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1.
BMJ Case Rep ; 14(1)2021 Jan 18.
Artigo em Inglês | MEDLINE | ID: mdl-33461997

RESUMO

Primary cardiac valve tumours are rare. This is a case report of a 32-year-old non-smoker man with a history of stroke 1 year prior and no other cardiovascular risk factors. The patient was admitted to our acute stroke ward for recurrent left hemiparesis, slurring of speech, facial asymmetry and central retinal artery occlusion. Initial laboratory investigations and ECG were normal. An urgent CT brain showed a large hypodense area at the right frontal, parietal, temporal, occipital region with effaced sulci and right lateral ventricle with midline shift and cerebral oedema in keeping with acute infarction. We proceeded with CT angiography of the cerebral and carotid on the following day, which revealed no evidence of thrombosis, aneurysm or arteriovenous malformation. There were no abnormal beaded vessels to suggest vasculitis. Transthoracic echocardiography revealed a large mobile mass in the left atrium. Meanwhile, MRI cardiac confirmed a large ill-defined mobile solid mass attached to the mitral valve's inferoseptal component suggestive of mitral valve myxoma. This case report highlights the significance of considering a cardiogenic source of emboli in patients with large cerebral infarcts and other cardiac embolic phenomena. Imaging modalities such as echocardiography and cardiac MRI will help detect treatable conditions, such as valvular myxoma and prevent further complications.


Assuntos
Ecocardiografia , Neoplasias Cardíacas/diagnóstico por imagem , Mixoma/diagnóstico por imagem , Oclusão da Artéria Retiniana/etiologia , Tomografia Computadorizada por Raios X , Adulto , Neoplasias Cardíacas/complicações , Humanos , Masculino , Valva Mitral/diagnóstico por imagem , Valva Mitral/patologia , Mixoma/complicações , Oclusão da Artéria Retiniana/diagnóstico
2.
BMJ Case Rep ; 14(1)2021 Jan 20.
Artigo em Inglês | MEDLINE | ID: mdl-33472808

RESUMO

We report a rare case of cardiac angiosarcoma in a young boy who presented with cardiac tamponade. His initial symptoms were non-specific. He was initially being managed in the line of fungal infection, with a possibility of malignancy. Cardiac imaging was also not conclusive and he worsened on antibiotics and antifungals and succumbed to the illness. After his death tissue biopsy from heart and lung was done and histopathological examination revealed the diagnosis of metastatic angiosarcoma. The case highlights the importance of considering the diagnosis of cardiac angiosarcoma in the patients presenting with haemorrhagic pericardial effusion and non-specific symptoms.


Assuntos
Tamponamento Cardíaco/etiologia , Neoplasias Cardíacas/complicações , Hemangiossarcoma/complicações , Derrame Pericárdico/etiologia , Tamponamento Cardíaco/diagnóstico por imagem , Tamponamento Cardíaco/terapia , Drenagem , Ecocardiografia , Evolução Fatal , Átrios do Coração , Neoplasias Cardíacas/diagnóstico por imagem , Neoplasias Cardíacas/patologia , Hemangiossarcoma/diagnóstico por imagem , Hemangiossarcoma/patologia , Hemangiossarcoma/secundário , Humanos , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/secundário , Imagem por Ressonância Magnética , Masculino , Derrame Pericárdico/diagnóstico por imagem , Derrame Pericárdico/terapia , Choque/etiologia , Tomografia Computadorizada por Raios X , Adulto Jovem
3.
BMC Surg ; 21(1): 64, 2021 Jan 29.
Artigo em Inglês | MEDLINE | ID: mdl-33514381

RESUMO

BACKGROUND: Myxoma is an uncommon disease and its symptoms vary greatly depending on size, location and mobility. Right-sided myxoma, especially right ventricular myxoma, is much rarer, and the symptoms are alien and uncharacteristic. The lack of understandings poses challenges to prompt diagnosis and timely treatment. CASE PRESENTATION: A 44-year-old female patient was diagnosed with giant right ventricular tumor. Right heart failure and systemic congestion caused by right ventricular outflow tract obstruction were observed on this case. Surgery was performed to excise the mass which was measured at 9.5 * 5.0 cm and confirmed as myxoma pathologically. CONCLUSIONS: Right-side myxoma is easy to be unnoticed due to its low incident rate and atypical symptoms. Delay in surgical intervention might cause unrecoverable complications. More comprehensive understanding of the symptoms is expected to help improving the diagnose and treat of right-sided myxoma.


