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Fu J, Li H, Pan Z, Wu C, Li Y, Wang G, Dai J, Zhao L. Surgical treatment of primary cardiac tumors in children. Gen Thorac Cardiovasc Surg 2024; 72:112-120. [PMID: 37515628 PMCID: PMC10805930 DOI: 10.1007/s11748-023-01958-z] [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: 03/28/2023] [Accepted: 07/02/2023] [Indexed: 07/31/2023]
Abstract
OBJECTIVE Summarizing the treatment experience of primary cardiac tumors in children. METHODS The date of 24 children with primary cardiac tumors who underwent surgery in our department from July 2003 to September 2022 was collected and analyzed treatment efficacy. RESULTS All patients completed the surgery successfully, including 21 cases of complete tumor resection, 2 cases of partial tumor resection, and 1 case of tumor biopsy. The location: 5 cases in the right atrium, 5 cases in the right ventricle, 6 cases in the left atrium, 6 cases in the left ventricle, 1 case in the left, right ventricle and ventricular septum, and 1 case in the ventricular septum. 23 cases were benign: 11 cases of myxoma, 7 cases of fibroma, 3 cases of rhabdomyoma, 1 case of infantile capillary hemangioma, and 1 case of lipoma. There was 1 case of borderline or malignant tumor. 23 patients were discharged successfully, 1 patient died of cardiac failure on the first day after operation. Follow-up was done from 5 months to 19 years and 2 months, 2 cases were lost to follow-up, and 1 case died of cardiac failure in the second year after operation due to severe mitral regurgitation. There was 1 case of tumor biopsy with space-occupying lesion gradually shrinking during follow-up. The prognosis of another 19 children with complete or partial tumor resection was good. There was no recurrence, enlargement, or reoperation of the tumor during the follow-up period. CONCLUSIONS Primary cardiac tumors in children are mostly benign. Surgery is effective, but the timing of surgery depends on the patient's condition.
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Affiliation(s)
- Jian Fu
- Department of Cardiothoracic Surgery, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, No.136, Zhongshan 2nd Road, Yuzhong District, Chongqing, 400014, China.
| | - HongBo Li
- Department of Cardiothoracic Surgery, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, No.136, Zhongshan 2nd Road, Yuzhong District, Chongqing, 400014, China
| | - ZhengXia Pan
- Department of Cardiothoracic Surgery, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, No.136, Zhongshan 2nd Road, Yuzhong District, Chongqing, 400014, China
| | - Chun Wu
- Department of Cardiothoracic Surgery, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, No.136, Zhongshan 2nd Road, Yuzhong District, Chongqing, 400014, China
| | - YongGang Li
- Department of Cardiothoracic Surgery, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, No.136, Zhongshan 2nd Road, Yuzhong District, Chongqing, 400014, China
| | - Gang Wang
- Department of Cardiothoracic Surgery, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, No.136, Zhongshan 2nd Road, Yuzhong District, Chongqing, 400014, China
| | - JiangTao Dai
- Department of Cardiothoracic Surgery, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, No.136, Zhongshan 2nd Road, Yuzhong District, Chongqing, 400014, China
| | - Lu Zhao
- Department of Cardiothoracic Surgery, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, No.136, Zhongshan 2nd Road, Yuzhong District, Chongqing, 400014, China
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Mathavan A, Mathavan A, Krekora U, Mathavan M, Rodriguez V, Altshuler E, Nguyen B, Ruzieh M. Clinical presentation and neurovascular manifestations of cardiac myxomas and papillary fibroelastomas: a retrospective single-institution cohort study. Front Cardiovasc Med 2023; 10:1222179. [PMID: 37719971 PMCID: PMC10503431 DOI: 10.3389/fcvm.2023.1222179] [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: 05/13/2023] [Accepted: 08/11/2023] [Indexed: 09/19/2023] Open
Abstract
