Asunto(s)
Cardiomiopatía Restrictiva , Neoplasias Cardíacas , Hemangiosarcoma , Humanos , Hemangiosarcoma/patología , Hemangiosarcoma/complicaciones , Hemangiosarcoma/diagnóstico , Neoplasias Cardíacas/patología , Neoplasias Cardíacas/complicaciones , Neoplasias Cardíacas/diagnóstico por imagen , Cardiomiopatía Restrictiva/patología , Cardiomiopatía Restrictiva/etiología , Masculino , Persona de Mediana Edad , Femenino , Resultado FatalRESUMEN
The antemortem diagnosis of secondary cardiac involvement by lymphoma remains suboptimal. Prognosis is worse with delayed diagnosis as the tumor burden increases with the multicompartment participation. Chemotherapy may improve survival, but there is a risk of mortality due to treatment-related complications, such as myocardial rupture and fatal arrhythmias. Modified chemotherapy regimens may prevent such complications, but the data are limited. We report the case of a 72-year-old woman diagnosed with diffuse large B-cell lymphoma with cardiac involvement, where early diagnosis prevented cardiac complications from the disease and its treatment as well. The aim of this case report is to highlight the fact that cardiac involvement in lymphoma is frequent and can be easily missed, leading to complications. Treatment requires an individualized approach.
Asunto(s)
Neoplasias Cardíacas , Linfoma de Células B Grandes Difuso , Humanos , Femenino , Anciano , Linfoma de Células B Grandes Difuso/patología , Linfoma de Células B Grandes Difuso/diagnóstico , Linfoma de Células B Grandes Difuso/tratamiento farmacológico , Neoplasias Cardíacas/patología , Neoplasias Cardíacas/complicaciones , Ecocardiografía , Tabique Interatrial/patología , Tabique Interatrial/diagnóstico por imagen , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéuticoRESUMEN
BACKGROUND: Primary cardiac synovial sarcoma is a rare condition with limited treatment options for advanced stages. Surgery and chemotherapy are currently the mainstay treatments; however, survival rates remain low. CASE PRESENTATION: A 64-year-old woman presenting with symptoms of chest tightness and shortness of breath was found to have an obstructive right atrial mass, along with pulmonary infarction and metastasis. She was ultimately diagnosed with advanced primary cardiac synovial sarcoma. Following surgery, the patient's symptoms improved, and she underwent chemotherapy and anti-angiogenic therapy, but unfortunately, her survival time was only 8 months. CONCLUSION: This case report aims to enhance clinicians' understanding of the diagnosis and treatment of primary cardiac synovial sarcoma. Enhancing both survival outcomes and quality of life in individuals with primary cardiac synovial sarcoma continues to present a significant challenge.
Asunto(s)
Neoplasias Cardíacas , Infarto Pulmonar , Sarcoma Sinovial , Humanos , Sarcoma Sinovial/patología , Sarcoma Sinovial/complicaciones , Sarcoma Sinovial/diagnóstico , Femenino , Persona de Mediana Edad , Neoplasias Cardíacas/patología , Neoplasias Cardíacas/complicaciones , Infarto Pulmonar/patología , Infarto Pulmonar/etiología , Tabique Interatrial/patologíaRESUMEN
Cardiac myxoma is extremely rare in children. However, if not treated immediately, it may cause varying symptoms until sudden death. A-9-years old male Javanese child was brought to the emergency department of Prof. Soekandar General Hospital, Mojokerto with progressive dyspnoea since one month which got worse in the left decubitus position. There was no significant past medical history. Physical examination revealed hypotension, mitral stenosis, tricuspid regurgitation, and pulmonary congestion. Transthoracic echocardiography revealed a round pedunculated 3x3.3 cm mass in the Left Atrium that swingingly moved to the Left Ventricle during diastole. This was diagnosed provisionally as Myxoma with a differential of thrombus. After stabilization, he was referred to a tertiary hospital for emergency excision. Histopathology confirmed the myxoma. There were no symptoms and activity limitations during the 6 months follow-up. To the best of our knowledge, this is the first paediatric cardiac myxoma with Acute Heart Failure symptoms reported in Indonesia. Echocardiography is imperative for diagnosing myxoma. Appropriate and timely management results in an excellent outcome.