Assuntos
Neoplasias Cardíacas/complicações , Neoplasias Cardíacas/cirurgia , Mixoma/complicações , Mixoma/cirurgia , Adulto , Feminino , Insuficiência Cardíaca/etiologia , Insuficiência Cardíaca/cirurgia , Neoplasias Cardíacas/diagnóstico por imagem , Ventrículos do Coração/diagnóstico por imagem , Ventrículos do Coração/cirurgia , Humanos , Mixoma/diagnóstico por imagem , Doenças Raras , Resultado do Tratamento
4.
BMJ Case Rep ; 14(1)2021 Jan 11.
Artigo em Inglês | MEDLINE | ID: mdl-33431472

RESUMO

A previously well 48-year-old man presented with presyncope and was found to be in complete heart block. Blood tests, echocardiography and coronary angiography were reported as normal, and a dual chamber permanent pacemaker was inserted. Six months later he re-presented with breathlessness. His chest X-ray showed cardiomegaly and echocardiography revealed a 4.4 cm pericardial effusion. A CT thorax revealed a mass originating from the intra-atrial septum, extending into the right atrium and ventricle. There were multiple pulmonary lesions suspected to be metastases. Histology demonstrated high-grade B-cell lymphoma. He was treated with eight cycles of R-CHOP chemotherapy and showed good radiological and clinical improvement. Post-treatment echocardiography found severe left ventricular dysfunction with an ejection fraction of <20%. Heart failure medical therapy was optimised and the pacemaker was upgraded to a resynchronisation device. A repeat scan 6 months post device upgrade showed an improvement in ejection fraction to 45%-50%.


Assuntos
Bloqueio Cardíaco/etiologia , Neoplasias Cardíacas/complicações , Neoplasias Cardíacas/diagnóstico , Linfoma de Células B/complicações , Linfoma de Células B/diagnóstico , Bloqueio Cardíaco/diagnóstico , Bloqueio Cardíaco/terapia , Neoplasias Cardíacas/terapia , Humanos , Linfoma de Células B/terapia , Masculino , Pessoa de Meia-Idade
5.
Cardiovasc Pathol ; 50: 107266, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-32814149

RESUMO

We report a case of a 75-year-old female post orthotopic heart transplantation, who presented to the emergency department with a six-week history of shortness of breath, hand tremor and ultimately delirium. She had lobular breast carcinoma more than 5 years prior to her heart transplant, treated by lumpectomy followed by anthracycline based chemotherapy. The reason for her heart transplant was heart failure that was suspected to be from anthracycline cardiomyopathy, however, her explanted heart actually showed cardiac sarcoidosis. She was placed on long-term immunosuppression with tacrolimus, mycophenolate mofetil and prednisone. Two years after her heart transplant, she underwent bilateral mastectomies for recurrent breast cancer. Her neurological workup, including brain imaging (CT, MRI, LP and EEG) did not show any structural abnormalities, ischemia, mass or neurosarcoidosis as cause for delirium. Tacrolimus was held due to renal dysfunction and hemolytic anemia, and then she developed signs of right heart failure so an endomyocardial biopsy was carried out for suspected allograft rejection. The biopsy did not show any evidence of cellular or antibody medicated rejection; however, it demonstrated infiltration by bland appearing cells with signet ring morphology cells many of which showed intracytoplasmic mucin. The cells were strongly positive with cytokeratins AE1/3, CK7 and mammaglobin. The morphology and immunoprofile were consistent with metastatic lobular breast carcinoma and this was thought to be the cause of her clinical presentation with delirium, hemolytic anemia and renal dysfunction as a paraneoplastic syndrome.


