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Hu L, Wang Z, Chen Y, Zhang X. Case Report: Assessment of primary myxofibrosarcoma in the left atrium using multimodal ultrasonography. Front Cardiovasc Med 2024; 11:1378655. [PMID: 38826818 PMCID: PMC11140025 DOI: 10.3389/fcvm.2024.1378655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 05/06/2024] [Indexed: 06/04/2024] Open
Abstract
Primary myxofibrosarcoma of the heart, a rare cardiac malignancy, was diagnosed in a middle-aged female patient exhibiting progressive dyspnea following transthoracic echocardiography and pathological analysis. Postoperatively, the patient underwent chemotherapy and Lenvatinib mesylate therapy, with regular check-ups confirming her survival. After 10 months the patient is still alive and well.
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Affiliation(s)
- Liyan Hu
- Department of Ultrasonography, People’s Hospital of Dong yang, Dong yang, Zhejiang, China
| | - Zhaohui Wang
- Department of Cardiac Surgery, People’s Hospital of Dong yang, Dong yang, Zhejiang, China
| | - Yu Chen
- Department of Ultrasonography, People’s Hospital of Dong yang, Dong yang, Zhejiang, China
| | - Xiaowei Zhang
- Department of Pathology, People’s Hospital of Dong yang, Dong yang, Zhejiang, China
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Machuca-Aguado J, Rendón-García R, Miraglia A, Téllez-Cantero JC, Gutiérrez-Domingo Á. Rare primary cardiac myxofibrosarcoma in adolescence: Diagnostic challenges and surgical insights. Cardiovasc Pathol 2024; 70:107623. [PMID: 38373641 DOI: 10.1016/j.carpath.2024.107623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Revised: 02/13/2024] [Accepted: 02/14/2024] [Indexed: 02/21/2024] Open
Abstract
This article presents a unique case of primary myxofibrosarcoma, an exceptionally rare cardiac neoplasm, in a 16-year-old girl. With fewer than 40 documented cases, this tumor's occurrence in adolescence is particularly uncommon. The patient presented with right-sided paresthesia and subsequent right hemiparesis and dysarthria, along with bilateral pleural effusion. Imaging tests revealed a cerebral ischemic lesion and the presence of a left atrial mass. Initially suspected as a myxoma, the tumor exhibited significant infiltration. Despite prompt excision and cardiac intervention, the patient experienced rapid decompensation and succumbed to heart failure 2 days later. Histopathological analysis revealed an intermediate grade myxofibrosarcoma. This case underscores the diagnostic complexity, emphasizing the need for early identification given the grim prognosis associated with cardiac myxofibrosarcomas, requiring detailed imaging, surgical, and histopathological insights.
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Affiliation(s)
- Jesús Machuca-Aguado
- Pathology Department, Virgen Macarena University Hospital, Seville, Spain.; University of Seville, Seville, Spain..
| | - Rosa Rendón-García
- Pathology Department, Virgen Macarena University Hospital, Seville, Spain
| | - Alessia Miraglia
- Cardiovascular Surgery Department, Virgen Macarena University Hospital, Seville, Spain
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Azuma R, Sato K, Sunadoi H, Ishii Y, Tomaru U, Motohashi M. Primary cardiac myxofibrosarcoma of the left atrium and pericardium: a case report. J Cardiothorac Surg 2023; 18:334. [PMID: 37974190 PMCID: PMC10655424 DOI: 10.1186/s13019-023-02441-9] [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: 11/13/2022] [Accepted: 11/04/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Primary cardiac myxofibrosarcoma is rare and commonly occurs in the left atrium. Myxofibrosarcoma is aggressive and has a high mortality rate due to its high rate of recurrence. Complete surgical resection is considered important; however, effective treatment options have not been established. CASE PRESENTATION We report the case of a 75-year-old woman who developed a myxofibrosarcoma spreading to the left atrium and pericardium. We performed surgical resection of the tumor to prevent sudden death due to mitral valve obstruction or cerebral infarction due to embolism of the scattered mass. However, we were unable to complete the resection of the tumors. The patient developed brain metastasis 2 months after surgery and eventually died due to brain hemorrhage 3 months after surgery. CONCLUSIONS In this report, we described a rare case of primary cardiac myxofibrosarcoma located not only in the left atrium but also in the pericardium. Considering preoperative laboratory findings, surgical and adjuvant therapy, and the patient's wishes are important for the best therapeutic course for an individual.
