1
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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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2
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Hasnie AA, Muthukumar L, Galazka P, Schmidt L, Khraisat A, Crouch J, Tajik AJ. Large Symptomatic Ventricular Fibromas: A Surgical Challenge. CASE (PHILADELPHIA, PA.) 2023; 7:354-359. [PMID: 37791123 PMCID: PMC10542748 DOI: 10.1016/j.case.2023.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
•Cardiac fibromas are benign clinical entities that are rarely diagnosed in adulthood. •Echocardiography is considered the first imaging modality used for evaluation. •Multimodality imaging is critical for diagnosis and perioperative intervention. •Management remains largely case by case. •Tumor burden and surgical feasibility guide aggressiveness of management strategy.
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Affiliation(s)
- Ali A. Hasnie
- Aurora Cardiovascular and Thoracic Services, Aurora Sinai/Aurora St. Luke’s Medical Centers, Advocate Aurora Health, Milwaukee, Wisconsin
| | - Lakshmi Muthukumar
- Aurora Cardiovascular and Thoracic Services, Aurora Sinai/Aurora St. Luke’s Medical Centers, Advocate Aurora Health, Milwaukee, Wisconsin
| | - Patrycja Galazka
- Aurora Cardiovascular and Thoracic Services, Aurora Sinai/Aurora St. Luke’s Medical Centers, Advocate Aurora Health, Milwaukee, Wisconsin
| | | | - Ahmad Khraisat
- Aurora Cardiovascular and Thoracic Services, Aurora Sinai/Aurora St. Luke’s Medical Centers, Advocate Aurora Health, Milwaukee, Wisconsin
| | - John Crouch
- Department of Cardiothoracic Surgery, Aurora St. Luke’s Medical Center, Advocate Aurora Health, Milwaukee, Wisconsin
| | - A. Jamil Tajik
- Aurora Cardiovascular and Thoracic Services, Aurora Sinai/Aurora St. Luke’s Medical Centers, Advocate Aurora Health, Milwaukee, Wisconsin
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3
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Inserra MC, Cannizzaro MT, Passaniti G, Celona A, Secinaro A, Curione D, D'Angelo T, Garretto O, Romeo P. MR imaging of primary benign cardiac tumors in the pediatric population. Heliyon 2023; 9:e19932. [PMID: 37809686 PMCID: PMC10559362 DOI: 10.1016/j.heliyon.2023.e19932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 07/25/2023] [Accepted: 09/06/2023] [Indexed: 10/10/2023] Open
Abstract
Primary cardiac tumors are rare in all ages, especially in children, with a reported prevalence range of 0.0017-0.28% in autopsy series. Due to their rarity, the diagnostic and therapeutic pathways reserved to them are usually described by single case reports, leading to the point where a common diagnostic protocol is imperative to obtain a differential diagnosis. The first diagnostic approach is done with transthoracic echocardiogram (TTE), due to its wide availability, low cost, absence of ionizing radiations and non-invasiveness. Several tumors are discovered incidentally and, in many cases, TTE is helpful to determine location, size and anatomical features, playing a key role in the differential diagnosis. In the last few years, cardiac magnetic resonance imaging (CMR) has had an increased role in the diagnostic pathway of pediatric cardiac masses, due to its high accuracy in characterizing mass tissue properties (especially for soft tissue), and in detecting tumor size, extent, pericardial/pleural effusion, leading to the correct diagnosis, treatment and follow-up. Therefore, nowadays, several consensus statements consider CMR as a leading imaging technique, thanks to its non-invasive tissue characterization, without the use of ionizing radiation, in an unrestricted field of view. As suggested by the most recent literature, the pediatric protocol is not so different from the adult one, adapted to the size and cardiac frequency of the patient, sometimes requiring special conditions such as free-breathing sequences and/or sedation or general anesthesia in non-cooperating patients.