Assuntos
Carcinoma Lobular/secundário , Insuficiência Cardíaca/cirurgia , Neoplasias Cardíacas/secundário , Transplante de Coração , Miocárdio/patologia , Idoso , Antraciclinas/efeitos adversos , Antibióticos Antineoplásicos/efeitos adversos , Biópsia , Carcinoma Lobular/complicações , Carcinoma Lobular/terapia , Cardiomiopatias/induzido quimicamente , Cardiotoxicidade , Quimioterapia Adjuvante , Feminino , Insuficiência Cardíaca/etiologia , Neoplasias Cardíacas/complicações , Neoplasias Cardíacas/terapia , Transplante de Coração/efeitos adversos , Humanos , Síndromes Paraneoplásicas/etiologia , Valor Preditivo dos Testes , Fatores de Risco , Sarcoidose/complicações
6.
BMJ Case Rep ; 13(12)2020 Dec 17.
Artigo em Inglês | MEDLINE | ID: mdl-33334748

RESUMO

While cardiac myxomas are the most common primary cardiac tumours, their overall incidence remains rare. Most cases (90%) are sporadic and occur in the third-sixth decades of life with a female predominance and have a specific predilection for the left atrium (75%). While often asymptomatic, clinical presentations depend on the tumour size, architecture and location. Echocardiography remains the mainstay for diagnostic evaluation. Tumour resection is the only definitive treatment. Histopathology using H&E and immunohistochemical stains, such as calretinin and CD34, confirms the diagnosis. We present a case of a patient with reported history of asthma who presented with recurrent acute on chronic shortness of breath refractory to inhaler therapy, multiple outpatient visits and hospitalisations for 'asthma exacerbations'. After further evaluation, she was diagnosed with a left atrial myxoma attached to the inferior aspect of the intra-atrial septum complicated by severe functional mitral stenosis.


Assuntos
Dispneia/etiologia , Neoplasias Cardíacas/diagnóstico , Estenose da Valva Mitral/diagnóstico , Mixoma/diagnóstico , Asma/diagnóstico , Ponte Cardiopulmonar , Angiografia por Tomografia Computadorizada , Diagnóstico Diferencial , Dispneia/cirurgia , Ecocardiografia , Eletrocardiografia , Feminino , Átrios do Coração/diagnóstico por imagem , Átrios do Coração/patologia , Neoplasias Cardíacas/complicações , Neoplasias Cardíacas/patologia , Neoplasias Cardíacas/cirurgia , Humanos , Pessoa de Meia-Idade , Estenose da Valva Mitral/etiologia , Estenose da Valva Mitral/cirurgia , Mixoma/complicações , Mixoma/patologia , Mixoma/cirurgia , Esternotomia , Resultado do Tratamento
7.
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
8.
J Card Surg ; 35(10): 2802-2803, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33043656

RESUMO

We present the clinical case of a 60-year-old woman complained of dyspnea on exertion. Echocardiogram showed a giant mass in the right ventricle (RV) with obstruction to the outflow tract. Thorax computed tomography confirmed a mass of greater than 60 mm infiltrating RV and causing severe stenosis in the pulmonary artery, with severe pericardial effusion. Cardiac surgery was performed for tumor resection and pulmonary root replacement with a biological valved conduit. Histological analysis diagnosed a poorly differentiated large-cell neuroendocrine carcinoma. The patient had no immediate postoperative complications and has completed radiotherapy at a 9-month follow-up.


