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1.
Int Heart J ; 62(2): 453-457, 2021 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-33731526

RESUMO

Primary hemangioma of the mediastinum is extremely rare. Herein, we present a unique case of hemangioma mimicking left atrial mass in the posterior mediastinum. We reviewed the literature and found 17 other hemangiomas in the posterior mediastinum. Herein, we summarize the age, gender, symptoms, diagnostic methods, image diagnosis, size, treatments, histologic features, outcomes, and follow-up of 17 cases. Most of the cases were asymptomatic and were accidentally detected in chest radiographs. Diagnostic methods mainly included chest X-ray, computed tomography (CT), and magnetic resonance imaging (MRI). All patients underwent surgical resection, recovered well, and had no recurrence during follow-up.


Assuntos
Hemangioma/diagnóstico , Neoplasias do Mediastino/diagnóstico , Mediastino/diagnóstico por imagem , Idoso , Diagnóstico Diferencial , Átrios do Coração , Neoplasias Cardíacas/diagnóstico , Humanos , Imagem Cinética por Ressonância Magnética , Masculino , Tomografia Computadorizada por Raios X
2.
Int Heart J ; 62(2): 458-462, 2021 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-33731530

RESUMO

In this study, we present the case of a 34-year-old man who was diagnosed with primary cardiac angiosarcoma 1 month after hospital admission. Cardiac angiosarcoma is a relatively rare disease that can be easily misdiagnosed as pneumonia or other diseases. Although surgery is the preferred treatment to prolong survival time, highly malignant tumors with local infiltration and systemic metastasis can lead to poor prognosis.


Assuntos
Neoplasias Cardíacas/diagnóstico , Hemangiossarcoma/diagnóstico , Adulto , Diagnóstico Diferencial , Ecocardiografia , Átrios do Coração , Humanos , Masculino , Tomografia Computadorizada por Raios X
3.
Medicine (Baltimore) ; 100(10): e24033, 2021 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-33725817

RESUMO

INTRODUCTION: One of the purposes of echocardiography is to determine the nature of a space-occupying lesion. The conventional transthoracic echocardiogram (TTE) is the preferred method for the diagnosis of cardiac space-occupying lesions as it can reveal the baseline information. For patients with poor conditions, however, TTE cannot clearly display the boundary, it has a limited role in determining the nature of the lesions. PATIENT CONCERNS: A 47-year-old woman presented with intermittent fever for 7 days and chest distress/shortness of breath for 5 days. DIAGNOSIS: In our current case, we inferred the nature of space-occupying lesions in the left atrium more accurately using transesophageal echocardiography (TEE) than TTE, which may offer diagnostic evidence for surgical treatment. INTERVENTIONS: The patient underwent surgical resection of the left atrial tumor and reconstruction of the left atrial wall. However, the patient's posterior lobe of the mitral valve was infiltrated by tumor, which was difficult to completely remove. OUTCOMES: Echocardiography was performed 3 months after surgery and the tumor recurred in the posterior lobe of the mitral valve. Although almost all tumors have been removed by surgery, the average survival time is often less than 1 year, as it is difficult to completely remove and easy to relapse with poor prognosis. CONCLUSION: Transesophageal echocardiography (TEE) plays a relatively more important role in the determination and differential diagnosis of cardiac space-occupying lesions.


Assuntos
Ecocardiografia Transesofagiana , Átrios do Coração/diagnóstico por imagem , Neoplasias Cardíacas/diagnóstico , Sarcoma/diagnóstico , Procedimentos Cirúrgicos Cardíacos , Diagnóstico Diferencial , Feminino , Átrios do Coração/patologia , Átrios do Coração/cirurgia , Neoplasias Cardíacas/patologia , Neoplasias Cardíacas/cirurgia , Humanos , Pessoa de Meia-Idade , Sarcoma/patologia , Sarcoma/cirurgia , Tomografia Computadorizada por Raios X
4.
Intern Med ; 60(3): 373-378, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33518610

RESUMO

A 60-year-old man had received octreotide for a metastatic neuroendocrine tumor (NET) in the rectum. Computed tomography and ultrasonography revealed a cardiac tumor, diffuse thickness of the ventricular wall and pericardial effusion, which was diagnosed as cardiac metastasis. The metastatic lesions continued to grow despite the alteration of chemotherapy, and the patient complained of repeated syncope and was admitted to our hospital at 11 months after the diagnosis of cardiac metastasis. An electrocardiogram during syncope showed sustained ventricular tachycardia, which was considered to be caused by the cardiac metastasis. We herein report a case of NET with cardiac metastasis which caused lethal arrhythmia along with a review of the pertinent literature.