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Affiliation(s)
| | | | - Giulia Passaniti
- Division of Cardiology, A.O.U. Policlinico “G. Rodolico - San Marco”, Catania, Italy
| | - Antonio Celona
- UOC Radiodiagnostica, San Vincenzo Hospital, Provincial Health Agency of Messina, Taormina, Italy
| | - Aurelio Secinaro
- Advanced Cardiothoracic Imaging, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Davide Curione
- Advanced Cardiothoracic Imaging, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Tommaso D'Angelo
- Diagnostic and Interventional Radiology Unit, BIOMORF Department, University Hospital “Policlinico G. Martino”, Messina Italy
- Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, the Netherlands
| | - Orazio Garretto
- UOSD Radiologia 2 CAST, A.O.U. Policlinico “G. Rodolico - San Marco”, Catania, Italy
| | - Placido Romeo
- Radiology Department of AO “San Marco”, A.O.U. Policlinico “G. Rodolico - San Marco”, Catania, Italy
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4
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Wilke PI, Biermann D, Grafmann M, Kozlik-Feldmann R, Papingi D, Sachweh JS, Stute F, Olfe J. Siblings with Gorlin-Goltz syndrome associated with cardiac tumors: a case report and review of literature. Orphanet J Rare Dis 2023; 18:178. [PMID: 37408081 DOI: 10.1186/s13023-023-02792-5] [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: 04/21/2022] [Accepted: 06/23/2023] [Indexed: 07/07/2023] Open
Abstract
Primary cardiac tumors in children are very rare and may be associated with severe arrhythmias and sudden infant death syndrome. These cardiac arrhythmias vary depending on the location and size of the tumor. Sixty-four percent of children with cardiac fibroma, the second most common benign cardiac tumor in children, have ventricular arrhythmias, affecting therapeutic management and risk profile of these children. We report on two siblings with cardiac fibromas whose clinical presentations differed depending on their locations and size of the tumors. The first child, a three-year-old girl, was diagnosed with a cardiac fibroma in the left ventricle at the age of 8 months after surviving resuscitation due to ventricular fibrillation. Secondary prophylactic implantation of an ICD was performed. On propranolol, no further malignant arrhythmias have occurred to date. The seven-month-old brother was diagnosed postnatally with a cardiac tumor adjacent to the right ventricle. A few weeks after birth, the boy had refractory supraventricular tachycardia and ventricular arrhythmia that only resolved with amiodarone. In genetic testing, Gorlin-Goltz syndrome was diagnosed in both children. Conservative pharmacological therapy is a therapeutic strategy for asymptomatic patients with cardiac fibromas. The anti-arrhythmic medication depends on the location of the tumor. Implantation of an ICD should be performed in cases of malignant arrhythmias. In rare cases, there is an association between cardiac tumors and genetic syndromes, such as Gorlin-Goltz syndrome. These should always be considered when such a tumor is diagnosed.
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Affiliation(s)
- Paula I Wilke
- Pediatric Cardiology, University Medical Center Hamburg-Eppendorf University Heart & Vascular Center, Martinistr. 52, 20246, Hamburg, Germany
| | - Daniel Biermann
- Pediatric Cardiac Surgery, University Medical Center Hamburg-Eppendorf University Heart & Vascular Center, Hamburg, Germany
| | - Maria Grafmann
- Pediatric Cardiology, University Medical Center Hamburg-Eppendorf University Heart & Vascular Center, Martinistr. 52, 20246, Hamburg, Germany
| | - Rainer Kozlik-Feldmann
- Pediatric Cardiology, University Medical Center Hamburg-Eppendorf University Heart & Vascular Center, Martinistr. 52, 20246, Hamburg, Germany
| | - Dzhoy Papingi
- Institute of Human Genetics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jörg S Sachweh
- Pediatric Cardiac Surgery, University Medical Center Hamburg-Eppendorf University Heart & Vascular Center, Hamburg, Germany
| | - Fridrike Stute
- Pediatric Cardiology, University Medical Center Hamburg-Eppendorf University Heart & Vascular Center, Martinistr. 52, 20246, Hamburg, Germany
| | - Jakob Olfe
- Pediatric Cardiology, University Medical Center Hamburg-Eppendorf University Heart & Vascular Center, Martinistr. 52, 20246, Hamburg, Germany.
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5
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Kurmann R, El-Am E, Ahmad A, Abbasi MA, Mazur P, Akiki E, Anand V, Herrmann J, Casanegra AI, Young P, Crestanello J, Bois MC, Maleszewski JJ, Klarich K. Cardiac Masses Discovered by Echocardiogram; What to Do Next? STRUCTURAL HEART : THE JOURNAL OF THE HEART TEAM 2023; 7:100154. [PMID: 37520139 PMCID: PMC10382990 DOI: 10.1016/j.shj.2022.100154] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 12/06/2022] [Accepted: 12/21/2022] [Indexed: 02/12/2023]
Abstract
Cardiac tumors are rare conditions, typically diagnosed on autopsy, but with the advancement of imaging techniques they are now encountered more frequently in clinical practice. Echocardiography is often the initial method of investigation for cardiac masses and provides a quick and valuable springboard for their characterization. While some cardiac masses can be readily identified by echocardiography alone, several require incorporation of multiple data points to reach diagnostic certainty. Herein, we will provide an overview of the main clinical, diagnostic, and therapeutic characteristics of cardiac masses within the framework of their location.