Background Primary cardiac tumors are often benign and commonly present as cardiac myxomas (CMs) or papillary fibroelastomas (CPFEs). There is a paucity of prognostic indicators for tumor burden or potential for embolic cerebrovascular events (CVEs). This study was performed to address these gaps. Methods Medical records at the University of Florida Health Shands Hospital between 1996 and 2021 were screened to identify patients with CMs or CPFEs. Clinical features, echocardiographic reports, and CVE outcomes were quantitatively assessed. Results A total of 55 patients were included in the study: 28 CM (50.9%) and 27 CPFE (49.1%) patients. Baseline patient characteristics were similar among patients. The neutrophil-lymphocyte ratio was correlated (p < 0.005 in all cases) to three metrics of tumor size in both CM (r = 64-67%) and CPFE (r = 56-59%). CVEs were the presenting symptom in 30 (54.5%) patients. CVE recurrence was high; the 5-year CVE recurrence rate in patients with tumor resection was 24.0% compared to 60.0% without resection. No baseline patient characteristics or tumor features were associated with an initial presentation of CVEs compared to any other indication. Univariate analysis indicated that prolonged duration to surgical resection, left atrial enlargement, male sex, and a neutrophil-lymphocyte ratio >3.0 at the follow-up were significantly associated with 5-year CVE recurrence. Left atrial enlargement and a neutrophil-lymphocyte ratio >3.0 at the follow-up remained significantly associated with 5-year CVE recurrence in multivariate analysis. Conclusion The neutrophil-lymphocyte ratio may prognosticate tumor size and recurrence of neurologic events. An increased risk of CVE within 5 years of mass resection is almost exclusive to patients initially presenting with CVEs.
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Affiliation(s)
- Akshay Mathavan
- Department of Internal Medicine, University of Florida, Gainesville, FL, United States
| | - Akash Mathavan
- Department of Internal Medicine, University of Florida, Gainesville, FL, United States
| | - Urszula Krekora
- University of Central Florida College of Medicine, University of Central Florida, Orlando, FL, United States
| | - Mohit Mathavan
- Department of Family Medicine, Ocala Hospital, Ocala, FL, United States
| | - Vanessa Rodriguez
- Department of Internal Medicine, University of South Florida, Tampa, FL, United States
| | - Ellery Altshuler
- Department of Internal Medicine, University of Florida, Gainesville, FL, United States
| | - Brianna Nguyen
- University of Florida College of Medicine, University of Florida, Gainesville, FL, United States
| | - Mohammed Ruzieh
- Division of Cardiovascular Medicine, University of Florida, Gainesville, FL, United States
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Hernández K, Puchulu J, Zapata M, Ruz M. Rabdomioma intracardiaco: presentación clínica y opciones terapéuticas actuales a propósito de tres casos. REVISTA COLOMBIANA DE CARDIOLOGÍA 2020. [DOI: 10.1016/j.rccar.2019.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Aguilar C, Carbajal T, Beltran BE, Segura P, Muhammad S, Choque-Velasquez J. Cerebral embolization associated with parenchymal seeding of the left atrial myxoma: Potential role of interleukin-6 and matrix metalloproteinases. Neuropathology 2020; 41:49-57. [PMID: 32776398 DOI: 10.1111/neup.12697] [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] [Received: 03/12/2020] [Revised: 06/06/2020] [Accepted: 06/12/2020] [Indexed: 12/28/2022]
Abstract
Systemic embolization has been reported in up to 40% of patients with left atrial myxoma, half of them with cerebral involvement. However, development of intracerebral embolization associated with parenchymal seeding of the myxoma emboli is an extremely rare complication, with only 36 histologically diagnosed cases reported in the published literature. We describe a 69-year-old woman who arrived at the emergency service with hemiparesis associated with drug-resistant epilepsy and a medical history of resection of a left atrial myxoma 10 months previously. Cranial computed tomography revealed multiple large lesions of heterogeneous density and cystic components in the occipital lobes and posterior fossa parenchyma. Histopathological analyses after stereotactic biopsy of the occipital lesion revealed infiltrative myxoma cells with benign histological findings and uniform expression of calretinin similar to that of the primary cardiac myxoma. Additional immunohistochemical studies confirmed brain parenchymal seeding of the myxoma cells with strong expression of interleukin-6 (IL-6) and focal expression of matrix metalloproteinases-2 (MMP-2). Here, we discuss the clinicopathological features of intracerebral embolization of left atrial myxomas associated with progressive parenchymal seeding of the tumor emboli and the potential pathogenic role of IL-6 and MMPs.
