[Primary cardiac angiosarcoma: an unexpected presentation]. / Angiosarcoma cardiaco primitivo: una manifestazione clinica inaspettata.

Among cardiac tumors, angiosarcoma is the most common primary malignancy, with a relatively higher prevalence in young male adults and a weak dominance in the right atrium as a primary site of growth. It is characterized by rapid infiltration of cardiac structures and possible metastasis to mediastinal and distant organs. The patient may be asymptomatic until advanced phases. It therefore has a poor prognosis. Diagnosis requires the use of multimodality imaging, including echocardiography, computed tomography (CT), cardiac magnetic resonance and positron emission tomography. The definitive diagnosis is based on histological examination. We report the case of a young male adult who was referred to the cardiology department for a syncopal event 5 h after cocaine assumption. During the diagnostic work-up, a chest X-ray was performed, showing multiple pulmonary lesions, which were evaluated with a chest CT highlighting the presence of a cardiac mass in the right atrium and ventricle. For this reason, a complete cardiological evaluation was performed. The clinical and instrumental suspicion of a malignant cardiac tumor was confirmed by multimodality imaging and finally by histological examination.

Phase I clinical trial of intracerebroventricular transplantation of allogeneic neural stem cells in people with progressive multiple sclerosis.

We report the analysis of 1 year of data from the first cohort of 15 patients enrolled in an open-label, first-in-human, dose-escalation phase I study (ClinicalTrials.gov: NCT03282760, EudraCT2015-004855-37) to determine the feasibility, safety, and tolerability of the transplantation of allogeneic human neural stem/progenitor cells (hNSCs) for the treatment of secondary progressive multiple sclerosis. Participants were treated with hNSCs delivered via intracerebroventricular injection in combination with an immunosuppressive regimen. No treatment-related deaths nor serious adverse events (AEs) were observed. All participants displayed stability of clinical and laboratory outcomes, as well as lesion load and brain activity (MRI), compared with the study entry. Longitudinal metabolomics and lipidomics of biological fluids identified time- and dose-dependent responses with increased levels of acyl-carnitines and fatty acids in the cerebrospinal fluid (CSF). The absence of AEs and the stability of functional and structural outcomes are reassuring and represent a milestone for the safe translation of stem cells into regenerative medicines.