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Affiliation(s)
- Reto Kurmann
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Edward El-Am
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Ali Ahmad
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Piotr Mazur
- Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Elias Akiki
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Vidhu Anand
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Joerg Herrmann
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Ana I. Casanegra
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Phillip Young
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | - Juan Crestanello
- Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Melanie C. Bois
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
- Department of Laboratory Medicine & Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Joseph J. Maleszewski
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
- Department of Laboratory Medicine & Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Kyle Klarich
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
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6
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Motonaga KS. The rare ventricular arrhythmia recurrence following fibroma resection: Can we predict who is at risk? Heart Rhythm 2023; 20:250-251. [PMID: 36336301 DOI: 10.1016/j.hrthm.2022.10.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 10/28/2022] [Indexed: 11/06/2022]
Affiliation(s)
- Kara S Motonaga
- Department of Pediatrics, Division of Pediatric Cardiology, Stanford University, Palo Alto, California.
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7
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Multimodality Imaging of Benign Primary Cardiac Tumor. Diagnostics (Basel) 2022; 12:diagnostics12102543. [PMID: 36292232 PMCID: PMC9601182 DOI: 10.3390/diagnostics12102543] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/04/2022] [Accepted: 10/18/2022] [Indexed: 11/17/2022] Open
Abstract
Primary cardiac tumors (PCTs) are rare, with benign PCTs being relatively common in approximately 75% of all PCTs. Benign PCTs are usually asymptomatic, and they are found incidentally by imaging. Even if patients present with symptoms, they are usually nonspecific. Before the application of imaging modalities to the heart, our understanding of these tumors is limited to case reports and autopsy studies. The advent and improvement of various imaging technologies have enabled the non-invasive evaluation of benign PCTs. Although echocardiography is the most commonly used imaging examination, it is not the best method to describe the histological characteristics of tumors. At present, cardiac magnetic resonance (CMR) and cardiac computed tomography (CCT) are often used to assess benign PCTs providing detailed information on anatomical and tissue features. In fact, each imaging modality has its own advantages and disadvantages, multimodality imaging uses two or more imaging types to provide valuable complementary information. With the widespread use of multimodality imaging, these techniques play an indispensable role in the management of patients with benign PCTs by providing useful diagnostic and prognostic information to guide treatment. This article reviews the multimodality imaging characterizations of common benign PCTs.
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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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Covington MK, Young PM, Bois MC, Maleszewski JJ, Anand V, Dearani JA, Klarich KW. Clinical Impact of Cardiac Fibromas. Am J Cardiol 2022; 182:95-103. [DOI: 10.1016/j.amjcard.2022.06.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 06/20/2022] [Accepted: 06/28/2022] [Indexed: 11/01/2022]
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10
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Qian T, Wu Z, Yang Y, Xie L, Yin N, Lu T, Huang C, Yang H. Surgery for Primary Cardiac Tumors in Children: Successful Management of Large Fibromas. Front Cardiovasc Med 2022; 9:808394. [PMID: 35321111 PMCID: PMC8934860 DOI: 10.3389/fcvm.2022.808394] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 01/27/2022] [Indexed: 11/13/2022] Open
Abstract
Background Pediatric primary cardiac tumors (PCTs) are rare. Its clinical features and prognoses are not well defined. The management of asymptomatic patients with cardiac fibromas remains controversial. Objective We aimed to examine our experience in surgical resection of pediatric PCT, with specific focuses on the management of large fibromas. Methods This study included all the children who underwent surgical resection of PCT in our institution between December 2008 and June 2021. The last follow-up was performed between June 1st and August 26th, 2021. Kaplan–Meier method was used to estimate the postoperative survival, freedom from reoperation, event-free survival, and also related risk factors. The tumor volume and volume index (volume divided by body surface area) were measured for cardiac fibromas. Results Of the 39 patients with median operative age of 9.5 [interquartile range (IQR): 1.2–16.5] years, 35 (89.7%) had benign tumors (fibromas for 15, myxomas for 13, and others for 7). The length and volume of fibromas were independent of age and symptoms (Ps > 0.05). The fibroma volume index was negatively correlated with age (P = 0.039), with a mean value of 105 ± 70 ml/m2. Of the 15 patients with fibromas, 5 were asymptomatic, 4 received partial resection, 4 required transmural resection, and 4 presented postoperative left ventricular (LV) dysfunction (ejection fraction <50%). During the median follow-up period of 3.1 years and maximum of 12.5 years, adverse events included 2 early and 1 late death, 4 reoperations, 4 tumor recurrences, and 1 LV dysfunction lasting over one year. The 8-year survival, freedom from reoperation, and event-free survival rates were 90.4, 81.8, and 64.2%, respectively. Malignant tumor (P < 0.001) was associated with more adverse events. Transmural resection (P = 0.022) and larger tumor volume index than LV end-diastolic volume (P = 0.046) were risk factors for LV dysfunction following fibromas resection. Conclusion Pediatric surgery for PCT can be performed with low mortalities and few adverse events. The size of cardiac fibroma in children relatively decreases with the increase of age. Larger tumor volume index than LV end-diastolic volume index and transmural tumor resection predicts postoperative LV dysfunction.
