1
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Johnson JN, Pouraliakbar H, Mahdavi M, Ranjbar A, Pfirman K, Mehra V, Ahmed S, Ba-Atiyah W, Galal MO, Zahr RA, Hussain N, Tadikamalla RR, Farah V, Dzelebdzic S, Muniz JC, Lee M, Williams J, Lee S, Aggarwal SK, Clark DE, Hughes SG, Ganigara M, Nagiub M, Hussain T, Kwok C, Lim HS, Nolan M, Kikuchi DS, Goulbourne CA, Sahu A, Sievers B, Sievers B, Sievers B, Garg R, Armas CR, Paleru V, Agarwal R, Rajagopal R, Bhagirath P, Kozor R, Aneja A, Tunks R, Chen SSM. Society for Cardiovascular Magnetic Resonance 2022 Cases of SCMR case series. J Cardiovasc Magn Reson 2023; 26:100007. [PMID: 38211509 PMCID: PMC11211240 DOI: 10.1016/j.jocmr.2023.100007] [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: 11/27/2023] [Accepted: 12/10/2023] [Indexed: 01/13/2024] Open
Abstract
"Cases of SCMR" is a case series on the SCMR website (https://www.scmr.org) for the purpose of education. The cases reflect the clinical presentation, and the use of cardiovascular magnetic resonance (CMR) in the diagnosis and management of cardiovascular disease. The 2022 digital collection of cases are presented in this manuscript.
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Affiliation(s)
- Jason N Johnson
- Division of Pediatric Cardiology and Pediatric Radiology, The University of Tennessee Health Science Center, Memphis, TN, USA
| | - Hamidreza Pouraliakbar
- Rajaie Cardiovascular, Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Mahdavi
- Rajaie Cardiovascular, Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Abdolmohammad Ranjbar
- Rajaie Cardiovascular, Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran; Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Kristopher Pfirman
- Department of Cardiovascular Medicine, Geisinger Medical Center, Danville, PA, USA
| | - Vishal Mehra
- Department of Cardiovascular Medicine, Geisinger Medical Center, Danville, PA, USA
| | - Shahzad Ahmed
- Department of Cardiovascular Medicine, Geisinger Medical Center, Danville, PA, USA
| | - Wejdan Ba-Atiyah
- Pediatric Cardiology Section, Department of Pediatrics, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Mohammed Omar Galal
- Pediatric Cardiology Section, Department of Pediatrics, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Riad Abou Zahr
- Pediatric Cardiology Section, Department of Pediatrics, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Nasir Hussain
- Department of Advanced Cardiac Imaging, Allegheny General Hospital, Pittsburgh, PA, USA
| | | | - Victor Farah
- Department of Advanced Cardiac Imaging, Allegheny General Hospital, Pittsburgh, PA, USA
| | | | | | - Marc Lee
- Division of Pediatric Cardiology, Nationwide Children's Hospital, Columbus, OH, USA
| | - Jason Williams
- Division of Pediatric Cardiology, Nationwide Children's Hospital, Columbus, OH, USA
| | - Simon Lee
- Division of Pediatric Cardiology, Nationwide Children's Hospital, Columbus, OH, USA
| | | | - Daniel E Clark
- Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Sean G Hughes
- Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Madhusudan Ganigara
- Division of Pediatric Cardiology, The University of Chicago & Biological Sciences, Chicago, IL, USA
| | - Mohamed Nagiub
- Division of Pediatric Cardiology, Virginia Tech Carilion School of Medicine, Roanoke, VA, USA
| | - Tarique Hussain
- Division of Pediatric Cardiology, Children's Medical Center Dallas, Dallas, TX, USA
| | - Cecilia Kwok
- Cardiology Department, Western Health, St Albans, Victoria, Australia
| | - Han S Lim
- Cardiology Department, Austin and Northern Health, University of Melbourne, Victoria, Australia
| | - Mark Nolan
- Cardiology Department, Western Health, St Albans, Victoria, Australia; Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Daniel S Kikuchi
- Osler Medical Residency, The Johns Hopkins Hospital, Baltimore, MD, USA
| | - Clive A Goulbourne
- Division of Cardiology, Department of Medicine, Emory University, Atlanta, GA, USA
| | - Anurag Sahu
- Division of Cardiology, Department of Medicine, Emory University, Atlanta, GA, USA
| | - Berge Sievers
- International School Düsseldorf, Düsseldorf, Germany
| | - Berk Sievers
- International School Düsseldorf, Düsseldorf, Germany
| | - Burkhard Sievers
- Department of Internal Medicine, Divisions of Cardiology, Pulmonology, Vascular Medicine, Nephrology and Intensive Care Medicine, Sana Klinikum Remscheid, Germany
| | - Rimmy Garg
- University of Illinois College of Medicine Peoria, OSF St. Francis Medical Center, Peoria, IL, USA
| | - Carlos Requena Armas
- University of Illinois College of Medicine Peoria, OSF St. Francis Medical Center, Peoria, IL, USA
| | - Vijayasree Paleru
- University of Illinois College of Medicine Peoria, OSF St. Francis Medical Center, Peoria, IL, USA
| | - Ritu Agarwal
- Department of Radiology, Eternal Hospital, Jaipur, India
| | - Rengarajan Rajagopal
- Department of Radiology, All India Institute of Medical Sciences, Jodhpur, India
| | - Pranav Bhagirath
- Department of Cardiology, St. Thomas Hospital, London, England, UK
| | - Rebecca Kozor
- Department of Cardiology, Royal North Shore Hospital, The University of Sydney, St Leonards, Australia
| | - Ashish Aneja
- Department of Cardiology, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Robert Tunks
- Division of Pediatric Cardiology, Penn State Health, Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Sylvia S M Chen
- Adult Congenital Heart Disease, The Prince Charles Hospital, Australia.
