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1.
Kyobu Geka ; 73(11): 905-909, 2020 Oct.
Artigo em Japonês | MEDLINE | ID: mdl-33130711

RESUMO

A 48-year-old woman developed paralysis of the left upper limb and dysarthria. Two days later, she was admitted to a local hospital due to no improvement of symptoms. Brain magnetic resonance imaging showed acute hemorrhagic cerebral infarction in the left nucleus basalis. Echocardiography demonstrated a large left atrial mass in the left atrium, shuttling between the left atrium and the left ventricle and moderate mitral regurgitation. Then, she was transferred to our hospital for surgery. Five days after the initial symptoms, resection of the left atrial mass was performed under total cardiopulmonary bypass. First, heparin sodium, and then nafamostat mesilate were used as intraoperative anticoagulation treatment. The left mitral mass was removed via an atrial septal incision and the defect was repaired using a bovine pericardium. The mitral valve was intact and there was no regurgitation. The mass was immunohistologically diagnosed as myxoma. Postoperative brain computed tomography scans demonstrated no exacerbation of the cerebral infarction. She was discharged 13 days after surgery without neurological symptoms.


Assuntos
Fibrilação Atrial , Neoplasias Cardíacas , Insuficiência da Valva Mitral , Mixoma , Animais , Bovinos , Infarto Cerebral/diagnóstico por imagem , Infarto Cerebral/etiologia , Infarto Cerebral/cirurgia , Feminino , Átrios do Coração/diagnóstico por imagem , Átrios do Coração/cirurgia , Neoplasias Cardíacas/complicações , Neoplasias Cardíacas/diagnóstico por imagem , Neoplasias Cardíacas/cirurgia , Humanos , Pessoa de Meia-Idade , Insuficiência da Valva Mitral/diagnóstico por imagem , Insuficiência da Valva Mitral/etiologia , Insuficiência da Valva Mitral/cirurgia , Mixoma/complicações , Mixoma/diagnóstico por imagem , Mixoma/cirurgia
2.
Zhonghua Bing Li Xue Za Zhi ; 49(10): 1027-1030, 2020 Oct 08.
Artigo em Chinês | MEDLINE | ID: mdl-32992417

RESUMO

Objective: To investigate the clinicopathological features, treatment and prognosis of fibrin-associated diffuse large B cell lymphoma (DLBCL) arising within concurrent atrial myxoma. Methods: Six cases of fibrin-associated DLBCL arising within concurrent atrial myxoma diagnosed at the Department of Pathology, Guangdong General Hospital, from 2006 to 2019 were included. The histology, immunophenotype, treatment and prognoses were analyzed. Results: The patients' age ranged from 46 to 78 years (mean 59 years). There were 3 males and 3 females. The tumors were all discovered incidentally on histological examination of surgical pathology specimens excised for atrial myxoma. All patients appeared to have morphological features of DLBCL, B lineage immunophenotype, high proliferative index and latency type III of Epstein-Barr viral infection. They had complete tumor resections without adjuvant chemotherapy and were healthy at 5- to 120-month follow-ups. Conclusions: Fibrin-associated DLBCL arising within concurrent atrial myxoma is an unusual form of DLBCL associated with chronic inflammation, and its clinical outcome is indolent. The findings suggest that this type of lymphoma does not warrant excessive or unnecessary treatments after complete resection.


Assuntos
Fibrilação Atrial , Neoplasias Cardíacas/cirurgia , Linfoma Difuso de Grandes Células B , Mixoma/complicações , Mixoma/cirurgia , Idoso , Feminino , Fibrina , Humanos , Masculino , Pessoa de Meia-Idade
3.
Cardiovasc Pathol ; 49: 107264, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32805552

RESUMO

We report a 60-year-old male with fibrin-associated diffuse large B-cell lymphoma (fa-DLBCL) in left atrial myxoma. Echocardiography showed a mass (63 mm × 33 mm) in the left atrium. Histological inspection indicated fa-DLBCL on the surface of atrial myxoma incidentally, together with extensive fibrinous like exudation on myxoma surface. Malignant cells were localized in solid sheets and nests at the peripheral area of the fibrinous exudation which were positive for B-lineage markers (CD20+, CD79a+, PAX-5+) and in situ hybridization of EBV-encoded RNA (EBER). PCR amplification showed clonal rearrangement of immunoglobulin heavy chain (IgH) genes. The patient was still alive with no recurrence in the 35-month follow-up after surgery. We also did a detailed clinicopathological analysis and literature review, which indicated that fa-DLBCL was a heterogeneous entity.