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Affiliation(s)
- Tao Qian
- Department of Cardiovascular Surgery, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Zhongshi Wu
- Department of Cardiovascular Surgery, The Second Xiangya Hospital of Central South University, Changsha, China
- National Health Commission Key Laboratory of Birth Defects Research, Prevention, and Treatment, Changsha, China
- *Correspondence: Zhongshi Wu
| | - Yifeng Yang
- Department of Cardiovascular Surgery, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Li Xie
- Department of Cardiovascular Surgery, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Ni Yin
- Department of Cardiovascular Surgery, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Ting Lu
- Department of Cardiovascular Surgery, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Can Huang
- Department of Cardiovascular Surgery, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Hui Yang
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, China
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11
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Ikegami H, Lemaire A, Gowda S, Fyfe B, Ali M, Russo MJ, Lee LY. Case report: surgical resection of right ventricular cardiac fibroma in an adult patient. J Cardiothorac Surg 2021; 16:136. [PMID: 34016147 PMCID: PMC8139114 DOI: 10.1186/s13019-021-01514-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Accepted: 05/05/2021] [Indexed: 12/03/2022] Open
Abstract
Background Cardiac fibromas are rare benign cardiac neoplasms, most frequently occurring in the pediatric population; with very rare cases identified in adults. The tumors are comprised of spindled cells with myofibroblastic ultrastructural features embedded in generally collagenous and elastic stroma. The tumors are intramural in the ventricles, most commonly the left ventricle. Clinical symptoms vary by location and size of tumor and some are asymptomatic. Surgical resection is curative, but rare cases require cardiac transplantation. Case presentation We report an asymptomatic, large, right ventricular fibroma in a 64-year-old woman. The patient underwent open incisional tumor biopsy via lower hemi-sternotomy, followed by complete tumor resection via full sternotomy a week later after confirming the tumor is benign. The tumor was resected using cardiopulmonary bypass, and the defect of right ventricular free wall was repaired using a prosthetic double-patch technique. The postoperative course was uneventful. The patient was discharged to home on day 4 post-complete tumor resection. Conclusion This report expands the existing literature for better comprehension and detection of cardiac fibroma patients and also highlights the various imaging modalities, surgical management, and histological analysis.
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Affiliation(s)
- Hirohisa Ikegami
- Division of Cardiothoracic Surgery, Department of Surgery, Rutgers-Robert Wood Johnson Medical School, 125 Paterson Street, New Brunswick, NJ, USA.
| | - Anthony Lemaire
- Division of Cardiothoracic Surgery, Department of Surgery, Rutgers-Robert Wood Johnson Medical School, 125 Paterson Street, New Brunswick, NJ, USA
| | - Subhashini Gowda
- New Brunswick Cardiology Group, 75 Veronica Avenue, Suite 101, Somerset, NJ, USA
| | - Billie Fyfe
- Department of Pathology and Laboratory Medicine, Rutgers-Robert Wood Johnson Medical School, 125 Paterson Street, New Brunswick, NJ, USA
| | - Mahmoud Ali
- Department of Pathology and Laboratory Medicine, Rutgers-Robert Wood Johnson Medical School, 125 Paterson Street, New Brunswick, NJ, USA
| | - Mark J Russo
- Division of Cardiothoracic Surgery, Department of Surgery, Rutgers-Robert Wood Johnson Medical School, 125 Paterson Street, New Brunswick, NJ, USA
| | - Leonard Y Lee
- Division of Cardiothoracic Surgery, Department of Surgery, Rutgers-Robert Wood Johnson Medical School, 125 Paterson Street, New Brunswick, NJ, USA
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12
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Menon D, Dentel JN, Sanil Y, Lawrence D. Cardiac Fibroma with Asymptomatic Ventricular Arrhythmia in an Adolescent with Gorlin's Syndrome. J Pediatr Genet 2021; 12:171-174. [PMID: 37090839 PMCID: PMC10118701 DOI: 10.1055/s-0040-1722287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 12/01/2020] [Indexed: 10/22/2022]
Abstract
AbstractNevoid basal cell carcinoma syndrome (NBCCS), also referred to as Gorlin's syndrome, is an autosomal dominant inherited condition that predisposes affected individuals to various tumors such as cardiac fibromas. Though technically benign, cardiac fibromas may result in malignant arrhythmias and sudden death. The pertinent literature pertaining to pediatric cases of cardiac fibromas and their clinical features were reviewed. We present the case of an asymptomatic teenage with de novo NBCCS who was diagnosed with both NBCCS and cardiac fibroma later in life. The patient was noted to have clinically significant ventricular arrhythmias that were eliminated with tumor resection. There are no established best practice guidelines for the management of cardiac fibromas in patients with NBCCS. Given the risk of sudden arrhythmic death, the presence of ventricular arrhythmias should prompt strong consideration of tumor resection.