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Affiliation(s)
- Ryota Azuma
- Department of Cardiovascular Surgery, Hakodate Central General Hospital, 33-2 Honcho, Hakodate, Hokkaido, 040-8585, Japan.
| | - Kazuyoshi Sato
- Department of Cardiovascular Surgery, Hakodate Central General Hospital, 33-2 Honcho, Hakodate, Hokkaido, 040-8585, Japan
| | - Hiroki Sunadoi
- Department of Cardiovascular Surgery, Hakodate Central General Hospital, 33-2 Honcho, Hakodate, Hokkaido, 040-8585, Japan
| | - Yasushi Ishii
- Department of Pathology, Faculty of Medicine, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Utano Tomaru
- Department of Pathology, Faculty of Medicine, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Masatoshi Motohashi
- Department of Cardiovascular Surgery, Hakodate Central General Hospital, 33-2 Honcho, Hakodate, Hokkaido, 040-8585, Japan
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Zhang W, Tang Q, Bolathan B, Xing Y, Sun X, Huo Q. Multiple cardiac myxofibrosarcomas with complete right pulmonary artery occlusion: a case report. Front Oncol 2023; 13:1197463. [PMID: 37731640 PMCID: PMC10507320 DOI: 10.3389/fonc.2023.1197463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 08/14/2023] [Indexed: 09/22/2023] Open
Abstract
Primary cardiac myxofibrosarcoma is a rare form of cardiac malignant tumors. MFS usually involves the left atrium and presents as a unicentric or multicentric tumor mass. We reported on a 37-year-old female who presented with chest tightness and dyspnea for a month, dry cough, and occasionally having blood streak sputum for half a month. Echocardiography, cardiac computed tomography and cardiac positron emission tomography revealed multiple tumors in the heart. The right ventricle and right pulmonary artery were involved, with occlusion of the right pulmonary artery. Cardiac tumors were surgically resected and were consistent with low-grade MFS. No recurrence or metastasis occurred at 20 months of follow-up.
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Affiliation(s)
- Weimin Zhang
- Department of Cardiac Surgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Qi Tang
- Cardiac Ultrasound Department, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Balhen Bolathan
- Department of Cardiac Surgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Yan Xing
- Imaging Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Xiaoxin Sun
- Nuclear Medicine Department, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Qiang Huo
- Department of Cardiac Surgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
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Makarov IA, Papko KA, Makarova TA, Bendov DV, Mitrofanova LB. Heart Transplantation as a Treatment Option for Recurrent Myxofibrosarcoma: A Clinical Case. EXP CLIN TRANSPLANT 2023; 21:784-789. [PMID: 37885296 DOI: 10.6002/ect.2023.0033] [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: 10/28/2023]
Abstract
Myxofibrosarcoma is one of the most rare tumors of the heart. Surgical resection is the principal method of treatment; however, in some cases, radical removal of the tumor is not possible. Here, we present a case of heart transplant in a patient who experienced recurrent myxofibrosarcoma of the left atrium and examine the morphological features of this tumor. A 40-year-old female patient presented for treatment for heart failure of a high functional class. An examination revealed a tumor in the left atrial cavity, which was subsequently surgically removed. Morphological examination revealed an inflammatory myofibroblastic tumor. After 2 years, the patient's tumor recurred. The tumor was removed, and a morphological study again diagnosed myxofibrosarcoma of the heart. A year later, recurrence was again diagnosed. Instrumental examination determined that the tumor had incurred into the mitral valve and possibly spread to the myocardium. Tumor resection was not possible, and the need to perform a heart transplant was determined. The given case contributes to the practical conclusion that heart transplant contributes to an increase in the life expectancy for patients with inoperable cases of cardiac sarcoma.