Assuntos
Biomarcadores Tumorais/análise , Fibrina/análise , Neoplasias Cardíacas/patologia , Linfoma Difuso de Grandes Células B/patologia , Mixoma/patologia , Biomarcadores Tumorais/genética , Genes de Cadeia Pesada de Imunoglobulina , Neoplasias Cardíacas/química , Neoplasias Cardíacas/cirurgia , Herpesvirus Humano 4/genética , Humanos , Linfoma Difuso de Grandes Células B/química , Linfoma Difuso de Grandes Células B/cirurgia , Linfoma Difuso de Grandes Células B/virologia , Masculino , Pessoa de Meia-Idade , Mixoma/química , Mixoma/cirurgia , RNA Viral/genética , Resultado do Tratamento
4.
J S Afr Vet Assoc ; 91(0): e1-e5, 2020 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-32787426

RESUMO

A 3-year-old, pregnant, Alpine Brown cow showed a rapidly growing, pedunculated, skin mass located at the umbilical region, reaching 8 kg in weight over a 3-month period after its initial detection. Six days after parturition, the mass was completely surgically excised. During the follow-up period, the cow remained in good health, without signs of recurrence, and showed increased milk production. Histological examination of the mass revealed a loose proliferation of spindle-shaped or stellate cells, immersed in an abundant myxoid matrix with admixed numerous thin-walled blood vessels. Immunohistochemically, the tumour cells were positive for vimentin, α-smooth muscle actin, and desmin. Gross and histopathological features were compatible with superficial angiomyxoma, a subtype of angiomyxoma rarely described in humans, but not in the veterinary literature. The tumour did not infiltrate into the surrounding tissues, and there was no post-excision recurrence after 3 months. The possibility of hormonal dependence of the tumour during pregnancy is discussed based on such findings in some human cases.


Assuntos
Doenças dos Bovinos/diagnóstico , Mixoma/veterinária , Neoplasias Cutâneas/veterinária , Animais , Bovinos , Doenças dos Bovinos/etiologia , Doenças dos Bovinos/cirurgia , Feminino , Mixoma/diagnóstico , Mixoma/etiologia , Mixoma/cirurgia , Gravidez , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/etiologia , Neoplasias Cutâneas/cirurgia
5.
J Card Surg ; 35(10): 2863-2865, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32720392

RESUMO

BACKGROUND: Cardiac myxomas are common and account for 50% of primary intracardiac tumors. Atypical locations of cardiac myxoma increase the risk of intraoperative iatrogenic injuries. Herein, we report a case of using three-dimensional printing (3D) to facilitate the removal of an atypical cardiac myxoma in a 63-year-old woman. METHODS AND RESULTS: Mass in the high posterior atrial septum was confirmed through imaging. Due to the potential involvement of the mass to surrounding vital structures, 3D printing of the cardiac mass was performed. The tumor was completely resected via median sternotomy and the resulting defect was repaired with the bovine pericardium. The patient had an uncomplicated postoperative course except for the development of sick sinus syndrome. One-year follow-up showed no tumor recurrent. CONCLUSION: 3D printing technology in patients with atypical cardiac tumors enhances our understanding of the extent of the tumor invasion and facilitates planning the operation to avoid intraoperative complications.


Assuntos
Procedimentos Cirúrgicos Cardíacos/métodos , Neoplasias Cardíacas/diagnóstico por imagem , Neoplasias Cardíacas/cirurgia , Doença Iatrogênica/prevenção & controle , Complicações Intraoperatórias/prevenção & controle , Modelos Anatômicos , Mixoma/diagnóstico por imagem , Mixoma/cirurgia , Impressão Tridimensional , Animais , Bioprótese , Bovinos , Feminino , Átrios do Coração/diagnóstico por imagem , Átrios do Coração/patologia , Átrios do Coração/cirurgia , Neoplasias Cardíacas/patologia , Septos Cardíacos/diagnóstico por imagem , Septos Cardíacos/cirurgia , Humanos , Pessoa de Meia-Idade , Mixoma/patologia , Invasividade Neoplásica , Pericárdio/transplante , Esternotomia/métodos , Tomografia Computadorizada por Raios X , Resultado do Tratamento
6.
J Card Surg ; 35(8): 2097-2099, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32652738

RESUMO

Cardiac myxomas are benign primer cardiac tumors of the heart. They can be fatal with a thromboembolic presentation. Myocardial infarction is one of these unusual thromboembolic presentations. We report a patient who presented with cardiac arrest due to ventricular fibrillation related to myocardial infarction. After successful resuscitation, coronary angiography and transthoracic echocardiography were performed. A left atrial mass was observed and interpreted as a possible cause of coronary embolism leading to myocardial infarction. After surgical excision, the pathological examination confirmed myxoma, which was the essential cause of the tendency to arterial embolism.


