scholarly journals Surgical Treatment of Cardiac Myxomas: A 23-Case Experience

2018 ◽  
Vol 21 (5) ◽  
pp. E370-E374 ◽  
Author(s):  
Ali Kemal Gür ◽  
Mehmet Coşkun Aykaç
Keyword(s):  
Cardiac Tumor ◽  
Tumor Location ◽  
Cardiac Tumors ◽  
Aortic Cross Clamp ◽  
Tumor Patients ◽  
Common Complaint ◽  
Surrounding Healthy Tissue ◽  
Cardiac Myxomas ◽  
The Right ◽  
Operation Risk

Objective: Although seen rarely compared to all tumors, cardiac tumors are tumors which may have a mortal course with possible complications. The most common cardiac tumor in adults is myxoma with its benign character. The results of cardiac tumors resected with open cardiac surgery in our center are reported in this study. Materials and Methods: Twenty-three cardiac tumor patients electively operated on in our clinic between January 2010 and August 2017 were retrospectively included in the study. Information of the patients participating in the study were registered. The patients were between 25 and 67 years of age, and 18 were female (72.3%), and 5 were male (21.7%). The average age of the patients was 42.1 ± 8.9 years. Echocardiography was used for diagnosis in all patients. There was no common complaint for the patients, with the complaints changing according to tumor location. All patients were operated on by means of cardiopulmonary bypass with aortic cross-clamp and bicaval cannulation. Preoperative demographical characteristics and perioperative and postoperative data were registered for the patients and were evaluated statistically. Results: Nineteen of the tumors (82.6%) were in the left atrium, and 4 were (17.4%) in the right atrium. Diameter of the tumors changed between 2.5 × 1.5 and 8.5 × 6.5 cm. The tumoral structure was resected together with the solid tissue located in its root in all patients operated on. Pericardial patch was used for 11 (47.8%), and primary closure was used for 12 (51.2%) of the defects. Early and late mortality was not observed in any patient. Conclusion: To prevent possible complications of cardiac myxomas, they need to be resected together with the surrounding healthy tissue as soon as possible after the diagnosis. Cardiac myxomas can be operated on with a tolerable operation risk. Echocardiography should be made annually for any possible relapse after operation.

scholarly journals A Giant Right Atrial Myxoma with Blood Supply from the Left and Right Coronary Arteries: Once in a Blue Moon

2020 ◽  
Vol 4 (3) ◽  
pp. 201-204
Author(s):  
Yichao Xiao ◽  
Zhenfei Fang ◽  
Xinqun Hu ◽  
Qiming Liu ◽  
Zhaowei Zhu ◽  
...  
Keyword(s):  
Coronary Arteries ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Right Atrial ◽  
Cardiac Tumors ◽  
Right Atrial Mass ◽  
Right Atrial Myxoma ◽  
Left And Right ◽  
Cardiac Myxomas ◽  
The Right

Cardiac myxomas, the commonest primary benign cardiac tumors, are extremely rare, with an incidence ranging from 0.0017 to 0.19% and only about one-fifth of them originating from the right chambers of the heart. A 60-year-old woman was admitted because of recurrent attacks of chest tightness and shortness of breath. Transthoracic echocardiography detected a giant mass in the right atrium; myxoma was indicated by [18F]fluorodeoxyglucose PET/CT. Preoperative selective coronary angiography was performed to assess the extent and severity of coronary stenosis, and showed a strongly neovascularized right atrial mass supplied by two feeding vessels with multiple branches from the left and right coronary arteries. The myxoma was successfully excised with open heart surgery and the patient was free of myxoma recurrence during the 3-year follow-up.

scholarly journals Diagnosis of Carney complex following multiple recurrent cardiac myxomas

2021 ◽  
Author(s):  
Shigeki Yokoyama ◽  
Kanetsugu Nagao ◽  
Akihiko Higashida ◽  
Masaya Aoki ◽  
Shigeyuki Yamashita ◽  
...  
Keyword(s):  
Surgical Excision ◽  
Genetic Mutation ◽  
Carney Complex ◽  
Right Atrial ◽  
Systemic Review ◽  
Cardiac Tumors ◽  
Left Atrial Myxoma ◽  
Atrial Tumors ◽  
Cardiac Myxomas ◽  
The Right