Assuntos
Neoplasias Cardíacas , Tumores Neuroendócrinos , Neoplasias Pancreáticas , Neoplasias Retais , Arritmias Cardíacas/diagnóstico , Arritmias Cardíacas/etiologia , Neoplasias Cardíacas/complicações , Neoplasias Cardíacas/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Tumores Neuroendócrinos/complicações , Tumores Neuroendócrinos/diagnóstico
6.
J Cardiothorac Surg ; 16(1): 1, 2021 Jan 06.
Artigo em Inglês | MEDLINE | ID: mdl-33407682

RESUMO

Cardiac lipoma is an uncommon primary cardiac tumor. With the advancement of diagnostic methods and treatment techniques, more cases of cardiac lipomas have been reported and suggest that the entity previously widely thought to display classic features may also show atypical findings. A systemic review of the rare cardiac tumor was done by searching the literature of cardiac lipoma. We endeavor to summarize the clinical features of the rare disease from pathogenesis to treatment. Literature of cardiac lipoma was retrospectively searched through PubMed and 255 cases of cardiac lipoma were included into this analysis. Cardiac lipomas can occur anywhere within the heart, 53.1% were located within the cardiac chambers, 32.5% in the pericardium, 10,7% within the myocardium and 3.7% involved multiple structures. More than half of the reported cardiac lipomas (66%) may be clinically symptomatic, presenting with symptoms ranging from chest discomfort to syncope depending on their size and location as well as extent of myocardial involvement. Noninvasive cardiac imaging has replaced the role of autopsy and cardiothoracic surgery in detection and diagnosis of cardiac lipomas. Most symptomatic patients (83.7%) were treated by resection of cardiac lipomas and 68.3% of asymptomatic patients also underwentprophylactic resection. Overgrowth and myocardial infiltration of lipomas may result in unsuccessful resection. Recurrence of cardiac lipomas was rare but reported in a few cases. The early detection and accurate diagnosis of cardiac lipoma is of great significance in clinical management, to avoid an unfavourable outcome due to overgrowth.


Assuntos
Neoplasias Cardíacas , Lipoma , Neoplasias Cardíacas/diagnóstico , Neoplasias Cardíacas/etiologia , Neoplasias Cardíacas/cirurgia , Humanos , Lipoma/diagnóstico , Lipoma/etiologia , Lipoma/cirurgia , Pericárdio , Doenças Raras
7.
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
8.
Heart Fail Clin ; 17(1): 121-133, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33220881

RESUMO

"Cardiac imaging is an essential tool in the field of cardio-oncology. Cardiovascular magnetic resonance (CMR) stands out for its accuracy, reproducibility, and ability to provide tissue characterization. These attributes are particularly helpful in screening and diagnosing cardiotoxicity, infiltrative disease, and inflammatory cardiac disease. The ability of CMR to detect subtle changes in cardiac function and tissue composition has made it a useful tool for understanding the pathophysiology of cardiotoxicity. Because of these unique features, CMR is gaining prominence in both the clinical and research aspects of cardio-oncology."


Assuntos
Cardiologia , Neoplasias Cardíacas/diagnóstico , Imagem Cinética por Ressonância Magnética/métodos , Oncologia , Humanos
9.
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
10.
J Card Surg ; 35(7): 1740-1742, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32484973

RESUMO

BACKGROUND AND AIMS: Lipomatous hypertrophy of the interatrial septum is an uncommon type of cardiac adipose tumor. It is extremely rare for these lesions to be located in the interventricular septum. METHODS: We report this case of incidentally diagnosed lipomatous hypertrophy of the interventricular septum with right ventricular outflow obstruction which caused minimal symptoms and Wolff-Parkinson-White pattern on EKG. CONCLUSION: We also discuss the diagnosis and management of this condition.