Assuntos
Trombose Coronária/diagnóstico por imagem , Trombose Coronária/etiologia , Neoplasias Cardíacas/complicações , Mixoma/complicações , Angiografia Coronária , Ecocardiografia , Feminino , Parada Cardíaca/etiologia , Neoplasias Cardíacas/diagnóstico por imagem , Neoplasias Cardíacas/cirurgia , Humanos , Pessoa de Meia-Idade , Infarto do Miocárdio/etiologia , Mixoma/diagnóstico por imagem , Mixoma/cirurgia , Fibrilação Ventricular/etiologia
7.
Khirurgiia (Mosk) ; (6): 114-117, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32573542

RESUMO

Patients with anterior mediastinum tumors fall into a difficult category due to high risk of invasion of vital structures and complexity of surgical correction. We report resection of recurrent hemangioma of anterior mediastinum with aortic arch replacement and simultaneous resection of left atrial myxoma in a 35-year-old woman. Successful treatment of these patients correlates with aggressive surgical approach followed by total resection of tumor and all affected vessels and other tissues.


Assuntos
Neoplasias Cardíacas/cirurgia , Hemangioma/cirurgia , Neoplasias do Mediastino/cirurgia , Mixoma/cirurgia , Recidiva Local de Neoplasia/cirurgia , Neoplasias Primárias Múltiplas/cirurgia , Adulto , Aorta Torácica/cirurgia , Implante de Prótese Vascular , Procedimentos Cirúrgicos Cardiovasculares/métodos , Feminino , Átrios do Coração/cirurgia , Humanos , Mediastino/cirurgia
11.
J Stroke Cerebrovasc Dis ; 29(6): 104796, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32220555

RESUMO

We administered intravenous thrombolytic therapy to a 51-year-old female patient with a 101-min stroke onset. The patient was unconscious during the manifestation of symptoms. Computed tomography angiography examination of the intracranial artery at the time of admission suggested that the left middle cerebral artery was occluded. The patient regained consciousness after the intravenous thrombolytic treatment was administered. On an urgent cerebral angiography, it was revealed that the recanalization of the left middle cerebral artery was successful. Although blood perfusion was restored, occlusion of the distal blood flow remained. The symptoms of the patient gradually improved after the treatment. However, 6 months after the onset of the condition, intracranial aneurysms formed distal to the recanalized arteries that were previously embolized. The full process underlying the development of cerebral embolism caused by atrial myxomas and subsequent formation of aneurysms is illustrated in this patient. Although the underlying mechanism remains unclear, intravenous thrombolysis can successfully restore cerebral blood flow in and may improve the prognosis of patients with cerebral embolism caused by cardiac myxoma. Despite the positive revascularization therapy, the occurrence of the complication of intracranial aneurysms is possible. Long-term follow-up to evaluate the progression of myxomatous aneurysms after cerebral embolism with conservative treatment may be a suitable strategy for managing such patients.


Assuntos
Fibrinolíticos/administração & dosagem , Neoplasias Cardíacas/complicações , Infarto da Artéria Cerebral Média/tratamento farmacológico , Aneurisma Intracraniano/etiologia , Embolia Intracraniana/etiologia , Mixoma/complicações , Células Neoplásicas Circulantes/patologia , Terapia Trombolítica , Ativador de Plasminogênio Tecidual/administração & dosagem , Administração Intravenosa , Feminino , Neoplasias Cardíacas/patologia , Neoplasias Cardíacas/cirurgia , Humanos , Infarto da Artéria Cerebral Média/diagnóstico por imagem , Infarto da Artéria Cerebral Média/etiologia , Aneurisma Intracraniano/diagnóstico por imagem , Aneurisma Intracraniano/patologia , Embolia Intracraniana/diagnóstico por imagem , Embolia Intracraniana/patologia , Pessoa de Meia-Idade , Mixoma/patologia , Mixoma/cirurgia , Fatores de Risco , Resultado do Tratamento
13.
J Med Case Rep ; 14(1): 29, 2020 Feb 13.
Artigo em Inglês | MEDLINE | ID: mdl-32051024