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2
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Tumors of the cardiovascular system: heart and blood vessels. Cardiovasc Pathol 2022. [DOI: 10.1016/b978-0-12-822224-9.00015-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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3
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Razera RJ, Araújo AMD, Bernardes VP, Moisés FM, Mundim LS, Araújo RA. High-Grade Pleomorphic Sarcoma of the Left Atrium after Incomplete Resection and Adjuvant Chemotherapy. INTERNATIONAL JOURNAL OF CARDIOVASCULAR SCIENCES 2021. [DOI: 10.36660/ijcs.20200140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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4
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Ugarte S, Sandhu RS, Sung J, Knopf KB. Primary undifferentiated pleomorphic cardiac sarcoma presenting as right heart failure. Radiol Case Rep 2021; 16:829-834. [PMID: 33552334 PMCID: PMC7847826 DOI: 10.1016/j.radcr.2021.01.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 01/04/2021] [Accepted: 01/04/2021] [Indexed: 11/01/2022] Open
Abstract
Right-sided heart failure is a common sequela of left heart failure and seldom presents as a primary disorder. The differential diagnosis of right heart failure includes a cardiac tumor. Cardiac malignancies are rare tumors with an overall poor prognosis. We evaluated a 69-year-old man who presented with a 3-week history of progressive lower extremity swelling, ascites, and scrotal swelling. Laboratory studies were significant only for mildly elevated liver function tests. CT scan of the abdomen and pelvis showed ascites, hepatic swelling, and a bland clot in the inferior vena cava extending from the level of the kidneys to the right atrium. A large mass originating from the right atrium was identified, and biopsy confirmed an undifferentiated pleomorphic cardiac sarcoma. Given the extensive tumor and clot burden, he was not an operative candidate. He developed portal hypertension with esophageal varices and expired due to variceal bleeding.
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Affiliation(s)
- Shannon Ugarte
- Highland Hospital, Alameda Health System, 6370 Racine Street, Oakland, CA 94609, USA
| | - Rabinder S Sandhu
- Highland Hospital, Alameda Health System, 6370 Racine Street, Oakland, CA 94609, USA
| | - Johnny Sung
- Highland Hospital, Alameda Health System, 6370 Racine Street, Oakland, CA 94609, USA
| | - Kevin B Knopf
- Highland Hospital, Alameda Health System, 6370 Racine Street, Oakland, CA 94609, USA
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5
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Lichtenberger JP, Carter BW, Pavio MA, Biko DM. Cardiac Neoplasms: Radiologic-Pathologic Correlation. Radiol Clin North Am 2020; 59:231-242. [PMID: 33551084 DOI: 10.1016/j.rcl.2020.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Cardiac neoplasms are a diagnostic challenge on many levels. They are rare, their clinical presentation may mimic other much more common cardiac diseases, and they are at an uncommon intersection of oncologic and cardiac imaging. The pathology of primary cardiac neoplasms explains their varied imaging features, for example, calcification in primary cardiac osteosarcomas and T2 hyperintensity in myxomas. Integrating the imaging and pathologic features of cardiac tumors furthers our understanding of the spectrum of appearances of these neoplasms and improves the clinical imager's ability to confidently make a diagnosis.
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Affiliation(s)
- John P Lichtenberger
- The George Washington University Medical Faculty Associates, 900 23rd Street Northwest, Suite G 2092, Washington, DC 20037, USA.
| | - Brett W Carter
- Department of Thoracic Imaging, MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1478, Houston, TX 77030, USA
| | - Michael A Pavio
- Department of Radiology, Walter Reed National Military Medical Center, 4494 North Palmer Road, Bethesda, MD 20889, USA
| | - David M Biko
- Department of Radiology, Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, 3401 Civic Center Boulevard, Philadelphia, PA 19104, USA
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6
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A rare case of cardiac tumor: Malignant fibrous histiocytoma. JOURNAL OF SURGERY AND MEDICINE 2020. [DOI: 10.28982/josam.698065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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7
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Tsuji S, Nawata K, Shimada S, Hirata Y, Ono M. A superior vena cava to right pulmonary artery shunt for severe right ventricular outflow tract stenosis caused by an unresectable cardiac tumor. J Cardiol Cases 2020; 21:97-100. [PMID: 32153682 DOI: 10.1016/j.jccase.2019.10.009] [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: 06/11/2019] [Revised: 09/21/2019] [Accepted: 10/22/2019] [Indexed: 11/15/2022] Open
Abstract
We report the case of a 47-year-old man who was diagnosed with severe right ventricular outflow tract (RVOT) stenosis due to a space-occupying lesion; the diagnosis was made using computed tomography. He underwent mass reduction, pulmonary valve replacement, and RVOT reconstruction with a bovine pericardial patch. The pathological diagnosis was undifferentiated pleomorphic sarcoma originating from the myocardium. As the mass resection was incomplete, he received heavy particle therapy. He did not want to receive adjuvant chemotherapy. Four months later, severe RVOT stenosis recurred because the residual mass had invaded the prosthetic valve in the pulmonic position and one of the cusps was fixed in the closed position. He presented with dyspnea and marked lower leg edema. We performed superior vena cava (SVC) to right pulmonary artery (RPA) shunting as a palliative operation to improve his heart failure symptoms. After surgery, his symptoms improved; his hemodynamics have been stable for one year. SVC-RPA shunting is a palliative operation but can be used to effectively treat severe RVOT stenosis caused by unresectable cardiac tumors. <Learning objective: Malignant primary cardiac tumors commonly recur after complete surgical resection and they have the potential to obstruct intracardiac blood flow. The superior vena cava to right pulmonary artery shunt may be useful for treating right ventricular outflow tract stenosis due to unresectable cardiac tumors.>.