Asunto(s)
Ecocardiografía , Insuficiencia Cardíaca , Neoplasias Cardíacas , Mixoma , Humanos , Mixoma/complicaciones , Mixoma/cirugía , Mixoma/diagnóstico , Neoplasias Cardíacas/complicaciones , Neoplasias Cardíacas/cirugía , Neoplasias Cardíacas/diagnóstico , Neoplasias Cardíacas/diagnóstico por imagen , Masculino , Insuficiencia Cardíaca/etiología , Niño , Disnea/etiología , Atrios Cardíacos/diagnóstico por imagen , Atrios Cardíacos/patología , Enfermedad AgudaRESUMEN
BACKGROUND: Primary cardiac tumors, while rare, present significant clinical challenges due to their diverse pathology and presentation. Lung cancer frequently metastasizes to the heart; however, cases involving primary cardiac tumors of different origins alongside primary lung cancer are exceedingly rare in the literature. CASE PRESENTATION: We report the case of a 53-year-old female who presented with hemoptysis and was subsequently diagnosed with a left atrial myxoma, pulmonary squamous cell carcinoma, and a thymic cyst. This coexistence of multiple non-homologous tumors in a single patient is exceedingly rare. CONCLUSION: This case underscores the complexity of diagnosing and managing patients with multiple distinct tumors. The simultaneous occurrence of a primary cardiac myxoma, pulmonary squamous cell carcinoma, and thymic cyst is unprecedented, providing valuable insights for future clinical practice.
Asunto(s)
Carcinoma de Células Escamosas , Atrios Cardíacos , Neoplasias Cardíacas , Neoplasias Pulmonares , Quiste Mediastínico , Mixoma , Humanos , Mixoma/complicaciones , Mixoma/cirugía , Mixoma/patología , Femenino , Persona de Mediana Edad , Carcinoma de Células Escamosas/cirugía , Carcinoma de Células Escamosas/complicaciones , Carcinoma de Células Escamosas/patología , Neoplasias Pulmonares/cirugía , Neoplasias Pulmonares/complicaciones , Neoplasias Pulmonares/patología , Quiste Mediastínico/cirugía , Quiste Mediastínico/complicaciones , Quiste Mediastínico/patología , Neoplasias Cardíacas/cirugía , Neoplasias Cardíacas/complicaciones , Neoplasias Cardíacas/patología , Atrios Cardíacos/patología , Atrios Cardíacos/cirugía , Neoplasias Primarias Múltiples/cirugía , Neoplasias Primarias Múltiples/patología , Neoplasias Primarias Múltiples/complicacionesAsunto(s)
Neoplasias Cardíacas , Hemangioma , Propranolol , Rabdomioma , Esclerosis Tuberosa , Humanos , Propranolol/administración & dosificación , Propranolol/uso terapéutico , Rabdomioma/complicaciones , Rabdomioma/tratamiento farmacológico , Rabdomioma/diagnóstico , Esclerosis Tuberosa/complicaciones , Neoplasias Cardíacas/complicaciones , Neoplasias Cardíacas/tratamiento farmacológico , Neoplasias Cardíacas/diagnóstico , Lactante , Hemangioma/tratamiento farmacológico , Hemangioma/complicaciones , Antagonistas Adrenérgicos beta/uso terapéutico , Antagonistas Adrenérgicos beta/administración & dosificación , Neoplasias Cutáneas/tratamiento farmacológico , Neoplasias Cutáneas/complicaciones , Neoplasias Cutáneas/patología , Neoplasias Cutáneas/diagnóstico , Femenino , MasculinoRESUMEN
Lymphoma patients are at high risk of cardiovascular events due to anthracycline cardiotoxicity and, in rare cases, related to heart infiltration. The presence of cardiac masses adds further complexity to the management of lymphoma patients beyond myocardial chemotherapy-related toxicity, given possible unpredictable acute complications such as arrhythmias, atrioventricular block, myocardial ischemia, pericardial effusion and cardiac tamponade. Here we describe the clinical presentation and successful multidisciplinary management of diffuse large B-cell lymphoma with multifocal cardiac involvement identified by total body 18FDG positron emission tomography performed at disease staging.