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Affiliation(s)
- Dipika Menon
- Division of Pediatric Cardiology, Children's Hospital of Michigan, School of Medicine - Wayne State University, Detroit, Michigan, United States
| | - John N. Dentel
- Division of Cardiovascular Surgery, Children's Hospital of Michigan, School of Medicine - Wayne State University, Detroit, Michigan, United States
| | - Yamuna Sanil
- Division of Pediatric Cardiology, Children's Hospital of Michigan, School of Medicine - Wayne State University, Detroit, Michigan, United States
| | - David Lawrence
- Division of Pediatric Cardiology, Children's Hospital of Michigan, School of Medicine - Wayne State University, Detroit, Michigan, United States
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13
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Liu E, Zhang X, Sun T, Chen Z, Dong H, Liu C, Xie Q, Wang S, Wang S. Primary cardiac fibroma with persistent left superior vena cava in a young adult: Contrast-enhanced CT and 18F-FDG PET/CT finding. J Nucl Cardiol 2020; 27:1837-1840. [PMID: 31346946 DOI: 10.1007/s12350-019-01825-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 07/09/2019] [Indexed: 10/26/2022]
Affiliation(s)
- Entao Liu
- WeiLun PET Center, Department of Nuclear Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Xiaochun Zhang
- WeiLun PET Center, Department of Nuclear Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Taotao Sun
- WeiLun PET Center, Department of Nuclear Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Zerui Chen
- Department of Cardiovascular Surgery, Guangdong Provincial Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Haojian Dong
- Department of Cardiology, Vascular Center, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Chao Liu
- Department of Pathology and Laboratory Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Qiu Xie
- Division of Adult Echocardiography, Guangdong Provincial Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Siyun Wang
- WeiLun PET Center, Department of Nuclear Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Shuxia Wang
- WeiLun PET Center, Department of Nuclear Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China.
- Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Weilun Building, Room 517, 5/F, 106 Zhongshan Er Road, Guangzhou, 510080, Guangdong, China.
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14
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Kimura A, Kanzaki H, Izumi C. A case report of primary cardiac fibroma: an effective approach for diagnosis and therapy of a pathologically benign tumour with an unfavourable prognosis. EUROPEAN HEART JOURNAL-CASE REPORTS 2020; 4:1-5. [PMID: 32974467 DOI: 10.1093/ehjcr/ytaa186] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 03/31/2020] [Accepted: 05/29/2020] [Indexed: 11/12/2022]
Abstract
Background Primary cardiac fibroma is exceedingly rare. This condition involves a significant risk of life-threatening arrhythmias during follow-up and its prognosis is not as favourable as other benign tumours. We report a case of cardiac fibroma that was preoperatively diagnosed with echocardiography and magnetic resonance imaging. This fibroma was excised early as a preventative measure to avoid sudden death. Case summary A 46-year-old woman presented to our hospital with a 1-year history of chest tightness at rest. Echocardiography showed a large, isoechoic, well-circumscribed mass within the left ventricular myocardium with calcified tissue. Magnetic resonance imaging showed an intramural ventricular mass with iso signal intensity on T1-weighted imaging and low-signal intensity on T2-weighted imaging. There was no enhancement on first-pass perfusion imaging and homogeneous hyperenhancement on late gadolinium enhancement imaging. These features suggested a diagnosis of cardiac fibroma. Complete resection was performed to avoid sudden death and pathological analysis confirmed the tumour as cardiac fibroma. The patient was discharged 9 days after surgery and remains disease-free 5 months after surgery. Discussion Cardiac fibroma is a pathologically benign tumour with an unfavourable prognosis because of lethal arrhythmias, which can be controlled by its resection. Thus, it is important to preoperatively distinguish cardiac fibroma from other benign tumours, in order to prioritize surgical intervention for those with cardiac fibromas. Preoperative diagnosis with echocardiography and magnetic resonance imaging and early preventative surgery are the keys to improve prognosis of patients with cardiac fibromas.