RESUMO

BACKGROUND: Atrial myxoma remains a rare clinical entity with an incidence of surgically resected cases of 0.5-0.7 per million population and prevalence of < 5 per 10,000. It typically manifests in woman after third decade of life; symptoms vary greatly and may present with arrhythmia, intracardiac flow obstruction, embolic phenomenon, and associated constitutional symptoms. Neurological complications associated with atrial myxoma most frequently include cerebral infarct due to embolus. Cerebellar involvement is very rare and only a few cases have been reported in the literature. CASE PRESENTATION: A 55-year-old Brahmin man with no history of diabetes mellitus and hypertension, presented with complaints of dizziness, headache, vomiting, double vision, and unsteadiness of gait for 2 weeks. His headache was sudden in onset, of a pulsating type and localized on left temporal side. Vomiting was projectile and bilious. Double vision was present in all directions of gaze and he had uncoordinated movement of his body and tilting to the left side. On examination, his cerebellar functions were impaired. He was thoroughly investigated for the cause of stroke after abnormal magnetic resonance imaging results with normal computed tomography angiography of his brain. Echocardiography and computed tomography of his chest showed a mass attached to intra-atrial septum and prolapsing through mitral valve, which was suggestive of left atrial myxoma. Five days following admission, he developed abdominal pain due to thromboembolism causing splenic and renal infarct. CONCLUSION: Although rare, atrial myxoma has to be considered a cause of stroke and other embolic phenomenon causing multiorgan infarctions. Early and timely diagnosis of the condition can prevent further recurrence and inappropriate anticoagulant therapy. It would be pertinent to have echocardiography done in patients who present with a stroke, arrhythmias, and other constitutional symptoms. The tumor once detected must be removed surgically as early as possible, which not only reduces serious thromboembolic complications but can be potentially curative.


Assuntos
Neoplasias Cardíacas/cirurgia , Mixoma/cirurgia , Átrios do Coração/diagnóstico por imagem , Átrios do Coração/patologia , Neoplasias Cardíacas/complicações , Neoplasias Cardíacas/diagnóstico por imagem , Neoplasias Cardíacas/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Mixoma/complicações , Mixoma/diagnóstico por imagem , Mixoma/patologia , Infarto do Baço/diagnóstico por imagem , Infarto do Baço/etiologia , Infarto do Baço/patologia , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/etiologia
14.
Monaldi Arch Chest Dis ; 90(1)2020 Jan 21.
Artigo em Inglês | MEDLINE | ID: mdl-31970966

RESUMO

We report a case of a recurrence of 5 cardiac myxomas in both atria with atypical anatomical features difficult to image. Although a multimodality imaging was performed, three-dimensional echocardiography (3DE) was the only technique able to correctly identify all the recurrences and the anatomical characteristics of the myxomas. MRI detected the blood supply of the mass but even after careful review was able to identify only 4 of the 5 lesions. Even though it was already reported the usefulness of 3DE to better delineate the site of attachment of cardiac tumors, it was never reported its sensibility in the setting of multiple myxomas; this case highlights the ability of the 3DE in this challenging scenario and its potential for being considered the key adjunctive modality for the anatomy when advanced surgical plan is required.


Assuntos
Ecocardiografia Tridimensional/métodos , Átrios do Coração/patologia , Mixoma/diagnóstico por imagem , Adulto , Feminino , Neoplasias Cardíacas/patologia , Humanos , Imagem por Ressonância Magnética/métodos , Mixoma/cirurgia , Recidiva Local de Neoplasia/cirurgia , Reoperação/métodos , Resultado do Tratamento
18.
J Card Surg ; 35(2): 507-510, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31872924

RESUMO

BACKGROUND: Cardiac myxoma is the most common type of primary cardiac tumors. It is known that inflammatory markers are increased in the setting of myxoma, like C-reactive protein, erythrocyte sedimentation rate, and interleukin-6. The association between cardiac myxoma and abnormal blood cell counts has been scarcely reported. RESULTS: We present a patient with a right atrial myxoma found incidentally, who had hypereosinophilia, which dramatically resolved after resection of the tumor. CONCLUSION: Hypereosinophilia has mostly been found in patients with heart malignancies. It is extremely uncommon in patients with cardiac myxoma; therefore, its presence may signify a distinct biological tumoral behavior with the potential to become a marker of disease activity or recurrence. The true significance of this finding is still unknown and requires further investigation.