Assuntos
Neoplasias Cardíacas/diagnóstico , Neoplasias Cardíacas/cirurgia , Lipoma/diagnóstico , Lipoma/cirurgia , Neoplasias Lipomatosas/diagnóstico , Neoplasias Lipomatosas/cirurgia , Septo Interventricular/cirurgia , Procedimentos Cirúrgicos Cardíacos/métodos , Ecocardiografia Transesofagiana , Eletrocardiografia , Feminino , Neoplasias Cardíacas/patologia , Humanos , Hipertrofia , Lipoma/patologia , Imagem por Ressonância Magnética , Pessoa de Meia-Idade , Neoplasias Lipomatosas/patologia , Resultado do Tratamento , Septo Interventricular/patologia , Síndrome de Wolff-Parkinson-White
11.
J Card Surg ; 35(7): 1732-1735, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32484981

RESUMO

BACKGROUND: We encountered an extremely rare case of perivascular epithelioid cell tumor (PEComa) of the heart. CASE REPORT: A 54-year-old woman was admitted to our hospital because a solid mass developing in the left atrioventricular groove by computed tomography scans of the chest. Histologic examination of the resected tumor revealed that the tumor had proliferating fusiform or spheroid cells with clear cytoplasm. Immunostaining showed positive results for α-smooth muscle actin, a myogenic marker, and human melanin black-45 (HMB-45), leading to a diagnosis of PEComa. The patient was discharged uneventfully, and there was no recurrence for the last thirteen years postoperatively. CONCLUSIONS: We experienced a surgical case of PEComa primarily occurring in the heart. Although no sign of a recurrence is observed to date, we consider it necessary to follow up the case carefully.


Assuntos
Procedimentos Cirúrgicos Cardíacos/métodos , Neoplasias Cardíacas/cirurgia , Neoplasias de Células Epitelioides Perivasculares/cirurgia , Actinas/análise , Biomarcadores Tumorais/análise , Feminino , Neoplasias Cardíacas/diagnóstico , Neoplasias Cardíacas/patologia , Humanos , Antígenos Específicos de Melanoma/análise , Pessoa de Meia-Idade , Neoplasias de Células Epitelioides Perivasculares/diagnóstico , Neoplasias de Células Epitelioides Perivasculares/patologia , Doenças Raras , Tomografia Computadorizada por Raios X , Resultado do Tratamento
12.
J Cardiothorac Surg ; 15(1): 104, 2020 May 19.
Artigo em Inglês | MEDLINE | ID: mdl-32430055

RESUMO

BACKGROUND: Primary cardiac tumors are extremely rare. Most primary cardiac tumors are benign and around one quarter is malign. Sarcomas are accounting for 95% of these malign tumors and they show different histologies. The prognosis is poor with a mean survival of 3 months to 1 year, even with complete radical resection. We report the cases of two patients with primary cardiac sarcoma treated with surgery and radiation and/or chemotherapy. In addition we retrospectively collected data of patients with primary cardiac sarcoma treated between 2005 and 2019 with minimum follow-up of 12 months. Clinical characteristics, treatment modalities and outcomes were collected and analyzed. Finally a literature review was done. CASE PRESENTATION: The first patient presented with cerebellar infarction. When she developed a recurrence analysis showed a suspicious myocardial lesion for which irradical surgery (R2) was performed. Histopathology showed an intimal sarcoma of the left atrium. Postoperative radiotherapy was applied without complications. Three months after treatment multiple metastases were diagnosed and she died 13 months after initial diagnosis. The second patient presented with pericardial effusion. A tumor was found located in the right atrium and radical surgery was performed. Histopathology showed an angiosarcoma, without signs of metastases. Adjuvant radiotherapy was added because of close margins and based on high risk of recurrence and metastases it was decided to add chemotherapy. One year after finishing treatment, evaluation showed local recurrence together with pulmonary metastases. CONCLUSIONS: Surgery combined with postoperative radiotherapy is feasible in patients with resectable cardiac sarcoma. Distant metastases occur frequently. In patients with an irresectable sarcoma of the heart primary radiotherapy should be considered.