Asunto(s)
Neoplasias Cardíacas , Linfoma de Células B Grandes Difuso , Tomografía de Emisión de Positrones , Humanos , Linfoma de Células B Grandes Difuso/tratamiento farmacológico , Neoplasias Cardíacas/complicaciones , Fluorodesoxiglucosa F18 , Masculino , Radiofármacos , Persona de Mediana Edad , Estadificación de Neoplasias , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Femenino , AncianoRESUMEN
BACKGROUND: Carney syndrome is an uncommon autosomal disorder closely linked to mutations in the PRKAR1A gene. Skin lesions are the most pronounced feature of Carney syndrome, affecting over 80% of individuals with this condition. This syndrome is characterized by a triad of myxomas, skin pigmentation, and endocrine hyperfunction, featuring multiple endocrine neoplasms with skin and cardiac involvement. Dilated cardiomyopathy, a primary cardiomyopathy, is defined as the dilation and impaired systolic function of the left or both ventricles. Its clinical presentation varies from being asymptomatic to heart failure or sudden cardiac death, making it a leading global cause of heart failure. Currently, Dilated cardiomyopathy has an estimated prevalence of 1/2500-1/250 individuals, predominantly affecting those aged 30-40 years, with a male-to-female ratio of 3:1. This case report describes a heart failure patient with cardiac myxoma caused by Carney syndrome combined with dilated cardiomyopathy. The patient was successfully treated for heart failure by heart transplantation. CASE PRESENTATION: Herein, we report a case of heart failure due to Carney syndrome that resulted in cardiac myxoma combined with dilated cardiomyopathy. A 35-year-old male was admitted to the hospital three years ago because of sudden chest tightness and shortness of breath. Echocardiography indicated myxoma, and a combination of genetic screening and physical examination confirmed Carney syndrome with cardiac myxoma. Following symptomatic management, he was discharged. Surgical interventions were not considered at the time. However, the patient's chest tightness and shortness of breath symptoms worsened, and he returned to the hospital. A New York Heart Association grade IV heart function was confirmed, and echocardiography indicated the presence of dilated cardiomyopathy accompanied by cardiac myxoma. Ultimately, the patient's heart failure was successfully treated with heart transplantation. CONCLUSIONS: Cardiac myxoma caused by Carney syndrome combined with heart failure caused by dilated cardiomyopathy can be resolved by heart transplantation.
Asunto(s)
Cardiomiopatía Dilatada , Complejo de Carney , Insuficiencia Cardíaca , Neoplasias Cardíacas , Trasplante de Corazón , Mixoma , Humanos , Cardiomiopatía Dilatada/cirugía , Cardiomiopatía Dilatada/etiología , Cardiomiopatía Dilatada/diagnóstico , Cardiomiopatía Dilatada/diagnóstico por imagen , Masculino , Complejo de Carney/genética , Complejo de Carney/diagnóstico , Complejo de Carney/cirugía , Complejo de Carney/complicaciones , Adulto , Mixoma/complicaciones , Mixoma/cirugía , Mixoma/diagnóstico por imagen , Mixoma/diagnóstico , Mixoma/genética , Insuficiencia Cardíaca/etiología , Insuficiencia Cardíaca/diagnóstico , Insuficiencia Cardíaca/cirugía , Neoplasias Cardíacas/cirugía , Neoplasias Cardíacas/complicaciones , Neoplasias Cardíacas/diagnóstico por imagen , Neoplasias Cardíacas/diagnóstico , Neoplasias Cardíacas/genética , Resultado del Tratamiento , Subunidad RIalfa de la Proteína Quinasa Dependiente de AMP Cíclico/genéticaRESUMEN
BACKGROUND: Cardiac myxomas are the most common type of primary cardiac tumors in adults, but they can have variable features that make them difficult to diagnose. We report two cases of atrial myxoma with calcification or ossification, which are rare pathological subgroups of myxoma. CASE PRESENTATION: A 47-year-old woman and a 35-year-old man presented to our hospital with different symptoms. Both patients had a history of chronic diseases. Transthoracic and transesophageal echocardiography revealed a mass in the left or right atrium, respectively, with strong echogenicity and echogenic shadows. The masses were suspected to be malignant tumors with calcification or ossification. Contrast transthoracic echocardiography(cTEE) showed low blood supply within the lesions. The patients underwent surgical resection of the atrial mass, and the pathology confirmed myxoma with partial ossification or massive calcification. CONCLUSION: We report two rare cases of atrial myxoma with calcification or ossification and analyze their ultrasonographic features. Transthoracic echocardiography and cTEE can provide valuable information for the diagnosis and management of such mass. However, distinguishing calcification and ossification in myxoma from calcification in malignant tumors is challenging. More studies are needed to understand the pathogenesis and imaging characteristics of these myxoma variants.