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Affiliation(s)
- Akihisa Kimura
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita, Osaka 564-8565, Japan
| | - Hideaki Kanzaki
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita, Osaka 564-8565, Japan
| | - Chisato Izumi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita, Osaka 564-8565, Japan
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Sultan FAT, Ahmed SW. Cardiac Magnetic Resonance Evaluation of Cardiac Masses in Patients with Suspicion of Cardiac Masses on Echo or Computed Tomography. J Clin Imaging Sci 2020; 10:57. [PMID: 33024612 PMCID: PMC7533085 DOI: 10.25259/jcis_137_2020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 08/30/2020] [Indexed: 11/13/2022] Open
Abstract
Objectives: In recent years, cardiac magnetic resonance (CMR) imaging has emerged as an important tool in the identification and characterization of cardiac masses. No imaging data on cardiac masses are available from Pakistan. We aimed to review the clinical presentation, CMR findings, and outcome of patients referred for CMR due to suspicion of cardiac masses on echocardiogram or computed tomography (CT). Material and Methods: We reviewed all the patients referred for CMR at Aga Khan University Hospital, Karachi, from January 2011 to March 2020, with the suspicion of cardiac mass on echocardiogram and/or CT. Only those with the confirmed diagnosis of cardiac mass on CMR were included in the study. Results: A total of 27 patients were referred for CMR from January 2011 to March 2020, with the suspicion of cardiac mass on echocardiogram and/or CT. Four patients were excluded as no cardiac mass was found on CMR. Out of 23 cases, majority (n = 15, 65%) were female, age ranging from 3 months to 70 years, with a mean age of 40 ± 22 years. Shortness of breath was the main presenting symptom (n = 19, 83%). Echocardiogram was the initial imaging modality done in all the patients while CT was also performed in 6 patients (26%). Out of 23 patients, 4 (17%) were diagnosed to have thrombus on CMR. In two cases, it was in the left ventricle with evidence of myocardial infarction on late gadolinium images. Myxoma was the most common tumor diagnosed on CMR in 6 patients (26%) followed by rhabdomyoma (n = 3, 13%) and fibroma (n = 2, 8.7%). There were three malignant primary tumors of the heart based on CMR appearances and one with tumor thrombus extension of hepatocellular carcinoma in the right atrium from inferior vena cava. Two patients were diagnosed to have non-neoplastic lesions – one with large intracardiac hydatid cyst and one with possible large fungal vegetation. Among 23 patients, 9 patients (39%) underwent surgery, 5 with myxoma, 2 with rhabdomyoma, 1 with fibroma, and 1 with fibroelastoma. Findings on surgery and histopathology matched the CMR diagnosis in all the patients except the one with the CMR diagnosis of myxoma in which histopathology was consistent with thrombus. Conclusion: CMR can play an important role in confirming the presence or absence of a mass in the heart. It can also provide differentiation of non-neoplastic and neoplastic lesions and among different types of neoplastic lesions with reasonable accuracy. However, the limitations of CMR must be recognized.
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Affiliation(s)
- Fateh Ali Tipoo Sultan
- Department of Medicine (Cardiology), Aga Khan University Hospital, Karachi, Sindh, Pakistan
| | - Syed Waqar Ahmed
- Department of Medicine (Cardiology), Aga Khan University Hospital, Karachi, Sindh, Pakistan
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16
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Abstract
Cardiac fibroma is a rare benign primary tumour of the heart. In the paediatric population, it has been reported as the second most common benign cardiac tumour following rhabdomyoma. However, the prevalence of cardiac fibroma is rarely reported in the adult population. Signs and symptoms are nonspecific, including palpitations, cardiac murmur, arrhythmias, dyspnoea, cyanosis, chest pain, and sudden mortality, whereas, a number of patients with cardiac fibroma are asymptomatic. Surgical resection should be considered as the best option in symptomatic patients. This study reported four surgical cases of adults with cardiac fibroma arising from the left ventricle and a literature review regarding the clinical and pathological features, diagnostic modalities, therapeutic aspects, and prognosis of this rare entity.
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17
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Yuan X, Li B, Yang Y, Wang H, Sun H, Song Y, Wang W. Surgical results and pathological analysis of cardiac fibroma in the adolescent and the adult. J Card Surg 2020; 35:1912-1919. [PMID: 32652694 DOI: 10.1111/jocs.14790] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUNDS Disparities may exist between the adolescent and the adult patients with cardiac fibromas in the symptoms, surgical outcomes, and pathological characteristics. The aim of this study was to compare short and midterm surgical outcomes of cardiac fibromas and to compare the biomarker expressions of tumor tissue samples between the adult and the adolescent. METHODS Consecutive patients with the diagnosis of cardiac fibroma were admitted and received surgeries. Primary outcomes included in-hospital mortality, low cardiac output, and readmission due to heart failure. The expression of PCNA and Ki67, two widely adopted indicators of cell proliferation, were evaluated in tissue samples. RESULTS A total of five adolescent patients and five adult patients diagnosed as cardiac fibroma were admitted and given surgeries. When compare with the adults, the adolescent patients were more likely to present symptoms on admission (P = .048). Postoperative low cardiac output syndrome was significantly higher in the adolescents than in the adults (80.0% vs 0.0, P = .048). The tumor volume relative to ventricular end diastolic diameter had good discriminative ability for low cardiac output (c statistics: 0.96). Pathologically, the percentage of PCNA-positive cell nuclei was significantly higher in the adolescents than in the adults (36.04% ± 10.54% vs 4.15% ± 3.93%, P = .001). However, there were no Ki67-positive nuclei in the 10 cases. CONCLUSIONS In the current study, we found that postoperative low cardiac output was more likely to occur in the adolescent patients than in the adult patients. When compared with the adult patients, significantly more PCNA-positive nuclei were observed in the adolescents.