Assuntos
Neoplasias Cardíacas/diagnóstico , Sarcoma/diagnóstico , Neoplasias de Tecidos Moles/diagnóstico , Adolescente , Adulto , Idoso , Feminino , Neoplasias Cardíacas/patologia , Neoplasias Cardíacas/cirurgia , Hemangiossarcoma , Humanos , Neoplasias Pulmonares/secundário , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Prognóstico , Recidiva , Estudos Retrospectivos , Sarcoma/patologia , Sarcoma/cirurgia , Neoplasias de Tecidos Moles/patologia , Neoplasias de Tecidos Moles/cirurgia , Fatores de Tempo , Adulto Jovem
13.
Cesk Patol ; 56(1): 18-25, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32393042

RESUMO

Cardiac tumours represent a wide spectrum of neoplastic and non-neoplastic masses. Plenty of them, especially primary cardiac neoplasias, are rare diseases. Last revision of WHO classification introduced several changes in their histopathological assessment. Furthermore, an increasing amount of knowledge in molecular characteristics of the tumours bolstered discussion about the classification of primary cardiac sarcomas and primary intimal sarcoma of the heart became a hot topic of last years. This work aims at individual neoplastic and non-neoplastic cardiac tumours with focus at their characteristic histopathological features and main differential diagnoses.


Assuntos
Neoplasias Cardíacas , Sarcoma , Neoplasias de Tecidos Moles , Diagnóstico Diferencial , Neoplasias Cardíacas/diagnóstico , Humanos , Sarcoma/diagnóstico , Neoplasias de Tecidos Moles/diagnóstico
14.
Int J Hematol ; 112(1): 65-73, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32285360

RESUMO

The heart is a rare primary site of lymphoma, and cardiac involvement is thought to bring a poorer prognosis. A framework of known clinical presentations, diagnostic features, disease complications, treatments, and outcomes to improve prognostication was constructed by a systematic review in 2011. However, some aspects must be discussed further in light of recent advances in lymphoma research. We collected cardiac lymphoma case reports published from January 2009 to January 2019, collected statistics from each patient, and performed a systematic analysis. The epidemiological characteristics, clinical manifestations, treatments, responses, and survival of primary cardiac lymphoma (PCL) patients are described. We obtained 158 cases of heart lymphoma, of which 101 were defined as PCL. There were more male than female cases. Most cases were diffuse large B-cell lymphoma. Six cases of PCL in cardiac myxomas were described. Patients with arrhythmia had shorter progression-free survival compared those without (HR 0.334, 95% CI 0.112-0.999, log-rank P = 0.042). Surgery did not improve patients' long-term prognosis or reduce the risk of death within 1 month. These data suggest that central nervous system prophylaxis is necessary. The overall survival was longer than that in data from 1949 to 2009.


Assuntos
Neoplasias Cardíacas , Linfoma , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Arritmias Cardíacas/complicações , Arritmias Cardíacas/mortalidade , Feminino , Neoplasias Cardíacas/complicações , Neoplasias Cardíacas/diagnóstico , Neoplasias Cardíacas/mortalidade , Neoplasias Cardíacas/terapia , Humanos , Linfoma/complicações , Linfoma/diagnóstico , Linfoma/mortalidade , Linfoma/terapia , Linfoma Difuso de Grandes Células B , Masculino , Pessoa de Meia-Idade , Prognóstico , Sobrevida , Análise de Sobrevida , Fatores de Tempo , Adulto Jovem
15.
J Card Surg ; 35(5): 1132-1134, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32237173

RESUMO

BACKGROUND AND AIM: Lipomatous hypertrophy of the interatrial septum (LHIS), a fatty tumor, is usually diagnosed on both echo and CT/MRI imaging. Cases of LHIS located outside of the interatrial septum are extremely rare and rarer still are these cases large enough to cause symptoms. The clinical literature demonstrates a misunderstanding that fatty tumors outside the intra-atrial area represent lipomas. However, pathologic understanding of these fatty tumors is clear and is based on microscopic findings. METHODS: The tumor was removed by diving the base of attachment at the left ventricular apex via a median sternotomy on cardiopulmonary bypass. RESULTS: The patient made an uneventful recovery and remains well at 6 months postoperatively. CONCLUSIONS: On rare occasions, LHIS can arise from outside the interatrial septum. An LHIS can be differentiated from a lipoma by the presence of entrapped cardiac myocytes in LHIS, making it a pathological, rather than an anatomic, diagnosis.