AbstractCarney complex is a rare syndrome caused by a genetic mutation leading to multiple endocrine abnormalities and a variety of tumors. Here, we report a case of Carney complex diagnosed due to recurrent multiple myxomas in the right atrium of a patient 16 years after the resection of the primary left atrial myxoma. Surgical excision was performed for the multiple recurrent right atrial tumors under cardiopulmonary bypass. The patient remained complication-free after surgery and was discharged on the 14th day. He was scheduled to continue echocardiographic follow-up and periodic systemic review by an endocrinologist. This case emphasizes the fact that if cardiac myxomas tend to be multiple and recurrent at a relatively young age, the possibility of Carney complex should be considered, even in the absence of any other related feature other than cardiac tumors.

Fetal Cardiac Myxomas

2017 ◽  
Vol 221 (04) ◽  
pp. 175-179 ◽  
Author(s):  
Shi-Min Yuan
Keyword(s):  
Cardiac Myxoma ◽  
Diagnostic Technique ◽  
Tumor Location ◽  
Good Prognosis ◽  
Cardiac Tumors ◽  
Cardiac Events ◽  
Comprehensive Literature Review ◽  
Adverse Cardiac Events ◽  
Predictive Risk ◽  
Cardiac Myxomas

AbstractFetal cardiac myxomas are very rare. To date there has been no representative description of fetal cardiac myxomas. The aim of this study is to highlight the clinical features, possible outcomes and the disparities from the adult cardiac myxomas and other fetal cardiac tumors.A comprehensive literature review yielded 27 reports including 32 cases of fetal cardiac myxomas.Apart from the same pedunculated and solitary nature and echogenic appearance, fetal cardiac myxomas differ from those in adults in many aspects, including tumor location, clinical manifestation and malignant potential. Fetal cardiac myxomas are the most common in the left ventricle and the least common in the left atrium. Tumor size and tumor site could be predictive risk factors of adverse cardiac events of fetuses.Their clinical courses are often benign with fewer cases of adverse cardiac events. Prenatal echocardiography is a reliable diagnostic technique, which can detect cardiac myxomas at as early as 18 weeks gestation. Differential diagnosis should be made from other types of fetal cardiac tumors. Postnatal cardiac myxoma resection may provide a good prognosis.

scholarly journals Case Report: Giant Biatrial Myxoma Mimicking Malignant Cardiac Tumor in a Patient With a Hepatic Angiomatous Mass

2021 ◽  
Vol 8 ◽  
Author(s):  
Chengming Fan ◽  
Hao Zhang ◽  
Huanwei Zhuang ◽  
Zenan Jiang ◽  
Haoyu Tan ◽  
...  
Keyword(s):  
Cardiac Tumor ◽  
Stable Condition ◽  
Interatrial Septum ◽  
Resected Specimen ◽  
Hepatic Hemangioma ◽  
Cardiac Tumors ◽  
Exertional Dyspnea ◽  
Curative Therapy ◽  
Giant Tumor ◽  
Cardiac Myxomas

Cardiac myxomas, primarily originating from the left atrium, are the most prevalent types of benign cardiac tumors; however, biatrial myxomas are extremely rare. Herein, we present a rare case of a 55-year old male with exertional dyspnea and intermittent chest discomfort due to a giant biatrial mass with concomitant atrial fibrillation and hepatic hemangioma. The giant tumor with its peduncle at the interatrial septum involved both atria; however, bulging through the tricuspid valve to the right ventricle during systole. Hence, excision of the giant cardiac tumor (which grossly composed of three parts: stiff, fleshy, and soft) and Cox-Maze IV procedure was performed with the resected specimen measuring 100 × 80 × 40 mm. The patient who was in a stable condition was discharged home on the 12th post-operative day. Thus, given the excellent post-operative results achieved, surgical treatment in large multi-cavitary benign cardiac tumors is feasible and should be considered a potentially curative therapy.