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Affiliation(s)
- Xin Yuan
- National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.,Department of Cardiovascular Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Baotong Li
- National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.,Department of Cardiovascular Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Yan Yang
- National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.,Department of Cardiovascular Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Hongyue Wang
- National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.,Department of Pathology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Hansong Sun
- National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.,Department of Cardiovascular Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Yunhu Song
- National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.,Department of Cardiovascular Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Wei Wang
- National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.,Department of Cardiovascular Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
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18
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Anwar AS, Salem MI, Beltagy R, Madi K, Elwatidy AMF. Large Left Ventricular Fibroma: Case Report and Literature Review. INNOVATIONS-TECHNOLOGY AND TECHNIQUES IN CARDIOTHORACIC AND VASCULAR SURGERY 2020; 15:283-285. [PMID: 32362236 DOI: 10.1177/1556984520917139] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Benign cardiac tumors are rare and fibroma is second to rhabdomyoma in frequency in pediatric cardiac tumors. We report a case of a 14-year-old male patient, who presented with shortness of breath for 2 years. Echocardiogram and cardiac magnetic resonance imaging indicated a large mass located in the left ventricular lateral wall. The patient underwent surgical excision of the tumor, and histopathological examination confirmed the diagnosis of a cardiac fibroma. The patient had a good postoperative recovery and was discharged on sixth postoperative day.
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Affiliation(s)
- Ahmed S Anwar
- 68789 Cardiothoracic Surgery and Cardiac Anaesthesia Departments, Alexandria University, Egypt
| | - Mahmoud I Salem
- 289164 Cardiothoracic Surgery Department, Port-Said University, Egypt
| | - Ragab Beltagy
- 289154 Cardiothoracic Surgery Department, Kafr Elsheikh University, Egypt
| | - Karim Madi
- 48077 Cardiothoracic Surgery Department, Alshefa Hospital, Alexandria, Egypt
| | - Ahmed M F Elwatidy
- 68789 Cardiothoracic Surgery and Cardiac Anaesthesia Departments, Alexandria University, Egypt.,48077 Cardiothoracic Surgery Department, Alshefa Hospital, Alexandria, Egypt
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19
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Lee YJ, Kramer CM. Fourteen-Year Follow-Up Cardiac Magnetic Resonance Imaging of a Large Septal Cardiac Fibroma. Circ Cardiovasc Imaging 2019; 12:e009118. [PMID: 31230457 DOI: 10.1161/circimaging.119.009118] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Yoo Jin Lee
- Division of Noninvasive Cardiovascular Imaging, Department of Radiology and Medical Imaging (Y.J.L., C.M.K.), University of Virginia Health System, Charlottesville
| | - Christopher M Kramer
- Division of Noninvasive Cardiovascular Imaging, Department of Radiology and Medical Imaging (Y.J.L., C.M.K.), University of Virginia Health System, Charlottesville.,Cardiovascular Division, Department of Medicine (C.M.K.), University of Virginia Health System, Charlottesville
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20
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Jones JP, Ramcharan T, Chaudhari M, Bhole V, Mcleod K, Sadagopan S, Uzun O, Parry A, Till J, McMahon CJ, Stuart AG, Walsh MA. Ventricular fibromas in children, arrhythmia risk, and outcomes: A multicenter study. Heart Rhythm 2018; 15:1507-1512. [DOI: 10.1016/j.hrthm.2018.06.018] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Indexed: 11/16/2022]
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21
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Yörüker U, Yerebakan C, Mueller M, Akintürk H. Giant cardiac fibroma leading to cardiac arrest: Surgical resection on the beating heart. J Thorac Cardiovasc Surg 2015; 150:e83-5. [PMID: 26573364 DOI: 10.1016/j.jtcvs.2015.08.033] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Revised: 08/06/2015] [Accepted: 08/11/2015] [Indexed: 10/23/2022]
Affiliation(s)
- Uygar Yörüker
- Pediatric Heart Center Giessen, Justus-Liebig-University, Giessen, Germany
| | - Can Yerebakan
- Pediatric Heart Center Giessen, Justus-Liebig-University, Giessen, Germany
| | - Matthias Mueller
- Pediatric Heart Center Giessen, Justus-Liebig-University, Giessen, Germany
| | - Hakan Akintürk
- Pediatric Heart Center Giessen, Justus-Liebig-University, Giessen, Germany.
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22
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Yong MS, Brink J, Zimmet AD. Right ventricular reconstruction after resection of cardiac fibroma. J Card Surg 2015; 30:640-2. [PMID: 26096081 DOI: 10.1111/jocs.12584] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Cardiac fibromas are rare neoplasms of myocardial fibroblasts. We present a case of a right ventricular fibroma and review the surgical management of these neoplasms.