Asunto(s)
Calcinosis , Atrios Cardíacos , Neoplasias Cardíacas , Mixoma , Osificación Heterotópica , Humanos , Mixoma/diagnóstico , Mixoma/cirugía , Mixoma/complicaciones , Neoplasias Cardíacas/diagnóstico , Neoplasias Cardíacas/cirugía , Neoplasias Cardíacas/complicaciones , Neoplasias Cardíacas/patología , Neoplasias Cardíacas/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Calcinosis/diagnóstico por imagen , Calcinosis/diagnóstico , Calcinosis/cirugía , Atrios Cardíacos/patología , Atrios Cardíacos/diagnóstico por imagen , Femenino , Adulto , Osificación Heterotópica/diagnóstico , Osificación Heterotópica/complicaciones , Osificación Heterotópica/cirugía , Ecocardiografía , Ecocardiografía TransesofágicaRESUMEN
We present the case of a 60-year-old male patient who was admitted to our hospital after experiencing a syncopal episode. First ECGs showed sinus rhythm with polymorphic premature ventricular complexes and later ventricular tachycardia with a left bundle branch block morphology were recorded. Imaging with TEE and MRI revealed a space-occupying lesion in the left ventricle, which was ultimately identified as a rare cardiac metastasis of renal cell carcinoma. Treatment was initiated with monoclonal antibodies resulting in lesion regression. This case highlights the importance of comprehensive diagnostic in patients with history of malignancy.
Asunto(s)
Carcinoma de Células Renales , Electrocardiografía , Neoplasias Cardíacas , Ventrículos Cardíacos , Neoplasias Renales , Taquicardia Ventricular , Humanos , Masculino , Persona de Mediana Edad , Neoplasias Cardíacas/secundario , Neoplasias Cardíacas/complicaciones , Neoplasias Cardíacas/diagnóstico por imagen , Taquicardia Ventricular/etiología , Taquicardia Ventricular/fisiopatología , Taquicardia Ventricular/diagnóstico , Neoplasias Renales/patología , Neoplasias Renales/diagnóstico por imagen , Ventrículos Cardíacos/diagnóstico por imagen , Carcinoma de Células Renales/secundario , Carcinoma de Células Renales/complicaciones , Carcinoma de Células Renales/diagnóstico por imagen , Imagen por Resonancia Magnética , Diagnóstico Diferencial , Ecocardiografía TransesofágicaAsunto(s)
Carcinoma Hepatocelular , Atrios Cardíacos , Neoplasias Hepáticas , Invasividad Neoplásica , Humanos , Carcinoma Hepatocelular/virología , Carcinoma Hepatocelular/patología , Neoplasias Hepáticas/virología , Neoplasias Hepáticas/patología , Atrios Cardíacos/patología , Masculino , Neoplasias Cardíacas/patología , Neoplasias Cardíacas/virología , Neoplasias Cardíacas/complicaciones , Hepatitis B/complicaciones , Persona de Mediana Edad , Hepatitis B Crónica/complicaciones , Hepatitis B Crónica/patologíaRESUMEN
A 65-year-old man with previous history of smoking, controlled HIV infection, treated hepatitis B infection, and type III cryoglobulinemia, was admitted due to right heart failure symptoms and significant weight loss. Despite being haemodynamically stable, he had periods of 1:1 conduction atrial flutter and presented with respiratory alkalosis and metabolic acidosis, as well as acute kidney and hepatic dysfunction, elevated D-dimer and cardiac markers. He underwent imaging with chest computed tomography and echocardiogram that confirmed pulmonary embolism and most notably revealed a significant sized cardiac mass causing almost complete obstruction of the right chambers, with no cleavage plane with the myocardial walls and tricuspid valve. Cardiac magnetic resonance was highly suggestive of malignancy. Cardiac surgery for mass excision and endomyocardial biopsy for diagnosis were considered, but the patient died with obstructive shock unresponsive to medical treatment. The autopsy revealed a primary unspecified diffuse large B-cell lymphoma.