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Yue P, Xu Z, Wan K, Tan Y, Xu Y, Xie X, Mui D, Yi C, Han Y, Chen Y. Multiparametric mapping by cardiovascular magnetic resonance imaging in cardiac tumors. J Cardiovasc Magn Reson 2023; 25:37. [PMID: 37349765 PMCID: PMC10286406 DOI: 10.1186/s12968-023-00938-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 05/11/2023] [Indexed: 06/24/2023] Open
Abstract
BACKGROUND There is a paucity of quantitative measurements of cardiac tumors and myocardium using parametric mapping techniques. This study aims to explore quantitative characteristics and diagnostic performance of native T1, T2, and extracellular volume (ECV) values of cardiac tumors and left ventricular (LV) myocardium. METHODS Patients with suspected cardiac tumors who underwent cardiovascular magnetic resonance (CMR) between November 2013 and March 2021 were prospectively enrolled. The diagnoses of primary benign or malignant tumors were based on pathologic findings if available, comprehensive medical history evaluations, imaging, and long-term follow-up data. Patients with pseudo-tumors, cardiac metastasis, primary cardiac diseases, and prior radiotherapy or chemotherapy were excluded. Multiparametric mapping values were measured on both cardiac tumors and the LV myocardium. Statistical analyses were performed using independent-samples t-test, receiver operating characteristic, and Bland-Altman analyses. RESULTS A total of 80 patients diagnosed with benign (n = 54), or primary malignant cardiac tumors (n = 26), and 50 age and sex-matched healthy volunteers were included. Intergroup differences in the T1 and T2 values of cardiac tumors were not significant, however, patients with primary malignant cardiac tumors showed significantly higher mean myocardial T1 values (1360 ± 61.4 ms) compared with patients with benign tumors (1259.7 ± 46.2 ms), and normal controls (1206 ± 44.0 ms, all P < 0.05) at 3 T. Patients with primary malignant cardiac tumors also showed significantly higher mean ECV (34.6 ± 5.2%) compared with patients with benign (30.0 ± 2.5%) tumors, and normal controls (27.3 ± 3.0%, all P < 0.05). For the differentiation between primary malignant and benign cardiac tumors, the mean myocardial native T1 value showed the highest efficacy (AUC: 0.919, cutoff value: 1300 ms) compared with mean ECV (AUC: 0.817) and T2 (AUC: 0.619) values. CONCLUSION Native T1 and T2 of cardiac tumors showed high heterogeneity, while myocardial native T1 values in primary malignant cardiac tumors were elevated compared to patients with benign cardiac tumors, which may serve as a new imaging marker for primary malignant cardiac tumors.