Assuntos
Carcinoma Neuroendócrino/diagnóstico por imagem , Carcinoma Neuroendócrino/cirurgia , Procedimentos Cirúrgicos Cardíacos/métodos , Ecocardiografia , Neoplasias Cardíacas/diagnóstico por imagem , Neoplasias Cardíacas/cirurgia , Ventrículos do Coração/diagnóstico por imagem , Ventrículos do Coração/cirurgia , Artéria Pulmonar/diagnóstico por imagem , Artéria Pulmonar/cirurgia , Tomografia Computadorizada por Raios X , Implante de Prótese Vascular/métodos , Carcinoma Neuroendócrino/complicações , Carcinoma Neuroendócrino/patologia , Constrição Patológica/diagnóstico por imagem , Constrição Patológica/etiologia , Constrição Patológica/cirurgia , Feminino , Neoplasias Cardíacas/complicações , Neoplasias Cardíacas/patologia , Ventrículos do Coração/patologia , Humanos , Pessoa de Meia-Idade , Derrame Pericárdico/diagnóstico por imagem , Derrame Pericárdico/etiologia , Artéria Pulmonar/patologia , Índice de Gravidade de Doença , Resultado do Tratamento
9.
Rev. chil. cardiol ; 39(2): 147-153, ago. 2020. graf
Artigo em Espanhol | LILACS | ID: biblio-1138527

RESUMO

Abstract: A 49-year-old woman presented with dyspnea and palpitations, leading to Functional Class III.An echocardiogram showed a heterogeneous mass adhered to the right heart cavities. This was confirmed by NMR. A large right coronary artery was occluded in relation to the tumor, which was hyper vascularized. Resection of the tumor was performed; the right ventricular wall was sutured, and an atrial defect was closed using pericardial tissue. Post operative course was uneventful and she was asymptomatic 4 years after surgery.


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Paraganglioma/cirurgia , Neoplasias Cardíacas/cirurgia , Paraganglioma/complicações , Paraganglioma/diagnóstico por imagem , Angiografia , Espectroscopia de Ressonância Magnética , Dispneia/etiologia , Neoplasias Cardíacas/complicações , Neoplasias Cardíacas/diagnóstico por imagem
10.
Cardiovasc Pathol ; 49: 107244, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32652483

RESUMO

Cardiac myxoma is a rare benign neoplasm of the heart. Historically myxomas were incidental findings during autopsies, however improved imaging techniques made these diagnosis possible in living patients, making the surgical treatment of these neoplasms achievable. Cardiac myxomas may occur both sporadically and in a familial context, often in the clinico-pathological picture of the Carney complex. While familial myxomas occur in the context of well-known genetic mutations, the molecular etiology of sporadically occurring myxomas is still not completely clear. We must note however that many of the patients affected by myxomas are asymptomatic; when symptoms are present they are often nonspecific and hard to decipher, especially when referring to sporadically occurring heart myxomas. In this paper we describe a case of sudden death from the massive embolization of a left atrial cardiac myxoma. We also reviewed all the cases in the literature of sudden death from heart myxoma embolism. An accurate epidemiology of heart myxomas would be the key to outline the best treatment practices and the etiology of sporadic myxomas, nevertheless this target could only be pursued with a deep revaluation of the clinical autopsy as a fundamental diagnostic tool.


Assuntos
Morte Súbita/etiologia , Embolia/etiologia , Neoplasias Cardíacas/complicações , Mixoma/complicações , Células Neoplásicas Circulantes/patologia , Adulto , Autopsia , Biópsia , Causas de Morte , Morte Súbita/patologia , Embolia/patologia , Evolução Fatal , Neoplasias Cardíacas/patologia , Humanos , Masculino , Mixoma/patologia
11.
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
12.
Methodist Debakey Cardiovasc J ; 16(2): 158-161, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32670477

RESUMO

The incidence of primary cardiac tumors is exceedingly rare, whereas secondary cardiac tumors are more common in the global population. Cardiac involvement is seen in approximately 18% of patients with non-Hodgkin's lymphoma at the time of autopsy. Clinical manifestations of cardiac involvement are subtle and often go unrecognized until advanced stages of the disease. We present a rare case of metastatic cardiac lymphoma that presented as an ST-segment elevation myocardial infarction complicated by left ventricular free wall rupture and cardiogenic shock due to transmural myocardial necrosis from malignant cell infiltration.