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Affiliation(s)
- Cristian Aguilar
- Department of Pathology, Edgardo Rebagliati Martins National Hospital, Lima, Peru.,Laboratory of Pathology, National Cardiovascular Institute, Lima, Peru
| | - Tomas Carbajal
- Department of Pathology, Edgardo Rebagliati Martins National Hospital, Lima, Peru
| | - Brady E Beltran
- Department of Radiation Oncology, Edgardo Rebagliati Martins National Hospital, Lima, Peru
| | - Pedro Segura
- Department of Cardiology, Edgardo Rebagliati Martins National Hospital, Lima, Peru
| | - Sajjad Muhammad
- Department of Neurosurgery, Helsinki University Hospital, Helsinki, Finland.,Department of Neurosurgery, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany
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Guan T, Li Y, Qiu Z, Zhang Y, Lin W, Lai Y, Wang K, Shen Y, Du L, Liu C. Nomograms and risk classification systems predicting overall and cancer-specific survival in primary malignant cardiac tumor. J Card Surg 2019; 34:1540-1549. [PMID: 31794125 DOI: 10.1111/jocs.14299] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Primary malignant cardiac tumors (PMCTs) are fatal, but up to now, there is still a lack of survival prediction model for prognosis evaluation. We developed nomograms to predict overall survival (OS) and cancer-specific survival (CSS) for PMCTs by the Surveillance, Epidemiology, and End Result (SEER) database. METHODS A total of 506 PMCTs participants were identified in the SEER database from 1973 to 2014 and were randomly assigned into the training cohort (N = 354) and the validation cohort (N = 152). The prognostic factors for PMCTs were identified by Kaplan-Meier and multivariate Cox analysis and further incorporated to build OS and CSS nomograms. The nomograms were internally and externally validated via concordance indexes (C-index) and calibration curves. RESULTS The independent prognostic factors for OS and CSS in PMCTs were associated with age at diagnosis, histopathology, tumor stage, cancer-directed surgery, and chemotherapy (all P < .05). In the internal validation, the C-index values were 0.71 (95% confidence interval [CI]: 0.68-0.75) for OS nomogram, and 0.70 (95% CI: 0.67-0.74) for CSS nomogram. In the external validation, the C-index values were 0.71 (95% CI: 0.66-0.77) for OS nomogram, and 0.71 (95% CI: 0.65-0.77) for CSS nomogram. The calibration curves of internal and external validation showed consistency between the nomograms and the actual observation. The risk stratification of PMCTs was significant distinction (P < .05). CONCLUSION We developed and validated credible nomograms to predict OS and CSS in PMCTs. These nomograms can be offered to clinicians to more precisely estimate the survival and identify risk stratification of PMCTs.
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Affiliation(s)
- Tianwang Guan
- Department of Cardiology, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - Yanfang Li
- Department of Cardiology, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - Zicong Qiu
- Department of Clinical Medicine, Clinical Medical College, Guangzhou Medical University, Guangzhou, China
| | - Yichi Zhang
- Department of Clinical Medicine, Clinical Medical College, Guangzhou Medical University, Guangzhou, China
| | - Wenrui Lin
- Department of Clinical Medicine, Clinical Medical College, Guangzhou Medical University, Guangzhou, China
| | - Yanxian Lai
- Department of Cardiology, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - Kenie Wang
- Department of Clinical Medicine, Clinical Medical College, Guangzhou Medical University, Guangzhou, China
| | - Yan Shen
- Department of Cardiology, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - Liping Du
- Department of Cardiology, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - Cheng Liu
- Department of Cardiology, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, China.,Department of Cardiology, School of Medicine, Guangzhou First People's Hospital, South China University of Technology, Guangzhou, China
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