Assuntos
Eosinofilia/complicações , Eosinofilia/cirurgia , Neoplasias Cardíacas/complicações , Neoplasias Cardíacas/cirurgia , Mixoma/complicações , Mixoma/cirurgia , Procedimentos Cirúrgicos Cardíacos/métodos , Átrios do Coração , Humanos , Achados Incidentais , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento
19.
Medicine (Baltimore) ; 98(51): e18386, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31861001

RESUMO

RATIONALE: Pulmonary embolisms (PEs) are caused by emboli, which mostly originate from deep venous thrombi that travel to and suddenly block the pulmonary arteries. The emboli are usually thrombi, and right atrial myxoma emboli are rare. PATIENT CONCERNS: A 55-year-old man presented with shortness of breath and syncope. We proceeded with computed tomography pulmonary angiography (CTPA) and transthoracic echocardiogram (TTE), the results of which suggested that the diagnosis was a right atrial mass. DIAGNOSIS: A definitive diagnosis compatible with a right atrial myxoma (RAM) with tumoral pulmonary emboli after surgical excision was made. INTERVENTION: Right atrial and pulmonary artery embolectomy. OUTCOMES: The patient followed an uneventful course during the 6 years of follow-up after surgery. According to a review of the literature, RAMs are often not diagnosed in a timely manner or even go completely undiagnosed. TTE, transesophageal echocardiography (TEE), CT, magnetic resonance imaging (MRI), and positron emission tomography/computed tomography may be helpful in the preoperative diagnosis. Surgical removal of the masses from the atrium and pulmonary arteries was relatively uneventful. LESSONS: RAMs should be considered unlikely reasons for fatal pulmonary embolisms.


Assuntos
Átrios do Coração/diagnóstico por imagem , Neoplasias Cardíacas/diagnóstico por imagem , Mixoma/diagnóstico por imagem , Embolia Pulmonar/etiologia , Angiografia por Tomografia Computadorizada , Ecocardiografia , Átrios do Coração/cirurgia , Neoplasias Cardíacas/patologia , Neoplasias Cardíacas/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Mixoma/patologia , Mixoma/cirurgia , Embolia Pulmonar/cirurgia
20.
Am J Case Rep ; 20: 1930-1935, 2019 Dec 24.
Artigo em Inglês | MEDLINE | ID: mdl-31871313

RESUMO

BACKGROUND Although left atrial myxoma is the most common benign primary cardiac tumor, infected atrial myxoma is rare. This report presents a case of infected left atrial myxoma with embolization to the left anterior descending (LAD) coronary artery, which was identified following an initial presentation with ST-elevation myocardial infarction (STEMI). CASE REPORT A 34-year-old man with a history of smoking tobacco and intravenous cocaine use presented to the emergency room with symptoms of a feeling of pressure on the chest and symptoms in the left arm. An electrocardiogram (ECG) showed ST elevation in leads II, III, aVF, and V3-V5, consistent with an anterior-inferior STEMI. He underwent percutaneous intervention (PCI) with two drug-eluting stents to the mid-distal LAD coronary artery. The patient also had fever, chills, a history of weight loss, and signs of peripheral emboli. Blood cultures identified Gram-positive Streptococcus parasanguinis, a member of the Streptococcus viridans group. Transesophageal echocardiogram (TEE) identified a large, mobile, pedunculated left atrial mass protruding into the mitral valve in diastole and mitral valve vegetations. Surgical excision and the histology confirmed a diagnosis of benign left atrial myxoma containing Gram-positive cocci. The patient required mitral valve replacement and a postoperative two-week course of gentamicin and a six-week course of ceftriaxone CONCLUSIONS A rare case is reported of infected left atrial myxoma presenting as STEMI secondary to coronary artery embolization, which was treated with PCI, antibiotics, and mitral valve replacement.


Assuntos
Neoplasias Cardíacas/microbiologia , Neoplasias Cardíacas/cirurgia , Mixoma/microbiologia , Mixoma/cirurgia , Infarto do Miocárdio com Supradesnível do Segmento ST/microbiologia , Adulto , Antibacterianos/uso terapêutico , Ceftriaxona/uso terapêutico , Angiografia Coronária , Trombose Coronária/cirurgia , Diagnóstico Diferencial , Ecocardiografia Transesofagiana , Eletrocardiografia , Gentamicinas/uso terapêutico , Humanos , Masculino , Intervenção Coronária Percutânea , Infecções Estreptocócicas/tratamento farmacológico , Infecções Estreptocócicas/microbiologia , Streptococcus/efeitos dos fármacos , Streptococcus/isolamento & purificação
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