Abstract
BackgroundPrimary cardiac lymphomas (PCL) represent extremely rare cardiac tumors which are accompanied by poor prognosis, unless they are timely diagnosed and treated.Case presentationHerein we present a 28-year-old, immunocompetent man who presented to our hospital due to progressively worsening symptoms and signs of superior vena cava syndrome. Multi-modality imaging demonstrated a large intracardiac tumor, which was proven, by biopsy, to be a PCL. The patient received targeted chemotherapy which led to total remission of his disease, with no relapse over a 15-month follow-up period.ConclusionsAlthough PCLs are rare, they should always be kept in mind in the differential diagnosis of cardiac tumors. Timely diagnosis of PCLs and appropriate chemotherapy, alone or in combination with radiotherapy, seems to provide the best results.
Highlights
Primary cardiac lymphomas (PCL) represent extremely rare cardiac tumors which are accompanied by poor prognosis, unless they are timely diagnosed and treated
PCLs are accompanied by a poor prognosis, unless they are treated in the early stages [4]
Case presentation we present the case of a 28-year-old man, with a free medical history who presented to the allergology department of our hospital due to progressively worsening over the past 3 months facial oedema and erythema of the upper thorax markedly aggravated by bending forward
Summary
Primary cardiac tumors are extremely rare, appearing in less than 0.1% of cases in a large series of 12,000 autopsies [1, 2]. The patient demonstrated facial plethora with oedematous eyelids, dilated jugular veins and dilated chest wall collaterals (Fig. 1, panel a). The rest of his physical examination was unremarkable apart from bradycardia (50 beats per minute). The first cycle drugs doses were divided in 2 with 15 days interval to minimize complications as arrhythmias and tissue rupture according to the literature [5] Ten days after his first chemotherapy cycle the patient presented with severe rhythm disorders, pauses of up to 12 s, on the 24-h Holter monitoring accompanied by convulsions and a temporary pacemaker was implanted through the trans-femoral route. Serial echocardiographic studies at 3, 6 and 12 and 15 months after completion of treatment confirmed the absence of relapse, as did a follow-up 18-FDG PET/CT at 15 months
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