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Affiliation(s)
- Shigeto Tsuji
- Department of Cardiovascular Surgery, Iwate Medical University, Shiwa-gun, Iwate, Japan
| | - Kan Nawata
- Department of Cardiovascular Surgery, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Shogo Shimada
- Department of Cardiac Surgery, The University of Tokyo, Tokyo, Japan
| | - Yasutaka Hirata
- Department of Cardiac Surgery, The University of Tokyo, Tokyo, Japan
| | - Minoru Ono
- Department of Cardiac Surgery, The University of Tokyo, Tokyo, Japan
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8
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Aksu T, Gode S, Oz K, Ersoy B, Ustunısık CT, Guner Y, Atay OF, Erentug V. Rapidly Progressive Malignant Fibrous Histiocytoma of Right Atrium: a Rare Case Report. Braz J Cardiovasc Surg 2019; 34:372-376. [PMID: 31310479 PMCID: PMC6629222 DOI: 10.21470/1678-9741-2018-0114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
We are going to present a case of malignant fibrous histiocytoma in the right
atrium, which is a very rare entity. The patient had a right atrial mass, which
prolapsed through the tricuspid valve into the right ventricle, causing
functional tricuspid valve stenosis. The tumor was completely resected and the
patient had an uneventful postoperative period. Histopathological examination
reported malignant fibrous histiocytoma. The patient presented to the emergency
department five weeks after discharge with dyspnea and palpitation.
Echocardiography and magnetic resonance imaging revealed recurrent right atrial
tumor mass. His clinical status has worsened, with syncope and acute renal
failure. On the repeated echocardiography, suspected tumor recurrence was
observed in left atrium, which probably caused systemic embolization.
Considering the aggressive nature of the tumor and systemic involvement, our
Heart Council decided to provide palliative treatment by nonsurgical management.
His status deteriorated for the next few days and the patient succumbed to a
cardiac arrest on the 4th day.
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Affiliation(s)
- Timucin Aksu
- Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital Department of Cardiovascular Surgery İstanbul Turkey Department of Cardiovascular Surgery, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
| | - Safa Gode
- Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital Department of Cardiovascular Surgery İstanbul Turkey Department of Cardiovascular Surgery, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
| | - Kursat Oz
- Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital Department of Cardiovascular Surgery İstanbul Turkey Department of Cardiovascular Surgery, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
| | - Burak Ersoy
- Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital Department of Cardiovascular Surgery İstanbul Turkey Department of Cardiovascular Surgery, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
| | - Cigdem Tel Ustunısık
- Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital Department of Cardiovascular Surgery İstanbul Turkey Department of Cardiovascular Surgery, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
| | - Yesim Guner
- Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital Department of Cardiovascular Surgery İstanbul Turkey Department of Cardiovascular Surgery, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
| | - Omer Faruk Atay
- Kanuni Sultan Suleyman Training and Research Hospital Department of Pathology İstanbul Turkey Department of Pathology, Kanuni Sultan Suleyman Training and Research Hospital, İstanbul, Turkey
| | - Vedat Erentug
- Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital Department of Cardiovascular Surgery İstanbul Turkey Department of Cardiovascular Surgery, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
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9
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Combined effects of FH (E404D) and ACOX2 (R409H) cause metabolic defects in primary cardiac malignant tumor. Cell Death Discov 2018; 4:18. [PMID: 30062063 PMCID: PMC6056498 DOI: 10.1038/s41420-018-0072-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 03/14/2018] [Accepted: 06/03/2018] [Indexed: 12/21/2022] Open
Abstract
Primary malignant cardiac tumors (PMCTs) are extremely rare. The apparent immunity of the heart to invasive cancer has attracted considerable interest given the continuously rising incidence of cancer in other organs. This study aims to determine the conditions that could result in cardiac carcinoma and expand our understanding of cardiac tumor occurrence. We report two cases: a male (Patient-1) with primary cardiac malignant fibrous histiocytoma (MFH) and a female (Patient-2) with primary cardiac angiosarcoma. Merged genome-wide analyses of aCGH, Exome sequencing, and RNA-sequencing were performed on Patient-1 using peripheral blood, carcinoma tissue, and samples of adjacent normal tissue. Only whole-transcriptome analysis was carried out on Patient-2, due to insufficient quantities of sample from Patient-2. We identified a novel inherited loss of functional mutation of FH (Glu404Asp), a recurrent somatic hotspot mutation of PIK3CA (His1047Arg) and a somatic duplication in copy number of HIF1A. FH (E404D) severely compromised FH enzyme activity and lead to decreased protein expression in cardiac tumor tissues. We previously reported a functional mutation ACOX2 (R409H), which is potentially associated with decreased β-oxidation of fatty acids in the cardiac tumor tissue. Results of transcriptome analyses on two patients further revealed that the RNA expression of genes in the TCA cycle and beta-oxidation were uniformly downregulated. In this study, combined effects of FH (E404D) and ACOX2 (R409H) on metabolic switch from fatty acids to glucose were remarkably distinct, which might be an essential precondition to trigger the occurrence of PMCTs and mimic the Warburg effect, a hallmark of cancer metabolism.