1113 Primary and secondary malignant cardiac tumors - a 22 year case review

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
P Garcia Bras ◽  
L Moura Branco ◽  
A Castelo ◽  
V Vaz Ferreira ◽  
T Branco Mano ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Heart Transplantation ◽  
Median Time ◽  
Tumor Location ◽  
Cardiac Tumors ◽  
Primary Tumors ◽  
The Mean ◽  
The Right ◽  
Primary Cardiac Tumors

Abstract Background Primary cardiac tumors are extremely rare and are usually diagnosed late due to the non-specific symptomatology. Surgery is the main treatment option and despite chemotherapy, the prognosis remains poor. Cardiac invasion by metastatic tumors, while more common, also entails an unsatisfactory outcome. Purpose To review patients (P) with malignant cardiac tumours that were diagnosed by transthoracic echocardiography (TTE) or by transesophageal echocardiogram (TEE) in a tertiary center between 1997 and 2019. Methods Retrospective analysis of clinical data from the digital files, echocardiographic assessment of tumor location and morphology, histology results and survival outcomes. Results A total of 33 malignant cardiac tumors were diagnosed: 12 primary tumors (A) and 21 metastatic tumors (B). A Regarding primary cardiac tumors, the most common types were angiosarcomas (6 cases), 2 undifferentiated pleomorphic sarcomas, 1 right ventricle (RV) sarcoma, 1 primary cardiac lymphoma, 1 myxofibrosarcoma and 1 fibrosarcoma. The mean age of the P at time of diagnosis was 43 ± 15 years, 50% female gender. The most frequent presentation was heart failure symptoms (50% of P) followed by arrhythmias (20%). One patient had a rare presentation with pruritus and polyarthralgias. On TTE, the most prevalent tumor location was in the right-heart chambers (70%) - mostly the right atrium (50%), with mean dimensions of 40 ± 18 mm x 27 ± 11 mm. 85% of patients had preserved systolic left ventricular function and there was moderate or severe pericardial effusion in 38%. The most frequent distant metastatic involvement of primary tumors at diagnosis was pulmonary (33%) and hepatic (33%). 50% of P were submitted to tumor resection and 40% were submitted to chemotherapy. In the case of angiosarcomas, the most common immunohistochemical markers were vimentin, CD31 and CD34. The authors found a mortality rate of 81% in P with primary cardiac tumors, with a median time of follow-up of 6 months (minimum of 20 days and maximum of 18 years). In the latter case, the P was submitted to heart transplantation after diagnosis of a sarcoma of the RV and is still alive and well. B Regarding secondary cardiac invasion, there was a diagnosis of the following primary tumor sites: 6 thymomas, 4 cases of lymphoma, 3 lung carcinomas, 3 hepatocellular carcinomas, 2 bladder carcinomas, 1 parathyroid carcinoma, 1 soft tissue sarcoma and 1 melanoma. The mean age of P with metastastic involvement of the heart was 57 ± 22 years, 65% male. On TTE/TEE the authors also found a right-sided chambers predominance (60%), with pericardial metastasis in 35%. As expected, the mortality rate was also extremely high (90%), with a median time of follow up of 1.5 months (minimum of one week, maximum of 44 months) Conclusion Cardiac malignant tumors generally present in a late stage with a dismal prognosis. When possible, heart transplantation can be an option with a good outcome.

scholarly journals ACCURACY OF TRANSTHORACIC ECHOCARDIOGRAPHY IN DIAGNOSIS OF CARDIAC MYXOMA: SINGLE CENTRE EXPERIENCE

2021 ◽  
Author(s):  
Katja Prokšelj ◽  
Polona Kačar ◽  
Nejc Pavšič ◽  
Mojca Bervar ◽  
Zvezdana Dolenc Stražar
Keyword(s):  
Sensitivity And Specificity ◽  
Transthoracic Echocardiography ◽  
Imaging Modality ◽  
Cardiac Myxoma ◽  
Tumor Location ◽  
Accurate Diagnosis ◽  
Diagnostic Workup ◽  
Cardiac Tumors ◽  
Tertiary Centre ◽  
Cardiac Myxomas