Asunto(s)
Insuficiencia Cardíaca , Neoplasias Cardíacas , Linfoma de Células B Grandes Difuso , Humanos , Masculino , Anciano , Neoplasias Cardíacas/patología , Neoplasias Cardíacas/complicaciones , Neoplasias Cardíacas/cirugía , Resultado Fatal , Insuficiencia Cardíaca/etiología , Linfoma de Células B Grandes Difuso/patología , Linfoma de Células B Grandes Difuso/complicaciones , Autopsia , Biopsia , Imagen por Resonancia MagnéticaRESUMEN
BACKGROUND Papillary fibroelastoma is the most common type of benign primary cardiac tumor and is usually asymptomatic. However, tumor fragments or surface thrombus can embolize and cause transient ischemic attacks, strokes, or myocardial infarction. This report describes a 76-year-old woman who presented with dysarthria and right-sided weakness due to a stroke associated with a left atrial papillary fibroelastoma. CASE REPORT A 76-year-old woman visited the Emergency Department because she had right-sided weakness and dysarthria from 12 h ago. Brain magnetic resonance image was done at the Emergency Department, showing multiple small embolic, acute infarction in left basal ganglia and fronto-temporo-parietal lobes. Transthoracic and transesophageal echocardiogram showed a hypermobile echogenic mass (0.8×1.5 cm) with villous surface on the orifice of left atrial appendage. Twenty-four-hour Holter monitoring was performed to evaluate the cause of cerebral infarction, and there was no paroxysmal atrial fibrillation. Thoracic computed tomography angiography also showed a sea anemone-shaped mass around the left atrial appendage. Cardiac tumor excision was done via a lower partial sternotomy. Histopathologic analysis showed multiple delicate fronds, and the avascular fibroelastic cores were lined by a single layer of CD31-positive endothelial cells. Histopathologic findings were consistent with papillary fibroelastoma. The patient was discharged without any other complications on day 30 of hospitalization. CONCLUSIONS This case highlights the importance of cardiac imaging in patients with acute stroke, including transthoracic and transesophageal echocardiography, which can show the typical imaging features of papillary fibroelastoma and other intracardiac sources of embolus.
Asunto(s)
Fibroelastoma Papilar Cardíaco , Accidente Cerebrovascular , Humanos , Femenino , Anciano , Accidente Cerebrovascular/etiología , Neoplasias Cardíacas/complicaciones , Neoplasias Cardíacas/diagnóstico por imagen , Neoplasias Cardíacas/cirugía , Atrios Cardíacos , Ecocardiografía TransesofágicaRESUMEN
Renal embolisms due to cardiac myxomas are extremely rare; the clinical course, treatment, and prognosis of this disease are not established. A 69-year-old Japanese woman who underwent a nephrectomy for renal cell carcinoma 3 years earlier was hospitalized with a right occipital lobe cerebral infarction. Her renal function suddenly worsened 3 days post-admission: her serum creatinine rose from 1.46 mg/dL to 6.57 mg/dL and then to 8.03 mg/dL the next day, and hemodialysis therapy was started. Abdominal computed tomography (CT) scans showed patchy non-contrasted low-density areas in the right kidney, and chest CT scans and transesophageal ultrasonography revealed a left atrial tumor. We diagnosed renal infarction due to a left atrial myxoma. Hemodialysis and anticoagulant therapy (heparin) were continued, followed by the cardiac myxoma's resection. The patient's renal function gradually improved post-surgery, and the hemodialysis was discontinued. Considering our patient and 19 other case reports of renal infarction associated with cardiac myxoma, the treatment for such a renal infarction and the outcomes differ depending on the embolus site. The poor outcome of abdominal aortic embolism requires a prompt embolectomy, whereas a branch renal artery embolism requires anticoagulation therapy to prevent thrombosis formation around the myxoma.