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Affiliation(s)
- Pengfei Yue
- Division of Abdominal Tumor Multimodality Treatment, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan China
| | - Ziqian Xu
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan China
| | - Ke Wan
- Department of Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan China
| | - Yinxi Tan
- West China School of Public Health, Sichuan University, Chengdu, China
| | - Yuanwei Xu
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041 People’s Republic of China
| | - Xiaotong Xie
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041 People’s Republic of China
| | - David Mui
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA USA
| | - Cheng Yi
- Division of Abdominal Tumor Multimodality Treatment, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan China
| | - Yuchi Han
- Cardiovascular Division, Wexner Medical Center, The Ohio State University, Columbus, OH USA
| | - Yucheng Chen
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041 People’s Republic of China
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Șerban A, Dădârlat-Pop A, Tomoaia R, Trifan C, Molnar A, Manole S, Achim A, Suceveanu M. The Role of Multimodality Imaging in the Diagnosis and Follow-Up of Malignant Primary Cardiac Tumors: Myxofibrosarcoma-A Case Report and Literature Review. Diagnostics (Basel) 2023; 13:diagnostics13101811. [PMID: 37238295 DOI: 10.3390/diagnostics13101811] [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: 04/18/2023] [Revised: 05/14/2023] [Accepted: 05/16/2023] [Indexed: 05/28/2023] Open
Abstract
Cardiac tumors are a very rare but heterogenous group of diseases that may reveal themselves through a variety of nonspecific cardiac symptoms that may pose a challenge to the diagnostic process. Myxofibrosarcoma is a particularly rare type of cardiac tumor that carries a poor prognosis, thus making accurate and timely diagnosis essential. A 61-year-old woman presented with fatigue and shortness of breath during mild exercise, symptoms that have progressively worsened during the previous year. Multimodality imaging consisting of transthoracic and transesophageal echocardiography (TTE and TEE), cardiac magnetic resonance (CMR), cardiac computer tomography (CCT), and fluorodeoxyglucose positron emission computer tomography (18F-FDG PET-CT) was used for the diagnosis and postoperative follow-up of a myxofibrosarcoma.
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Affiliation(s)
- Adela Șerban
- Cardiology Department, Heart Institute Niculae Stăncioiu, 19-21 Motilor Street, 400001 Cluj-Napoca, Romania
- 5th Department of Internal Medicine, Iuliu Haţieganu University of Medicine and Pharmacy, 8 Victor Babes Street, 400012 Cluj-Napoca, Romania
| | - Alexandra Dădârlat-Pop
- Cardiology Department, Heart Institute Niculae Stăncioiu, 19-21 Motilor Street, 400001 Cluj-Napoca, Romania
- 5th Department of Internal Medicine, Iuliu Haţieganu University of Medicine and Pharmacy, 8 Victor Babes Street, 400012 Cluj-Napoca, Romania
| | - Raluca Tomoaia
- 5th Department of Internal Medicine, Iuliu Haţieganu University of Medicine and Pharmacy, 8 Victor Babes Street, 400012 Cluj-Napoca, Romania
- Clinical Rehabilitation Hospital, 46-50 Viilor Street, 400347 Cluj-Napoca, Romania
| | - Cătălin Trifan
- Cardiovascular Surgery Department, Heart Institute Niculae Stăncioiu, 19-21 Motilor Street, 400001 Cluj-Napoca, Romania
| | - Adrian Molnar
- Cardiovascular Surgery Department, Heart Institute Niculae Stăncioiu, 19-21 Motilor Street, 400001 Cluj-Napoca, Romania
| | - Simona Manole
- Radiology Department, Heart Institute Niculae Stăncioiu, 19-21 Motilor Street, 400001 Cluj-Napoca, Romania
| | - Alexandru Achim
- Cardiology Department, Heart Institute Niculae Stăncioiu, 19-21 Motilor Street, 400001 Cluj-Napoca, Romania
| | - Mihai Suceveanu
- Cardiology Department, Heart Institute Niculae Stăncioiu, 19-21 Motilor Street, 400001 Cluj-Napoca, Romania