The differential diagnosis of cardiac myxomas (CM), the most common benign primary cardiac tumors, is broad and a thorough diagnostic workup is required to establish accurate diagnosis prior to surgical resection. Transthoracic echocardiography (TTE) is usually the first imaging modality used for diagnosis of suspected CM. Purpose In a single tertiary centre study, we sought to determine the accuracy, sensitivity, and specificity of TTE in the diagnosis of CM and to determine echocardiographic characteristics indicative of CM. Methods and results We retrospectively analyzed clinical, echocardiographic, and pathohistological findings of 73 patients consecutively admitted for suspected CM. After diagnostic workup, 53 (73%) patients were treated surgically at our institution. Based on preoperative TTE, patients were divided into a CM group (n=45, 85%) and non-myxoma (NM) group. Of the 53 pathohistological specimens obtained during surgery, 39 (73%) were CM. The sensitivity and specificity of preoperative echocardiography were 97% and 50%, respectively. The overall accuracy was 85%. All NM tumors were found in an atypical location and 72% of CM were found in a typical position in the left atrium (p<0.001). Tumors in NM group were significantly smaller than CM (24.3±13.2 mm vs 37.9±18.3 mm, p=0.017). Conclusion Our study confirms very good accuracy of TTE in the diagnosis of CM. The most important echocardiographic characteristics to differentiate between CM and tumors of different etiology are tumor location and size. Smaller tumors presenting at an atypical location are less likely to be diagnosed as CM, and these require additional imaging modalities for accurate diagnosis.

scholarly journals Diagnostic pitfalls: intramyocardial lymphoma metastasis mimics acute coronary syndrome in a diffuse large B cell lymphoma patient—case report

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Lilla Prenek ◽  
Klára Csupor ◽  
Péter Beszterczán ◽  
Krisztina Boros ◽  
Erika Kardos ◽  
...  
Keyword(s):  
B Cell ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Pericardial Fluid ◽  
Cardiac Tumors ◽  
Lymphoma Patient ◽  
Coronary Syndrome ◽  
Large B Cell Lymphoma ◽  
The Right ◽  
Large B Cell

Abstract Background Cardiac tumors are very uncommon compared to other cardiac diseases. Their clinical symptoms can vary from absent to non-specific. The most common symptoms are arrhythmias, blood flow obstruction due to valvular dysfunction, shortness of breath, systemic embolization, and accumulation of pericardial fluid. Hereby, we describe a very rare case of a diffuse large B cell lymphoma patient who presented with the symptoms and signs of acute coronary syndrome (ACS) but the patient’s complaints were caused by his intramyocardial lymphoma metastasis. Case presentation Forty-eight-year-old diffuse large B cell lymphoma patient was admitted to our emergency department with chest pain, effort dyspnea, and fever. The patient had normal blood pressure, blood oxygen saturation, sinus tachycardia, fever, crackles over the left lower lobe, novum incomplete right bundle branch block with Q waves and minor ST alterations, elevated C-reactive protein, high-sensitivity troponin-T, and d-dimer levels. Chest X-ray revealed consolidation on the left side and enlarged heart. Bed side transthoracic echocardiography showed inferior akinesis with pericardial fluid. Coronary angiography showed no occlusion or significant stenosis. Chest computed tomography demonstrated the progression of his lymphoma in the myocardium. He was admitted to the Department of Hematology for immediate chemotherapy and he reached complete metabolic remission, followed by allogeneic hematopoietic stem cell transplantation. Unfortunately, about 9 months later, he developed bone marrow deficiency consequently severe sepsis, septic shock, and multiple organ failure what he did not survive. Conclusions Our case demonstrates a very rare manifestation of a heart metastasis. ACS is an unusual symptom of cardiac tumors. But our patient’s intramyocardial lymphoma in the right atrium and ventricle externally compressed the right coronary artery and damaged the heart tissue, causing the patient’s symptoms which imitated ACS. Fortunately, the quick diagnostics and immediate aggressive chemotherapy provided the patient’s remission and suitability to further treatment.