Assuntos
Neoplasias Cardíacas/complicações , Ruptura Cardíaca Pós-Infarto/etiologia , Linfoma Extranodal de Células T-NK/complicações , Miocárdio/patologia , Infarto do Miocárdio com Supradesnível do Segmento ST/etiologia , Choque Cardiogênico/etiologia , Evolução Fatal , Neoplasias Cardíacas/diagnóstico por imagem , Neoplasias Cardíacas/patologia , Neoplasias Cardíacas/terapia , Ruptura Cardíaca Pós-Infarto/diagnóstico por imagem , Ruptura Cardíaca Pós-Infarto/patologia , Ruptura Cardíaca Pós-Infarto/terapia , Humanos , Linfoma Extranodal de Células T-NK/diagnóstico por imagem , Linfoma Extranodal de Células T-NK/patologia , Linfoma Extranodal de Células T-NK/terapia , Necrose , Recidiva , Infarto do Miocárdio com Supradesnível do Segmento ST/diagnóstico por imagem , Infarto do Miocárdio com Supradesnível do Segmento ST/patologia , Infarto do Miocárdio com Supradesnível do Segmento ST/terapia , Choque Cardiogênico/diagnóstico , Choque Cardiogênico/terapia
15.
Virchows Arch ; 477(4): 603-607, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32372222

RESUMO

Three cases of unexpected/sudden death (N = 2) or acute heart failure (N = 1) were investigated in our centre. The first patient died unexpectedly after surgery for cardiac tamponade and constrictive pericarditis; at autopsy, gross features mimicked a pericardial mesothelioma. The second patient died suddenly after recovering from a respiratory insufficiency episode; autopsy revealed an epicardial mass encircling the right coronary artery. The third patient presenting symptoms mimicked a fulminant myocarditis and she underwent endomyocardial biopsy. In all cases, histology disclosed a diffuse large B cell non-Hodgkin lymphoma, localized to the pericardium together with the right ventricle and the conduction system, to the epicardium and the right coronary artery or to the myocardium, respectively. Histology was crucial for the diagnosis, the atypical presentation favouring other diagnostic hypotheses. Although primary cardiac lymphoma is uncommon and usually shows a sub-acute onset, it may also cause unexpected/sudden death or acute heart failure.


Assuntos
Morte Súbita Cardíaca/etiologia , Insuficiência Cardíaca/etiologia , Neoplasias Cardíacas/complicações , Linfoma Difuso de Grandes Células B/complicações , Miocárdio/patologia , Doença Aguda , Idoso , Autopsia , Biomarcadores Tumorais/análise , Biópsia , Causas de Morte , Morte Súbita Cardíaca/patologia , Evolução Fatal , Feminino , Insuficiência Cardíaca/patologia , Neoplasias Cardíacas/imunologia , Neoplasias Cardíacas/patologia , Humanos , Linfoma Difuso de Grandes Células B/imunologia , Linfoma Difuso de Grandes Células B/patologia , Masculino , Pessoa de Meia-Idade , Miocárdio/imunologia
16.
J Cardiothorac Surg ; 15(1): 71, 2020 May 04.
Artigo em Inglês | MEDLINE | ID: mdl-32366268