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10
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Maleszewski JJ, Bois MC, Bois JP, Young PM, Stulak JM, Klarich KW. Neoplasia and the Heart. J Am Coll Cardiol 2018; 72:202-227. [DOI: 10.1016/j.jacc.2018.05.026] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 05/01/2018] [Accepted: 05/03/2018] [Indexed: 12/17/2022]
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11
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Taguchi S. Comprehensive review of the epidemiology and treatments for malignant adult cardiac tumors. Gen Thorac Cardiovasc Surg 2018; 66:257-262. [DOI: 10.1007/s11748-018-0912-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 03/26/2018] [Indexed: 12/31/2022]
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12
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Mankad R, Herrmann J. Cardiac tumors: echo assessment. Echo Res Pract 2016; 3:R65-R77. [PMID: 27600455 PMCID: PMC5292983 DOI: 10.1530/erp-16-0035] [Citation(s) in RCA: 89] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 09/02/2016] [Indexed: 12/20/2022] Open
Abstract
Cardiac tumors are exceedingly rare (0.001–0.03% in most autopsy series). They can be present anywhere within the heart and can be attached to any surface or be embedded in the myocardium or pericardial space. Signs and symptoms are nonspecific and highly variable related to the localization, size and composition of the cardiac mass. Echocardiography, typically performed for another indication, may be the first imaging modality alerting the clinician to the presence of a cardiac mass. Although echocardiography cannot give the histopathology, certain imaging features and adjunctive tools such as contrast imaging may aid in the differential diagnosis as do the adjunctive clinical data and the following principles: (1) thrombus or vegetations are the most likely etiology, (2) cardiac tumors are mostly secondary and (3) primary cardiac tumors are mostly benign. Although the finding of a cardiac mass on echocardiography may generate confusion, a stepwise approach may serve well practically. Herein, we will review such an approach and the role of echocardiography in the assessment of cardiac masses.
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Affiliation(s)
- Rekha Mankad
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA
| | - Joerg Herrmann
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA
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13
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14
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Hirano Y. Editorial: Primary cardiac malignant fibrous histiocytoma is a rare case of cardiac tumor. J Cardiol Cases 2015; 12:143-144. [PMID: 30546579 PMCID: PMC6281891 DOI: 10.1016/j.jccase.2015.08.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Indexed: 11/26/2022] Open
Affiliation(s)
- Yutaka Hirano
- Division of Central Laboratory, Kinki University Hospital, Osaka, Japan
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15
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Prifti E, Ademaj F, Ikonomi M, Demiraj A. Unusual localization of a primary pleomorphic malignant fibrous histiocytoma on the mitral valve: a case report and review of the literature. J Med Case Rep 2015; 9:246. [PMID: 26518517 PMCID: PMC4628272 DOI: 10.1186/s13256-015-0726-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2015] [Accepted: 10/07/2015] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION It has been reported that cardiac malignant fibrous histiocytomas occur more frequently in the left side of the heart, especially in the left atrium, but rarely invade the mitral valve. We present a case with a giant malignant fibrous histiocytoma with an unusual localization involving almost the entire left atrium, mitral valve, and left superior pulmonary vein. CASE PRESENTATION We describe the case of a 54-year-old woman from Kosovo admitted to our emergency department with dyspnea. A transthoracic echocardiography demonstrated a giant mass localized on her left atrium. Our patient underwent emergent total surgical removal of the mass. The mass extended between her left superior pulmonary vein, and extended to her left atrium and the posterior mitral valve leaflet. We formulated a surgical plan for total separation of the mass from the endocardium. Total removal was performed and her left side pulmonary veins were entirely freed from the mass. We then performed a mitral valve replacement. The differential diagnosis included other masses of the left atrium, including thrombi, vegetations, and cardiac tumors. Postsurgical histopathologic results showed a pleomorphic malignant fibrous histiocytoma. Six monthly follow-up cardiac and abdominal sonographic examinations revealed no tumor recidivism. CONCLUSION We reviewed 90 cases with malignant fibrous histiocytoma reported in the literature. Our case was especially unusual because of the primary location in the mitral valve, the pleomorphic variant, and the dimensions and extension. Complete surgical resection is mandatory to ameliorate symptoms and to obtain histologic information.
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Affiliation(s)
- Edvin Prifti
- Division of Cardiac Surgery, University Hospital Center of Tirana, Tirana, Albania
| | - Fadil Ademaj
- Division of Cardiology, Regional Hospital of Gjakovo, Gjakovo, Kosovo.
