M.H.); (A.K.); (L.D.-S.); (E.L.)
| | - Hanna Jankowska
- Division of Cardiac Diagnostics, Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland; (H.J.); (K.D.)
| | - Karolina Dorniak
- Division of Cardiac Diagnostics, Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland; (H.J.); (K.D.)
| | - Anna Kochańska
- Department of Cardiology and Electrotherapy, Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland; (M.H.); (A.K.); (L.D.-S.); (E.L.)
| | - Ludmiła Daniłowicz-Szymanowicz
- Department of Cardiology and Electrotherapy, Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland; (M.H.); (A.K.); (L.D.-S.); (E.L.)
| | - Ewa Lewicka
- Department of Cardiology and Electrotherapy, Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland; (M.H.); (A.K.); (L.D.-S.); (E.L.)
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Hou S, Han Z, Wang H, Sun M. Multiple cardiac myxomas and cutaneous pigmentation revealing carney complex. JOURNAL OF CLINICAL ULTRASOUND : JCU 2023; 51:1332-1334. [PMID: 37434534 DOI: 10.1002/jcu.23519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 06/27/2023] [Indexed: 07/13/2023]
Affiliation(s)
- Suyun Hou
- Department of Ultrasound, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
| | - Zhengyang Han
- Department of Ultrasound, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
| | - Honghu Wang
- Department of Ultrasound, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
| | - Mengjiao Sun
- Department of Ultrasound, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
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Khan Z, Alkhatib H, Ramani GV. Case Report: An Atypical Case of Carney Complex. AMERICAN JOURNAL OF CASE REPORTS 2021; 22:e933744. [PMID: 34689149 PMCID: PMC8552419 DOI: 10.12659/ajcr.933744] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Patient: Male, 54-year-old
Final Diagnosis: Carney complex (CNC)
Symptoms: Cough • dyspnea • heart failure • lightheadedness • palpitation
Medication: —
Clinical Procedure: Mitral valve repair • open heart surgery • transesophageal echocardiogram • transthoracic echocardiogram
Specialty: Cardiac Surgery • Cardiology • Endocrinology and Metabolic • Genetics
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Affiliation(s)
- Zulqarnain Khan
- Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Hani Alkhatib
- Division of Cardiovascular Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Gautam V Ramani
- Division of Cardiovascular Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
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Patibandla S, Brito D, Sloyer D, Cook C, Badhwar V, Mills JD. Multimodality Cardiac Imaging Enhances Diagnosis and Management of Recurrent Atrial Myxomas in Carney Complex. ACTA ACUST UNITED AC 2021; 5:209-212. [PMID: 34430768 PMCID: PMC8370850 DOI: 10.1016/j.case.2021.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Cardiac myxomas are a recurrent, characteristic feature in Carney complex patients. Multimodality imaging can help detect tumors missed with echocardiography alone. Recurrent myxomas should be promptly resected after they are diagnosed. Echocardiography or other imaging should be performed 6 months after resection.
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Affiliation(s)
- Saikrishna Patibandla
- Division of Cardiology, West Virginia University Heart and Vascular Institute, Morgantown, West Virginia
| | - Daniel Brito
- Division of Cardiology, West Virginia University Heart and Vascular Institute, Morgantown, West Virginia
| | - Daniel Sloyer
- Division of Cardiac Anesthesiology, West Virginia University Heart and Vascular Institute, Morgantown, West Virginia
| | - Chris Cook
- Department of Cardiovascular and Thoracic Surgery, West Virginia University Heart, Morgantown, West Virginia
| | - Vinay Badhwar
- Department of Cardiovascular and Thoracic Surgery, West Virginia University Heart, Morgantown, West Virginia
| | - James D Mills
- Division of Cardiology, West Virginia University Heart and Vascular Institute, Morgantown, West Virginia
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Jantuan E, Chiu B, Chiu B, Shen F, Oudit GY, Sergi C. The tumor microenvironment may trigger lymphoproliferation in cardiac myxoma. Transl Oncol 2020; 14:100911. [PMID: 33129111 PMCID: PMC7586245 DOI: 10.1016/j.tranon.2020.100911] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 10/02/2020] [Accepted: 10/05/2020] [Indexed: 02/06/2023] Open
Abstract
Lymphoproliferative disorders (LPD) in cardiac myxomas (CM) has been occasionally reported, and chronic inflammation in response to viral infection may be the key. CM can upregulate autophagy, creating a favorable environment for Epstein Barr Virus (EBV)-driven oncogenesis. P62 accumulates when autophagy is inhibited, and aberrant excessive p62 may result from autophagy defect, causing oxidative stress and tumorigenesis. NanoString technology is a relatively new method for capturing tumor-immune signaling in tissues exploring how the signaling axis is associated with inflammation.
Cardiac myxomas (CM) and primary cardiac lymphoproliferative disorders (LPD) are rare primary cardiac neoplasms. The composite occurrence of LPD in CM has been occasionally reported, and chronic inflammation in response to viral infection has been suggested to be at the basis of oncogenesis. Cancers can upregulate autophagy to endure microenvironmental stress and to increase local growth and aggressiveness. CM exhibit a dichotomous separation in low and high inflammatory grades (LIG vs. HIG). We studied 23 CMs using autophagy-related proteins and NanoString technology for gene expression. Autophagy-related proteins (Beclin-1, LAMP-1, LC3, and p62) were demonstrated in both tumor and stromal cells. ATG genes showed a progression of involvement in CM using an 8-gene signature. They were associated with Epstein-Barr virus (EBV) encoded latent membrane protein 1 (EBV LMP1) activation. We suggest that CM can upregulate autophagy, creating a favorable environment for EBV-driven oncogenesis. To the best of our knowledge, the present study is the first to report on the TME using the expression of autophagy-related genes and proteins in CM. The microenvironment of CM is dynamic, with a variety of cell types and different molecular pathways at play, and this study may clearly warrant further investigation.
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Affiliation(s)
- Eugeniu Jantuan
- Department of Laboratory Medicine and Pathology, University of Alberta Hospital, 8440-112 Street, Edmonton T6G 2B7, Alberta, Canada
| | - Brian Chiu
- Department of Laboratory Medicine and Pathology, University of Alberta Hospital, 8440-112 Street, Edmonton T6G 2B7, Alberta, Canada
| | - Bonnie Chiu
- Department of Laboratory Medicine and Pathology, University of Alberta Hospital, 8440-112 Street, Edmonton T6G 2B7, Alberta, Canada
| | - Fan Shen
- Department of Laboratory Medicine and Pathology, University of Alberta Hospital, 8440-112 Street, Edmonton T6G 2B7, Alberta, Canada
| | - Gavin Y Oudit
- Department of Medicine, Division of Cardiology, Mazankowski Alberta Heart Institute, Edmonton, AB, Canada
| | - Consolato Sergi
- Department of Laboratory Medicine and Pathology, University of Alberta Hospital, 8440-112 Street, Edmonton T6G 2B7, Alberta, Canada; Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada; National "111″ Center for Cellular Regulation and Molecular Pharmaceutics, Key Laboratory of Fermentation Engineering, Hubei University of Technology, Wuhan, Hubei, China; Tianyou Hospital, Wuhan University of Science and Technology, Wuhan, Hubei, China.
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Liddy S, McQuade C, Walsh KP, Loo B, Buckley O. The Assessment of Cardiac Masses by Cardiac CT and CMR Including Pre-op 3D Reconstruction and Planning. Curr Cardiol Rep 2019; 21:103. [DOI: 10.1007/s11886-019-1196-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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