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Huo X, Zhao W, Liu X, Zhang W, Xu L, Zhang B, Chen J. Ultrasonography in the assessment of primary myxofibrosarcoma in the left atrium: a case report. BMC Cardiovasc Disord 2022; 22:553. [PMID: 36536277 PMCID: PMC9764716 DOI: 10.1186/s12872-022-03009-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 12/12/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Cardiac myxofibrosarcoma is a rare cardiac malignant tumor, whose diagnosis is challenging due to its rare and non-specific manifestations. Ultrasound is the most important tool for detecting cardiac tumors. Yet, its diagnostic value in cardiac myxoidfibrosarcoma is rarely reported. Herein, we summarized the ultrasonic manifestations of myxofibrosarcoma in a 72-year-old Han woman. CASE PRESENTATION The patient presented with crushing chest pain without obvious inducement, lasting 3-5 min each time, which would be relieved after rest, accompanied by palpitation, chest tightness, shortness of breath, dizziness, and syncope. The electrocardiogram (ECG) suggested atrial fibrillation. Ultrasound found two moderate echogenic masses in the left atrium; one was about 48 × 31 mm in size, and the other was about 25 × 24 mm in size. The clinical diagnosis was atrial mass and atrial fibrillation. The patient underwent the operation of left atrial tumor resection + mitral valvuloplasty + atrial fibrillation radiofrequency ablation + left atrial appendectomy. The tumor was completely removed, and the patient did not receive radiotherapy or chemotherapy after surgery. The patient was reexamined by ultrasound at 6, 42, and 91 days after surgery, and no obvious abnormalities were found. On day 115, moderate echoic mass was detected on the posterior wall of the left atrium, nearing the mitral valve ring, with a size of about 28 × 23 mm. Currently, the patient is under follow-up care. CONCLUSION As the most important examination method for cardiac tumors, cardiac ultrasound has good diagnostic and differential diagnosis value and can be used regularly due to its simplicity and safety. The diagnosis rate of cardiac myxofibrosarcoma can be greatly improved by summarizing the ultrasonographic manifestations of cardiac myxofibrosarcoma and differentiating them from other lesions.
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Affiliation(s)
- Xiaoguang Huo
- grid.477019.cDepartment of Ultrasound, Zibo Central Hospital, No. 54 West Communist Youth League Road, Zhangdian District, Zibo, 255036 Shandong People’s Republic of China
| | - Wei Zhao
- grid.477019.cDepartment of Ultrasound, Zibo Central Hospital, No. 54 West Communist Youth League Road, Zhangdian District, Zibo, 255036 Shandong People’s Republic of China
| | - Xiao Liu
- grid.477019.cDepartment of Ultrasound, Zibo Central Hospital, No. 54 West Communist Youth League Road, Zhangdian District, Zibo, 255036 Shandong People’s Republic of China
| | - Wenzhong Zhang
- grid.477019.cDepartment of Ultrasound, Zibo Central Hospital, No. 54 West Communist Youth League Road, Zhangdian District, Zibo, 255036 Shandong People’s Republic of China
| | - Li Xu
- grid.477019.cDepartment of Ultrasound, Zibo Central Hospital, No. 54 West Communist Youth League Road, Zhangdian District, Zibo, 255036 Shandong People’s Republic of China
| | - Baohua Zhang
- grid.477019.cDepartment of Pathology, Zibo Central Hospital, No. 54 West Communist Youth League Road, Zhangdian District, Zibo, 255036 Shandong People’s Republic of China
| | - Ju Chen
- grid.477019.cDepartment of Ultrasound, Zibo Central Hospital, No. 54 West Communist Youth League Road, Zhangdian District, Zibo, 255036 Shandong People’s Republic of China
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Morka A, Kohut J, Radzymińska-Chruściel B, Mroczek T, Gładki M, Weryński P, Rudziński A, Skalski J, Szydłowski L. Echocardiography and Newer Imaging Techniques in Diagnosis and Long-Term Follow-Up of Primary Heart Tumors in Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17155471. [PMID: 32751243 PMCID: PMC7432637 DOI: 10.3390/ijerph17155471] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 07/17/2020] [Accepted: 07/24/2020] [Indexed: 11/24/2022]