- Division of Heart Disease, Gjakovo Hospital, Rr. Prizren, Gjakove, Kosove.
| | - Majlinda Ikonomi
- Division of Cardiac Surgery, University Hospital Center of Tirana, Tirana, Albania
| | - Aurel Demiraj
- Division of Cardiology, Regional Hospital of Gjakovo, Gjakovo, Kosovo
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16
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Yanagisawa R, Nakamura T, Ogiso Y, Hachiya A, Fujihara I, Morita D, Sakashita K, Kitamura M, Matsui H, Nishijima F, Hayashi H, Hidaka E, Sano K, Shiohara M, Yasukochi S. Interleukin-8-producing primary cardiac undifferentiated sarcoma in a child with sustained fever. Pediatr Int 2015; 57:742-5. [PMID: 26044540 DOI: 10.1111/ped.12621] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2014] [Revised: 11/15/2014] [Accepted: 11/26/2014] [Indexed: 11/27/2022]
Abstract
We report the case of a 12-year-old boy with primary undifferentiated sarcoma of the left atrium. He had sustained fever during the clinical course and multiple lung and brain metastases. Chemotherapy and irradiation were ineffective; he died 41 days after hospitalization. On retrospective analysis, interleukin-8 (IL-8) was elevated; this was supported by immunohistochemistry and gene expression analysis of tumor samples. IL-8 continued to increase with tumor progression accompanied by elevated neutrophil count and C-reactive protein. IL-8 is involved in malignant tumor proliferation, migration, and angiogenesis and may have been related to the clinical condition and prognosis in the present case.
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Affiliation(s)
- Ryu Yanagisawa
- Division of Hematology/Oncology, Nagano Children's Hospital, Azumino, Japan.,Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Japan
| | - Tomohiko Nakamura
- Division of Hematology/Oncology, Nagano Children's Hospital, Azumino, Japan.,Life Science Research Center, Nagano Children's Hospital, Azumino, Japan
| | - Yoshifumi Ogiso
- Division of Clinical Pathology, Nagano Children's Hospital, Azumino, Japan
| | - Akira Hachiya
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Japan
| | - Ikuko Fujihara
- Division of Hematology/Oncology, Nagano Children's Hospital, Azumino, Japan.,Department of Pediatric Intensive Care, Nagano Children's Hospital, Azumino, Japan
| | - Daisuke Morita
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Japan
| | - Kazuo Sakashita
- Division of Hematology/Oncology, Nagano Children's Hospital, Azumino, Japan.,Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Japan
| | - Masatomo Kitamura
- Department of Pediatric Intensive Care, Nagano Children's Hospital, Azumino, Japan
| | - Hikoro Matsui
- Department of Pediatric Intensive Care, Nagano Children's Hospital, Azumino, Japan
| | - Fumie Nishijima
- Department of Laboratory Medicine, Nagano Children's Hospital, Azumino, Japan
| | - Hidetaka Hayashi
- Department of Laboratory Medicine, Nagano Children's Hospital, Azumino, Japan
| | - Eiko Hidaka
- Life Science Research Center, Nagano Children's Hospital, Azumino, Japan.,Department of Laboratory Medicine, Nagano Children's Hospital, Azumino, Japan
| | - Kenji Sano
- Department of Laboratory Medicine, Shinshu University Hospital, Matsumoto, Japan
| | - Masaaki Shiohara
- Department of Pediatrics, Matsumoto Dental University School of Dentistry, Shiojiri, Japan
| | - Satoshi Yasukochi
- Division of Pediatric Cardiology, Nagano Children's Hospital, Azumino, Japan
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17
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Gok G, Elsayed M, Thind M, Uygur B, Abtahi F, Chahwala JR, Yıldırımtürk Ö, Kayacıoğlu İ, Pehlivanoğlu S, Nanda NC. Incremental value of live/real time three-dimensional transesophageal echocardiography over the two-dimensional technique in the assessment of primary cardiac malignant fibrous histiocytoma. Echocardiography 2015; 32:1164-70. [PMID: 26114896 DOI: 10.1111/echo.13005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
We describe a case of primary cardiac malignant fibrous histiocytoma where live/real time three-dimensional transesophageal echocardiography added incremental value to the two-dimensional modalities. Specifically, the three-dimensional technique allowed us to delineate the true extent and infiltration of the tumor, to identify characteristics of the tumor mass suggestive of its malignant nature, and to quantitatively assess the total tumor burden.
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Affiliation(s)
- Gulay Gok
- Division of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Research & Training Hospital, Istanbul, Turkey
| | - Mahmoud Elsayed
- Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, Alabama
| | - Munveer Thind
- Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, Alabama
| | - Begum Uygur
- Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, Alabama
| | - Firoozeh Abtahi
- Division of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Research & Training Hospital, Istanbul, Turkey
| | - Jugal R Chahwala
- Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, Alabama
| | - Özlem Yıldırımtürk
- Division of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Research & Training Hospital, Istanbul, Turkey
| | - İlyas Kayacıoğlu
- Division of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Research & Training Hospital, Istanbul, Turkey
| | - Seçkin Pehlivanoğlu
- Division of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Research & Training Hospital, Istanbul, Turkey
| | - Navin C Nanda
- Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, Alabama
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18
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Primary cardiac malignant fibrous histiocytoma with abdominal wall metastasis. J Cardiol Cases 2015; 12:139-142. [PMID: 30546578 DOI: 10.1016/j.jccase.2015.05.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Revised: 05/14/2015] [Accepted: 05/25/2015] [Indexed: 11/21/2022] Open
Abstract
We present a rare case of cardiac malignant fibrous histiocytoma (MFH; undifferentiated pleomorphic sarcoma); to date, fewer than 100 cases of cardiac MFH have been reported. In this case, transthoracic echocardiography revealed cardiac tumors in the left atrium (LA) of a 53-year-old woman with a 3-month history of worsening dyspnea; the largest tumor was found to protrude through the mitral valve in diastole, causing stenosis. Three of the four tumors were resected during emergency surgery; however, the residual tumor extension into the left pulmonary vein could not be removed. Histological findings of the resected tumors, such as organized thrombus and myxomatous tissue changes, indicated that the tumors were benign. After 3 months, the patient underwent total resection for a small mass that developed on her right abdominal wall, which was revealed histologically to be MFH; additionally, the residual mass in the LA had enlarged progressively. After undergoing radiation therapy without further surgery, she died of cerebral bleeding 6 months after cardiac surgery. Postmortem examination revealed that the tumor in the LA was an MFH. Thus, cardiac MFH should be considered as a differential diagnosis for tumors on the posterior wall of the LA. <Learning objective: Primary cardiac malignant fibrous histiocytoma (MFH), which is easily mistaken for atrial myxoma, is a rare type of cardiac sarcoma. MFH occurs most commonly on the posterior wall of the left atrium (LA), and total resection is currently the only effective therapy; however, the prognosis is poor. Therefore, a high level of suspicion is required to facilitate early diagnosis. Cardiac MFH should be considered as a differential diagnosis for tumors on the posterior wall of the LA.>.