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Affiliation(s)
- Matthew S Yong
- Department of Cardiothoracic Surgery, The Alfred Hospital, Melbourne, Australia
| | - Johann Brink
- Department of Cardiothoracic Surgery, The Alfred Hospital, Melbourne, Australia
| | - Adam D Zimmet
- Department of Cardiothoracic Surgery, The Alfred Hospital, Melbourne, Australia
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23
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Kusajima K, Hata H, Fujita T, Shimahara Y, Sato S, Ishibashi-Ueda H, Kobayashi J. Successful surgical treatment for recurrent cardiac fibroma 21 years after resection. Surg Case Rep 2015; 1:41. [PMID: 26943406 PMCID: PMC4747971 DOI: 10.1186/s40792-015-0043-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Accepted: 05/05/2015] [Indexed: 11/10/2022] Open
Abstract
Cardiac fibromas are rare benign tumors usually seen in the pediatric population. Generally, long-term survival after surgical resection is favorable, and recurrence of fibroma has been hardly reported. Herein, we report a case of a 34-year-old woman who presented with ventricular tachycardia 21 years after resection of a cardiac fibroma and was found to have a recurrent giant cardiac fibroma. We performed a complete resection of the recurrent fibroma. At the 2-year follow-up, she remains asymptomatic with no evidence of ventricular tachycardia or recurrence of fibroma.
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Affiliation(s)
- Kunio Kusajima
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Japan.
| | - Hiroki Hata
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Japan.
| | - Tomoyuki Fujita
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Japan.
| | - Yusuke Shimahara
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Japan.
| | - Shunsuke Sato
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Japan.
| | | | - Junjiro Kobayashi
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Japan.
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24
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Anvari MS, Naderan M, Eslami Shahr Babaki A, Shoar S, Boroumand MA, Abbasi K. Clinicopathologic review of non-myxoma cardiac tumors: a 10-year single-center experience. Cardiology 2014; 129:199-202. [PMID: 25342027 DOI: 10.1159/000365916] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2014] [Accepted: 07/14/2014] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To report the prevalence, clinical presentation and histological characteristics of non-myxoma cardiac tumors in a major tertiary heart center. METHOD Review of the medical profiles of 36,930 patients admitted to our hospital between 2003 and 2013 yielded a total of 86 cases of cardiac tumors (63 cases of myxomas and 23 cases of non-myxoma tumors). Clinical presentations and histological features were presented exclusively for primary and secondary tumors. RESULTS Of 23 enrolled patients with non-myxoma tumors, 5 had primary tumors and 18 had secondary or metastatic tumors. The most frequent origins of the secondary tumors were breast cancer, lymphoma, leukemia and lung cancer. Most secondary tumors had pericardial involvement, and only one tumor involved the left atrium. Sarcomas, including spindle-cell sarcoma and liposarcoma, comprised the majority of the primary malignant tumors. None of these tumors had pericardial involvement, and, except for one case, all were confined to the left side of the heart. All patients were symptomatic on admission, with dyspnea being the most frequent presenting symptom. CONCLUSION Metastatic cardiac tumors were more prevalent than the primary ones, with fibromas constituting the largest proportion of the primary tumors and breast cancer being the prevalent cause of metastasis.
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Affiliation(s)
- Maryam Sotoudeh Anvari
- Department of Surgical and Clinical Pathology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
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25
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Cronin B, Lynch MJ, Parsons S. Cardiac fibroma presenting as sudden unexpected death in an adolescent. Forensic Sci Med Pathol 2014; 10:647-50. [DOI: 10.1007/s12024-014-9582-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/05/2014] [Indexed: 02/05/2023]
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26
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Gong Y, Yin N, Yang J. Surgical treatment of left ventricular fibroma accompanied with ventricular septal defect in an infant: a case report. J Cardiothorac Surg 2014; 9:37. [PMID: 24552461 PMCID: PMC3933283 DOI: 10.1186/1749-8090-9-37] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2013] [Accepted: 02/17/2014] [Indexed: 11/17/2022] Open
Abstract
Primary cardiac tumor in infancy is an uncommon condition which is rarely accompanied with congenital heart disease. Although these tumors are generally benign, the complication associated with it, such as arrhythmia, outflow tract obstruction, and heart failure, may result in early mortality, when combined with congenital heart disease. Early surgical treatment may reduce complication risk and increase operative success rate which may improve the patient’s long-term prognosis. Herein, we report a case of an eight-month-old Chinese baby boy diagnosed with a calcified fibroma combined with ventricular septal defect, the tumor excision and repair of ventricular septal defect were done at the same time.
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Affiliation(s)
| | | | - Jinfu Yang
- Department of the cardiothoracic surgery of the 2nd Xiangya Hosptial, Central South University, 410011 Changsha, China.
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