RESUMO

BACKGROUND: Primary undifferentiated spindle cell sarcoma in the right ventricle is an extremely rare tumor. Radical surgical excision is the optimal treatment for long-term survival due to poor response to chemotherapy or radiotherapy at an advanced stage. CASE PRESENTATION: A 42-year-old man with no previous medical history presented with mild dyspnea on exertion and abdominal distension that lasted a week. Computed tomography (CT) revealed a huge homogeneous mass completely obstructing the right ventricle and extending into the pulmonary trunk. However, he suddenly collapsed the next day while on his way to an echocardiography. An extracorporeal membrane oxygenation (ECMO) device was inserted percutaneously and ECMO support was urgently initiated. Based on consideration of right ventricular outflow tract (RVOT) obstruction in the initial CT scan, we decided to remove the mass from the right ventricle immediately. The main mass was resected to relieve the RVOT obstruction, and after the operation, the ECMO was removed from the operation room. However, the patient failed to regain consciousness and electroencephalography (EEG) and subsequent magnetic resonance imaging (MRI) indicated severe hypoxic brain damage. We assume CPR was unsuccessful because the mass completely blocked the RVOT. Pathology revealed the mass was an undifferentiated spindle cell sarcoma. CONCLUSIONS: We present the case of a 42-year-old male with cardiac arrest due to right ventricular outflow tract obstruction by a tumor of the right ventricle. Surgical resection was performed and in histopathology it was proved to be an undifferentiated spindle cell sarcoma.


Assuntos
Neoplasias Cardíacas/diagnóstico por imagem , Sarcoma/diagnóstico por imagem , Obstrução do Fluxo Ventricular Externo/diagnóstico por imagem , Adulto , Reanimação Cardiopulmonar , Dispneia/etiologia , Ecocardiografia , Oxigenação por Membrana Extracorpórea , Parada Cardíaca/etiologia , Parada Cardíaca/terapia , Neoplasias Cardíacas/complicações , Neoplasias Cardíacas/patologia , Neoplasias Cardíacas/cirurgia , Ventrículos do Coração , Humanos , Hipóxia Encefálica/etiologia , Imagem por Ressonância Magnética , Masculino , Artéria Pulmonar , Sarcoma/complicações , Sarcoma/patologia , Sarcoma/cirurgia , Tomografia Computadorizada por Raios X , Obstrução do Fluxo Ventricular Externo/etiologia , Obstrução do Fluxo Ventricular Externo/patologia , Obstrução do Fluxo Ventricular Externo/cirurgia
17.
Kyobu Geka ; 73(3): 227-229, 2020 Mar.
Artigo em Japonês | MEDLINE | ID: mdl-32393707

RESUMO

We report a case of a 79-year-old woman with a right atrial mass. She had a history of hypertension, idiopathic thrombocytopenic purpura, and chronic atrial fibrillation. Computed tomography and transthoracic echocardiography showed a 31×31 mm mass in the right atrium. Though it was considered to be a thrombus at first, it did not become smaller despite anticoagulation, and tumor was suspected. To prevent onset of pulmonary embolism, she underwent surgery and the mass was removed. Pathological examination confirmed that it was a thrombus. Her postoperative course was uneventful.


Assuntos
Fibrilação Atrial , Neoplasias Cardíacas/complicações , Neoplasias , Trombose , Idoso , Fibrilação Atrial/etiologia , Feminino , Átrios do Coração , Humanos , Trombose/etiologia
18.
Kyobu Geka ; 73(2): 108-112, 2020 Feb.
Artigo em Japonês | MEDLINE | ID: mdl-32393716

RESUMO

We present a case of palliative pleuro-peritoneal shunt for refractory hydrothorax complicated with unresectable cardiac tumor. The patient was a 77-year-old woman, who was admitted to our hospital for evaluation of intractable pleural effusion. It was attributed to severe diastolic dysfunction associated with cardiac tumor. The cardiac tumor occupied a large area of the anterior surface of the right atrium, and curative surgical resection was difficult. Therefore, we planned multidisciplinary staged treatment with chemotherapy followed by tumor excision. Persistent intractable bilateral pleural effusion necessitated repeat chest drainage. To maintain the patient's quality of daily life, bilateral pleuro-peritoneal shunts were inserted. Then, the problem of pleural effusion was resolved and her symptoms were improved. However, she expired 3 months later, due to deterioration of general condition. Pleuro-peritoneal shunting is a useful palliative approach to improve quality of life in patients with refractory hydrothorax.