scholarly journals Comparing Glioblastoma Surgery Decisions Between Teams Using Brain Maps of Tumor Locations, Biopsies, and Resections

2019 ◽  
pp. 1-12 ◽  
Author(s):  
Domenique M.J. Müller ◽  
Pierre A.J.T. Robe ◽  
Roelant S. Eijgelaar ◽  
Marnix G. Witte ◽  
Martin Visser ◽  
...  
Keyword(s):  
Tumor Location ◽  
Three Dimensions ◽  
Multidisciplinary Teams ◽  
Surgical Removal ◽  
Treatment Variation ◽  
Probability Maps ◽  
Resected Patient ◽  
The Right ◽  
Referral Bias ◽  
The Brain

Purpose The aim of glioblastoma surgery is to maximize the extent of resection while preserving functional integrity, which depends on the location within the brain. A standard to compare these decisions is lacking. We present a volumetric voxel-wise method for direct comparison between two multidisciplinary teams of glioblastoma surgery decisions throughout the brain. Methods Adults undergoing first-time glioblastoma surgery from 2012 to 2013 performed by two neuro-oncologic teams were included. Patients had had a diagnostic biopsy or resection. Preoperative tumors and postoperative residues were segmented on magnetic resonance imaging in three dimensions and registered to standard brain space. Voxel-wise probability maps of tumor location, biopsy, and resection were constructed for each team to compare patient referral bias, indication variation, and treatment variation. To evaluate the quality of care, subgroups of differentially resected brain regions were analyzed for survival and functional outcome. Results One team included 101 patients, and the other included 174; 91 tumors were biopsied, and 181 were resected. Patient characteristics were largely comparable between teams. Distributions of tumor locations were dissimilar, suggesting referral bias. Distributions of biopsies were similar, suggesting absence of indication variation. Differentially resected regions were identified in the anterior limb of the right internal capsule and the right caudate nucleus, indicating treatment variation. Patients with (n = 12) and without (n = 6) surgical removal in these regions had similar overall survival and similar permanent neurologic deficits. Conclusion Probability maps of tumor location, biopsy, and resection provide additional information that can inform surgical decision making across multidisciplinary teams for patients with glioblastoma.

scholarly journals Essential language function of the right hemisphere in brain tumor patients

2004 ◽  
Vol 57 (1) ◽  
pp. 128-131 ◽  
Author(s):  
Alexander Thiel ◽  
Birgit Habedank ◽  
Lutz Winhuisen ◽  
Karl Herholz ◽  
Josef Kessler ◽  
...  
Keyword(s):  
Brain Tumor ◽  
Right Hemisphere ◽  
Language Function ◽  
Tumor Patients ◽  
The Right

scholarly journals Intracardiac Metastasis from a Large Cell Neuroendocrine Lung Carcinoma

2019 ◽  
Vol 08 (01) ◽  
pp. e41-e43
Author(s):  
Christopher Gaisendrees ◽  
Kaveh Eghbalzadeh ◽  
Navid Mader ◽  
Thorsten C. W. Wahlers
Keyword(s):  
Lung Carcinoma ◽  
Malignant Tumors ◽  
Close Contact ◽  
Large Cell ◽  
Cardiac Metastasis ◽  
Cardiac Tumors ◽  
Cardiac Metastases ◽  
The Right ◽  
Cava Vein ◽  
Inferior Cava Vein

AbstractPrimary malignant tumors of the heart are rare; the biggest group is sarcomas. Cardiac metastases make up the biggest group of secondary cardiac tumors. We present a rare case of cardiac metastasis (3.1 × 3.2 × 2.8 cm) localized in the right atrium, originating from a large cell neuroendocrine lung carcinoma, with close contact to the tricuspid valve and inferior cava vein.

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