Abstract
Background: Primary heart tumors (PHTs) in the pediatric population are very rare and do not manifest any characteristic symptoms. Methods: A retrospective analysis of 61 cases was undertaken. Data from three centers for the years 2003–2018 were gathered. The tumors’ clinical course, location, number, hemodynamic, treatment, and follow-up were evaluated. Echocardiography was complemented with magnetic resonance imaging, computer tomography, and histopathological examination. Results: Out of 61 PHT diagnoses, 56 (91.8%) were circumstantial including all 16 (26.2%) prenatal tumors. The reasons for cardiological consultations were arrhythmia, syncopes, lowered physical performance, and murmurs. Only five patients (8.2%) were suspected of tumors based on previous symptoms of sclerosis tuberosa. Rhabdomyoma was the most frequently found PHT (60.7%). The tumors were predominantly located in the ventricles (49.1%) and intraventricular septum (14.9%) and tended to be single (70.5%). About 37.7% of patients suffered from coexistent multi-organ problems, two (3.28%) from congenital heart defects and one (1.64%) from Carney’s syndrome. Tumor resection was performed on 26 (42.7%) patients, of which 16 (61.5%) underwent total and 10 (38.5%) partial tumor resection. During the follow-up (mean 4.3 years), 54 patients (88.5%) have improved or were stable, while seven (11.5%) died. Conclusions: Primary pediatric heart tumors are diagnosed completely circumstantially, and the most common is rhabdomyoma, although arrhythmia may suggest fibroma. Diagnosis of a heart tumor in children is not synonymous with fatal prognosis, and most of them require only constant observation. Life-saving operation allows improvement, while the prognosis for malignant tumors in children is definitely unfavorable.
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Affiliation(s)
- Aleksandra Morka
- Department of Pediatric Cardiac Surgery, University Children’s Hospital, Faculty of Health Sciences, Jagiellonian University Medical College, 30-663 Kraków, Poland
- Correspondence:
| | - Joanna Kohut
- Department of Pediatric Cardiology, Faculty of Medical Sciences, Medical University of Silesia in Katowice, 40-752 Katowice, Poland; (J.K.); (L.S.)
| | | | - Tomasz Mroczek
- Department of Pediatric Cardiac Surgery, University Children’s Hospital, Faculty of Medicine, Jagiellonian University Medical College, 30-663 Kraków, Poland; (T.M.); (J.S.)
| | - Marcin Gładki
- Department of Pediatric Cardiac Surgery, University Children’s Hospital, 30-663 Kraków, Poland;
| | - Piotr Weryński
- Department of Pediatric Cardiology, University Children’s Hospital, Faculty of Medicine, Jagiellonian University Medical College, 30-663 Kraków, Poland; (P.W.); (A.R.)
| | - Andrzej Rudziński
- Department of Pediatric Cardiology, University Children’s Hospital, Faculty of Medicine, Jagiellonian University Medical College, 30-663 Kraków, Poland; (P.W.); (A.R.)
| | - Janusz Skalski
- Department of Pediatric Cardiac Surgery, University Children’s Hospital, Faculty of Medicine, Jagiellonian University Medical College, 30-663 Kraków, Poland; (T.M.); (J.S.)
| | - Lesław Szydłowski
- Department of Pediatric Cardiology, Faculty of Medical Sciences, Medical University of Silesia in Katowice, 40-752 Katowice, Poland; (J.K.); (L.S.)
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Krishna MR, Marathe SP, Maghsoudi A, McCowage G, Sherwood MC, Orr Y. Emergency Ross Procedure for Pediatric Aortic Valve Myxofibrosarcoma. Ann Thorac Surg 2018; 107:e183-e185. [PMID: 30266618 DOI: 10.1016/j.athoracsur.2018.07.060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 06/12/2018] [Accepted: 07/01/2018] [Indexed: 10/28/2022]
Abstract
Primary cardiac tumors in children are uncommon and rarely demand surgical intervention. We report a malignant tumor arising from the aortic root in a 5-year-old boy presenting with left ventricular outflow tract obstruction and tumor embolism, its surgical management using the Ross procedure, and the unique histopathological aspects of the tumor.