Asunto(s)
Embolia , Atrios Cardíacos , Neoplasias Cardíacas , Mixoma , Humanos , Femenino , Mixoma/complicaciones , Mixoma/cirugía , Anciano , Neoplasias Cardíacas/complicaciones , Atrios Cardíacos/diagnóstico por imagen , Embolia/etiología , Embolia/complicaciones , Nefrectomía/efectos adversos , Carcinoma de Células Renales/complicaciones , Carcinoma de Células Renales/cirugía , Tomografía Computarizada por Rayos X , Diálisis Renal/efectos adversos , Anticoagulantes/uso terapéutico , Riñón/irrigación sanguíneaRESUMEN
Fetal pericardial teratomas are rare. They present with pericardial effusion and hydrops. The definitive management is postnatal resection of the tumor. The exact antenatal management is not known due to its rarity. We present a case of fetal pericardial teratoma with pericardial tamponade. Pericardiocentesis performed at 31 weeks significantly relieved the venous compression, leading to resolution of hydrops and prolonging the gestational age for the definitive management.
Asunto(s)
Neoplasias Cardíacas , Pericardiocentesis , Teratoma , Humanos , Teratoma/cirugía , Teratoma/complicaciones , Teratoma/diagnóstico , Teratoma/diagnóstico por imagen , Pericardiocentesis/métodos , Femenino , Neoplasias Cardíacas/complicaciones , Neoplasias Cardíacas/cirugía , Neoplasias Cardíacas/diagnóstico por imagen , Neoplasias Cardíacas/diagnóstico , Embarazo , Adulto , Ultrasonografía Prenatal , Derrame Pericárdico/cirugía , Derrame Pericárdico/diagnóstico por imagen , Derrame Pericárdico/etiología , Taponamiento Cardíaco/etiología , Taponamiento Cardíaco/cirugía , Taponamiento Cardíaco/diagnóstico , Hidropesía Fetal/etiología , Hidropesía Fetal/diagnóstico , Hidropesía Fetal/cirugía , Enfermedades Fetales/cirugíaRESUMEN
Primary cardiac lymphoma is an exceedingly rare malignant tumor, with diffuse large B-cell lymphoma (DLBCL) being the most prevalent histological subtype. This disease has non-specific clinical manifestations, making early diagnosis crucial. However, DLBCL diagnosis is commonly delayed, and its prognosis is typically poor. Herein, we report the case of a 51-year-old male patient with DLBCL who presented with recurrent chest tightness for 4 months as the primary clinical symptom. The patient was admitted to the hospital and diagnosed with acute myocardial infarction and left ventricular hypertrophy with heart failure. Echocardiography revealed a progression from left ventricular thickening to local pericardial thickening and adhesion in the inferior and lateral walls of the left ventricle. Finally, pathological analysis of myocardial biopsy confirmed the diagnosis of DLBCL. After treatment with the R-CHOP chemotherapy regimen, the patient's chest tightness improved, and he was discharged. After 2 months, the patient succumbed to death owing to sudden ventricular tachycardia, ventricular fibrillation, and decreased blood pressure despite rescue efforts. Transthoracic echocardiography is inevitable for the early diagnosis of DLBCL, as it can narrow the differential and guide further investigations and interventions, thereby improving the survival of these patients.