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19
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Primary pleomorphic malignant fibrous histiocytoma of the heart. Acta Histochem 2013; 115:761-6. [PMID: 23566556 DOI: 10.1016/j.acthis.2013.02.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2012] [Revised: 01/28/2013] [Accepted: 01/29/2013] [Indexed: 11/22/2022]
Abstract
Primary pleomorphic malignant fibrous histiocytoma of the heart is rare. The present study was performed to study the clinical and pathological features of the disease. We describe two rare cases of primary cardiac malignant fibrous histiocytoma and review the published individual data of the patients. Both patients complained of dyspnea, and underwent palliative tumor resection. However, they died several months after surgery. A thorough literature review with clinical presentations, diagnostic features, treatment, and outcomes was done. We have for the first time analyzed the factors related to the survival of malignant fibrous histiocytoma. It is usually difficult to make an appropriate preoperative diagnosis. Despite complete surgical resection and aggressive chemotherapy and radiotherapy, the prognosis is still poor.
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20
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Tamenishi A, Matsumura Y, Okamoto H. Malignant fibrous histiocytoma originating from right ventricular outflow tract. Asian Cardiovasc Thorac Ann 2013; 20:702-4. [PMID: 23284114 DOI: 10.1177/0218492312440806] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
A 70-year-old man presented with right heart failure due to obstruction of the right ventricular outflow tract by a large tumor mass. The tumor was surgically resected as much as possible. Neither chemotherapy nor radiotherapy was given. The patient died of local recurrence and multiple lung metastases 6 months after surgery. The prognosis of this very rare primary cardiac tumor is generally poor.
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Affiliation(s)
- Akinori Tamenishi
- Department of Cardiovascular Surgery, Yokkaichi Municipal Hospital, Yokkaichi, Japan.
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21
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22
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Bendel EC, Maleszewski JJ, Araoz PA. Imaging sarcomas of the great vessels and heart. Semin Ultrasound CT MR 2012; 32:377-404. [PMID: 21963161 DOI: 10.1053/j.sult.2011.06.001] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Primary sarcomas of the aorta, pulmonary artery, superior vena cava, inferior vena cava, and the heart are rare neoplasms. Aortic sarcomas are broadly categorized as either primarily luminal or primarily mural, with luminal sarcomas more likely to be misdiagnosed as thrombus. Pulmonary artery sarcomas are often mistaken for pulmonary embolism both clinically and at imaging. Vena caval sarcomas appear as intraluminal or extraluminal masses connecting to or filling the veins. The most common are leiomyosarcomas of the inferior vena cava. Primary sarcomas of the heart are rare and usually appear as heterogeneous aggressive masses.
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Affiliation(s)
- Emily C Bendel
- Department of Diagnostic Radiology, Mayo Clinic Rochester, Rochester, MN 55905, USA
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23
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Dorobantu LF, Stiru O, Prodea A, Cioranu R, Georgescu A, Filipescu D, Iliescu VA. Unique case of primary malignant fibrous histiocytoma of the right ventricle with moderator band involvement. Heart Surg Forum 2012; 14:E245-8. [PMID: 21859644 DOI: 10.1532/hsf98.20101154] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Malignant primary tumors of the heart are very rare and in most cases are located in the left side of the heart, but involvement of the moderator band of the right heart has not yet been described in the literature. We report the case of a 22-year-old woman who presented after an episode of transient sudden loss of consciousness. The transthoracic echocardiography (TTE) and transesophageal echocardiography evaluations showed an echogenic mass that originated in the right ventricle and protruded into the tricuspid valve during systole. While operating on the patient, we found a sessile tumor that originated exclusively from the moderator band of the right ventricle. The tumor was completely resected through the tricuspid valve. An immunohistochemistry examination of the tumor confirmed the diagnosis of a malignant fibrous histiocytoma (MFH) (undifferentiated pleomorphic sarcoma). To our knowledge, this case is the first of moderator band involvement among the 50 cases of primary MFH of the heart that have been reported in the literature. After a year and a half, TTE, computed tomography (CT), and positron emission tomography CT (PET-CT) showed the absence of cardiac tumor, a normal tricuspid function, and no metastasis. The completeness of the surgical resection and the absence of local recurrence >1 year after surgery are encouraging signs for the patient's outcome.