Assuntos
Septo Interatrial/patologia , Átrios do Coração/patologia , Neoplasias Cardíacas/diagnóstico , Neoplasias Cardíacas/patologia , Septos Cardíacos/patologia , Lipoma/diagnóstico , Lipoma/patologia , Adulto , Procedimentos Cirúrgicos Cardíacos , Ponte Cardiopulmonar , Neoplasias Cardíacas/cirurgia , Humanos , Hipertrofia , Lipoma/cirurgia , Imagem por Ressonância Magnética , Masculino , Esternotomia , Tomografia Computadorizada por Raios X , Resultado do Tratamento
16.
BMJ Case Rep ; 13(3)2020 Mar 19.
Artigo em Inglês | MEDLINE | ID: mdl-32193186

RESUMO

A 37-year-old man was presented in outpatient clinic of cardiology department with symptoms of easy fatigability and progressive increasing generalised anasarca since 5 months. Echocardiogram showed large mass of 9.8×7.8 cm in size in right atrium, attached to interatrial septum. Urgent opinion of thoracic surgeon was taken and surgical excision of mass under cardiopulmonary bypass was done. The tumour was large, fragile and histology confirmed it as myxoma. The patient made a good recovery and his symptoms resolved completely on follow-up.


Assuntos
Átrios do Coração/cirurgia , Insuficiência Cardíaca/cirurgia , Neoplasias Cardíacas/cirurgia , Mixoma/cirurgia , Adulto , Diagnóstico Diferencial , Ecocardiografia , Neoplasias Cardíacas/diagnóstico , Humanos , Masculino , Mixoma/diagnóstico , Doenças Raras
17.
BMC Cardiovasc Disord ; 20(1): 149, 2020 03 25.
Artigo em Inglês | MEDLINE | ID: mdl-32213175

RESUMO

BACKGROUND: Cardiac myxoma (CM) is the most common type of primary cardiac tumors. The prevalence of primary cardiac tumors is 0.0017-0.28% in various autopsy studies. The clinical symptoms of CM which includes embolism, intracardiac obstruction, general or constitutional manifestations and infected myxoma are largely depended on the size, growing speed, location and pedicle length of the tumor. The following case reported a missed diagnostic case of a right atrial myxoma firstly presented digestive, systemic symptoms and immunologic disorder, leading to emergent tricuspid valves obstruction situation. CASE PRESENTATION: We reported a critical case of a 51-year-old female with CM was firstly admitted to the gastroenterology clinical department because of poor appetite, marked fatigability and weight loss for 2 months. The physician diagnosed her as chronic gastritis and treated her with some symptomatic treatment such as ilaprazole and magnesium aluminum carbonate. After months without definitive diagnosis, this right atrial myxoma grew into right ventricle and obstructed the tricuspid valves, causing her dyspnea, sweating, dizziness, feeling of impending death when she was sleeping. Transthoracic echocardiogram revealed a 6.1 × 4.2 × 3.7 cm2 mass adjacent to tricuspid valves. The patient underwent surgical excision and pathology revealed a primary cardiac myxoma. CONCLUSION: This case reported a critical result of missed diagnosis of right atrial myxoma and showed its systematic symptoms and immunologic disorder, highlighting the importance of systematic examinations on patients. Furthermore, it appeals early diagnosis of CM and consideration of drug targets to suppress CM development.


Assuntos
Fadiga/etiologia , Transtornos da Alimentação e da Ingestão de Alimentos/etiologia , Neoplasias Cardíacas/diagnóstico , Mixoma/diagnóstico , Perda de Peso , Regulação do Apetite , Erros de Diagnóstico , Fadiga/fisiopatologia , Transtornos da Alimentação e da Ingestão de Alimentos/fisiopatologia , Feminino , Átrios do Coração , Neoplasias Cardíacas/complicações , Neoplasias Cardíacas/cirurgia , Humanos , Pessoa de Meia-Idade , Mixoma/complicações , Mixoma/cirurgia , Valor Preditivo dos Testes , Resultado do Tratamento
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