Assuntos
Neoplasias Cardíacas , Derrame Pleural , Idoso , Feminino , Neoplasias Cardíacas/complicações , Humanos , Hidrotórax , Pleura , Derrame Pleural/etiologia , Qualidade de Vida
19.
Pediatr Pulmonol ; 55(6): E1-E3, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32243731

RESUMO

Cardiac myxomas are rare occurrences in pediatric populations, as are pulmonary artery aneurysms. We report a 17-year-old adolescent with right atrial cardiac myxoma and concomitant multiple peripheral pulmonary artery aneurysms. Histological examination indicated infiltration of the pulmonary artery wall through the embolic cardiac myxoma cells, thereby weakening it. This report highlights the probable causal relationship between these two entities, proposes the possible pathomechanism and presents the diagnostic and therapeutic dilemmas in the management of this condition.


Assuntos
Aneurisma/complicações , Neoplasias Cardíacas/complicações , Mixoma/complicações , Artéria Pulmonar/patologia , Adolescente , Aneurisma/patologia , Neoplasias Cardíacas/patologia , Humanos , Masculino , Mixoma/patologia
20.
Diagn Pathol ; 15(1): 32, 2020 Apr 03.
Artigo em Inglês | MEDLINE | ID: mdl-32245475

RESUMO

BACKGROUND: Neuroendocrine tumors (NETs) can secrete bioactive amines in the bloodstream, resulting in the carcinoid syndrome characterized by diarrhea and flushing. The frequency of occurrence of primary cardiac neuroendocrine neoplasms is lesser than that of metastases, and hence, metastases must be adequately ruled out before diagnosis. Cardiac tumors, both primary and metastatic, mainly result in heart-related symptoms, such as heart failure and acquired valvular dysfunction. Here, we report a unique case of a primary left ventricular neuroendocrine tumor presenting with diarrhea. CASE PRESENTATION: A 51-year-old female complaining of intermittent diarrhea for 2 years was admitted to our hospital. Enhancement of total abdominal computed tomography scan, echocardiography, and magnetic resonance imaging indicated a mass in the left ventricle. The indexes of myocardial enzymes were normal. Histologically, round cells with well-differentiated neuroendocrine morphology were arranged in typical pseudo-glandular, trabecular, ribbon-like, and solid nest patterns. Immunohistochemically, the tumor cells were positive for cytokeratin, chromogranin, synaptophysin, and CD56. However, they were negative for caudal type homeobox 2, S100, paired box gene 8, thyroid transcription factor 1, and CD20, which ruled out the origin of gastrointestinal, pancreatic, lung, and Merkel cell carcinomas. The symptoms of diarrhea disappeared after the operation. The patient was asymptomatic at the 9-month follow-up. CONCLUSION: Cardiac neuroendocrine tumors with diarrhea are considerably rare and related clinical research is limited. We presented a case and reviewed related articles to improve the identification, diagnosis, and management of patients with cardiac neuroendocrine tumors. The site of origin of a neuroendocrine tumor is clinically vital, and identification of an occult primary tumor using imaging modalities is necessary. Immunohistochemistry is well-suited to indicate the origin of the tumor. Regular follow-up is necessary for both poorly differentiated and well-differentiated cardiac neuroendocrine tumors. It is suggested to detect some neuroendocrinal markers for patients with unexplained reasons of diarrhea.


Assuntos
Neoplasias Cardíacas/complicações , Neoplasias Cardíacas/patologia , Tumores Neuroendócrinos/complicações , Tumores Neuroendócrinos/patologia , Procedimentos Cirúrgicos Cardíacos/métodos , Diarreia/etiologia , Feminino , Neoplasias Cardíacas/cirurgia , Ventrículos do Coração/patologia , Ventrículos do Coração/cirurgia , Humanos , Pessoa de Meia-Idade , Tumores Neuroendócrinos/cirurgia
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