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Affiliation(s)
- Lucian Florin Dorobantu
- Department of Cardiovascular Surgery, C. C. Iliescu Institute for Emergencies in Cardiovascular Diseases, Sos. Fundeni 258, Bucharest, Romania.
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24
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Rashidi A, Silverberg ML, McCray RD. Malignant Fibrous Histiocytoma of the Heart. Echocardiography 2011; 28:E217-8. [DOI: 10.1111/j.1540-8175.2011.01497.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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26
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Balaceanu A, Mateescu D, Diaconu C, Sarsan A. Primary malignant fibrous histiocytoma of the right ventricle: case report and review of the literature. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2010; 29:655-658. [PMID: 20375386 DOI: 10.7863/jum.2010.29.4.655] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Affiliation(s)
- Alice Balaceanu
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
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27
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Kim EY, Choe YH, Sung K, Park SW, Kim JH, Ko YH. Multidetector CT and MR imaging of cardiac tumors. Korean J Radiol 2009; 10:164-75. [PMID: 19270863 PMCID: PMC2651440 DOI: 10.3348/kjr.2009.10.2.164] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2008] [Accepted: 08/26/2008] [Indexed: 11/15/2022] Open
Abstract
The purpose of this article is to provide a current review of the spectrum of multidetector CT (MDCT) and MRI findings for a variety of cardiac neoplasms. In the diagnosis of cardiac tumors, the use of MDCT and MRI can help differentiate benign from malignant masses. Especially, the use of MDCT is advantageous in providing anatomical information and MRI is useful for tissue characterization of cardiac masses. Knowledge of the characteristic MRI findings of benign cardiac tumors or thrombi can be helpful to avoid unnecessary surgical procedures. Presurgical assessment of malignant cardiac tumors with the use of MDCT and MRI may allow determination of the resectability of tumors and planning for the reconstruction of cardiac chambers.
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Affiliation(s)
- Eun Young Kim
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, Korea
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28
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Primary Pericardial Malignant Fibrous Histiocytoma Causing Cardiac Tamponade. Ann Thorac Surg 2008; 86:646-9. [DOI: 10.1016/j.athoracsur.2008.02.040] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2007] [Revised: 02/12/2008] [Accepted: 02/14/2008] [Indexed: 11/19/2022]
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30
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Abstract
Approximately 10% of surgically resected heart tumors are malignant. Of these, over 90% are sarcomas, and the remainder lymphomas. Sarcomas of the heart may be of a variety of histologic types. Angiosarcomas are usually right-sided, typically in the atrium. Most other heart sarcomas arise in the left atrium and may be clinically mistaken for myxoma. Left atrial sarcomas are typically pleomorphic, and may have areas of osteosarcoma or chondrosarcoma.
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Affiliation(s)
- Allen Burke
- CVPath Institute, Gaithersburg, Maryland 20878, USA.
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31
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32
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Torres Gómez FJ, Torres Olivera FJ. [Synchronous malignant fibrous histiocytomas in ileal and atrial locations]. GASTROENTEROLOGIA Y HEPATOLOGIA 2008; 31:22-4. [PMID: 18218276 DOI: 10.1157/13114579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Diagnosis of malignant fibrous histiocytoma in ileal and atrial locations is uncommon and diagnosis of synchronous lesions in both locations is exceptional. We present the case of a 60-year-old woman with a malignant fibrous histiocytoma in both locations. Malignant fibrous histiocytoma is an aggressive neoplasm. Definitive diagnosis is histological. Immunochemistry helps to establish the differential diagnosis with other entities.
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Milicic D, Juretic A, Bulum J, Saric N, Bisof V, Jelic I, Jelasic D. Primary Malignant Fibrous Histiocytoma of the Heart with Skeletal Muscles Metastases. J Card Surg 2007; 22:513-6. [DOI: 10.1111/j.1540-8191.2007.00451.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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34
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Left ventricular malignant fibrous histiocytoma. Clin Imaging 2007; 31:422-4. [DOI: 10.1016/j.clinimag.2007.03.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2007] [Accepted: 03/15/2007] [Indexed: 11/17/2022]
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Sato M, Suenaga E, Senaha S, Furutachi A. Primary malignant fibrous histiocytoma of the heart. Gen Thorac Cardiovasc Surg 2007; 55:29-31. [PMID: 17444170 DOI: 10.1007/s11748-006-0060-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
We describe a case of a primary cardiac malignant fibrous histiocytoma in the left atrium of a 72-year-old man. Local recurrences appeared twice, at 2 and 14 months after initial tumor resection, and were managed surgically. The patient died of pancreatic metastasis 22 months after the initial diagnosis. The prognosis for MFH of the heart is poor despite aggressive surgical treatment.
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Affiliation(s)
- Manabu Sato
- Division of Cardiovascular Surgery, Nagasaki Kouseikai Hospital, 1-3-12 Hayama, Nagasaki 852-8053, Japan.