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Affiliation(s)
- Mani Ram Krishna
- Heart Centre for Children, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Supreet P Marathe
- Heart Centre for Children, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Amir Maghsoudi
- Department of Pathology, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Geoffrey McCowage
- Cancer Centre for Children, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Megan C Sherwood
- Heart Centre for Children, The Children's Hospital at Westmead, Westmead, New South Wales, Australia; School of Child and Adolescent Health, Sydney Medical School, University of Sydney, Sydney, Australia
| | - Yishay Orr
- Heart Centre for Children, The Children's Hospital at Westmead, Westmead, New South Wales, Australia; School of Child and Adolescent Health, Sydney Medical School, University of Sydney, Sydney, Australia.
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Sun D, Wu Y, Liu Y, Yang J. Primary cardiac myxofibrosarcoma: case report, literature review and pooled analysis. BMC Cancer 2018; 18:512. [PMID: 29720127 PMCID: PMC5932848 DOI: 10.1186/s12885-018-4434-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Accepted: 04/25/2018] [Indexed: 12/18/2022] Open
Abstract
Background Primary cardiac myxofibrosarcoma is a very rare cardiac malignancy. The majority of publications are limited to case reports. No pooled analyses of primary cardiac myxofibrosarcoma cases are available. Little clinical features and outcome patterns are acknowledged. The purpose of this study is to identify the clinical characteristics and prognostic factors of primary cardiac myxofibrosarcoma. Case presentation A case report of primary cardiac myxofibrosarcoma was presented, and a review of English language literatures of primary cardiac myxofibrosarcomas were performed electronically. Demographics, clinicopathologic data, therapy and follow-up were summarized. The median survival time and the mean survival time were calculated by Kaplan-Meier method. Survival distribution and overall survival were figured by log-rank test and cox proportional hazards models. We present a case, and retrospectively analyzed additional 30 patients derived from 24 isolated articles. The cohort consisted of 18 male and 13 female patients. The age was 41.87 ± 17.89 years. Some common features were found in clinical presentations, pathologic features, treatments and outcome patterns of primary cardiac myxofibrosarcoma. There were special features in echocardiography, histological and immunohistochemical examinations, which should be considered in diagnosis of primary cardiac myxofibrosarcoma. The median survival time/mean survival time (MST) was 14/32.66 months. The median survival time/mean survival time (MST) was 14/32.66 months. Compared to the other groups, the following groups had shorter survival characteristics, including age ≥ 40 years (14/11.79 months), female (14/26.26 months), mass diameter ≥ 40 mm (14/14.64 months), high-grade (2/11.81 months), and no post-treatment (14/28.09 months). Statistical analyses revealed that primary cardiac myxofibrosarcomas were more likely to present with local recurrences and dismal metastases. Tumors ≥ 40 mm in size (P = 0.055, HR = 6.79) or with high-grade (P = 0.063, HR = 11.45) had significantly worse prognosis. Conclusions Primary cardiac myxofibrosarcomas were more likely to present with local recurrences and dismal metastases. Echocardiography, together with histological method should be considered in ordinary diagnosis. Tumors ≥ 40 mm in size or with high-grade had significantly worse prognosis, which should be early diagnosed and treated with rational surgery.
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Affiliation(s)
- Dandan Sun
- Department of Cardiovascular Ultrasound, the First Affiliated Hospital of China Medical University, 155 North Nanjing Street, Heping District, Shenyang, 110001, Liaoning Province, China.
| | - Yupeng Wu
- 2nd Department of Neurosurgery, The People's Hospital of China Medical University and The People's Hospital of Liaoning Province, Shenyang, 110016, Liaoning Province, China
| | - Yan Liu
- Department of Cardiovascular Ultrasound, the First Affiliated Hospital of China Medical University, 155 North Nanjing Street, Heping District, Shenyang, 110001, Liaoning Province, China
| | - Jun Yang
- Department of Cardiovascular Ultrasound, the First Affiliated Hospital of China Medical University, 155 North Nanjing Street, Heping District, Shenyang, 110001, Liaoning Province, China
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