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36
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Su HW, Hsu CS, Lin YH, Hsu MI, Chiang HK, Chou SY. Malignant fibrous histiocytoma during pregnancy: a case report. Taiwan J Obstet Gynecol 2007; 45:86-8. [PMID: 17272219 DOI: 10.1016/s1028-4559(09)60201-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVE We present a case of a 38-year-old postpartum woman who had antepartal undiagnosed sarcoma with multiple metastasis. Although the patient underwent aggressive treatment with surgery and chemotherapy, she died 3 months after the vaginal delivery of a healthy female infant weighing 2,090 g at 35 weeks of gestation. CASE REPORT The patient had right shoulder pain and mild chest discomfort during the last trimester of the pregnancy. Six days after delivery, she came to our emergency room because her pain had become more severe. A humeral neck tumor with bone destruction was found in the right shoulder on X-ray. After detailed evaluation, right humeral surgery, cardiac surgery, and liver biopsy were performed. All the removed specimens were sent for pathologic examination, and the results showed a sarcoma favoring malignant fibrous histiocytoma with its primary origin in the left atrium. CONCLUSION Obstetricians should be aware that any non-specific complaint may be due to severe disease. It is better to evaluate all symptoms and signs that persist. In this case, early intervention such as radiologic imaging of the bone or echocardiography could have been performed during pregnancy to prevent tumor spread, maternal morbidity, and even death.
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MESH Headings
- Adult
- Bone Neoplasms/diagnostic imaging
- Bone Neoplasms/drug therapy
- Bone Neoplasms/secondary
- Bone Neoplasms/surgery
- Chemotherapy, Adjuvant
- Fatal Outcome
- Female
- Heart Atria
- Heart Neoplasms/diagnostic imaging
- Heart Neoplasms/pathology
- Heart Neoplasms/surgery
- Histiocytoma, Malignant Fibrous/diagnostic imaging
- Histiocytoma, Malignant Fibrous/pathology
- Histiocytoma, Malignant Fibrous/secondary
- Histiocytoma, Malignant Fibrous/surgery
- Humans
- Humerus/surgery
- Infant, Newborn
- Postpartum Period
- Pregnancy
- Pregnancy Complications, Neoplastic/diagnostic imaging
- Pregnancy Complications, Neoplastic/pathology
- Pregnancy Complications, Neoplastic/surgery
- Pregnancy Trimester, Third
- Shoulder Joint
- Tomography, X-Ray Computed
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Affiliation(s)
- Hung-Wen Su
- Department of Obstetrics and Gynecology, Taipei Medical University-Wan Fang Medical Center, Taipei, Taiwan
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Suh SH, Park TH, Yoo JN, Cha KS, Kim MH, Kim YD, Wu JS, Roh MS. Primary undifferentiated pleomorphic sarcoma of the left atrium that presented as acute pulmonary edema. Yonsei Med J 2007; 48:131-4. [PMID: 17326257 PMCID: PMC2627998 DOI: 10.3349/ymj.2007.48.1.131] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
A 37-year-old woman was admitted to Dong-A University Hospital for rapidly progressive congestive heart failure. Transthoracic echocardiography demonstrated a large mass with a stalk that appeared to be a myxoma on the posterior wall of the left atrium. However, the histological diagnosis was undifferentiated pleomorphic sarcoma. We report a case of primary undifferentiated pleomorphic sarcoma of the left atrium with acute pulmonary edema caused by mitral inflow obstruction.
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Affiliation(s)
- Sung-Hwan Suh
- Division of Cardiology, Department of Cardiology, Dong-A University College of Medicine, Busan, Korea
| | - Tae-Ho Park
- Division of Cardiology, Department of Cardiology, Dong-A University College of Medicine, Busan, Korea
| | - Jung-Nam Yoo
- Division of Cardiology, Department of Cardiology, Dong-A University College of Medicine, Busan, Korea
| | - Kwang-Soo Cha
- Division of Cardiology, Department of Cardiology, Dong-A University College of Medicine, Busan, Korea
| | - Moo-Hyun Kim
- Division of Cardiology, Department of Cardiology, Dong-A University College of Medicine, Busan, Korea
| | - Young-Dae Kim
- Division of Cardiology, Department of Cardiology, Dong-A University College of Medicine, Busan, Korea
| | - Jong-Soo Wu
- Department of Thoracic and Cardiovascular Surgery, Dong-A University College of Medicine, Busan, Korea
| | - Mee-Sook Roh
- Department of Pathology, Dong-A University College of Medicine, Busan, Korea
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Uezu T, Kuniyoshi Y, Miyagi K, Arakaki K, Yamashiro S, Mabuni K, Koja K. Malignant Fibrous Histiocytoma of the Heart Complicated By Factor XI Deficiency in a Jehovah's Witness Patient. Ann Thorac Surg 2005; 79:351-3. [PMID: 15620983 DOI: 10.1016/j.athoracsur.2003.08.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/13/2003] [Indexed: 11/24/2022]
Abstract
We describe a 16-year-old girl with malignant fibrous histiocytoma (MFH) of the heart complicated by factor XI deficiency. The preoperative diagnosis was left atrial myxoma. We decided to perform the operation owing to a normal bleeding time. Operative findings suggested a malignant tumor. The patient was a Jehovah's Witness, and extensive excision was not performed because blood transfusion was not allowed. We resected as much of the tumor and left atrial appendage as possible. The pathologic diagnosis was MFH. Excessive bleeding was not observed during the operation. Bleeding time helps to determine whether a surgical procedure is indicated in patients with factor XI deficiency.
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Affiliation(s)
- Toru Uezu
- Second Department of Surgery, Faculty of Medicine, University of the Ryukyus, Okinawa, Japan.
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