Benign Cardiac Tumors Research Articles

Right Ventricular Lipomatous Mass and Biventricular Multifocal Fat in a Young Woman: A Case Report

Cardiac lipoma is a rare benign primary cardiac tumor and is usually asymptomatic (1). It is usually discovered incidentally but can be related to hemodynamic obstruction depending on its location (2). There have been several reports regarding cardiac lipoma, including its clinical presentation and characteristic findings on computed tomography (CT) (2, 3). However, few cases documented the characteristic CT findings of solitary or multiple cardiac lipomas in the patient with tuberous sclerosis; and to our knowledge, no cases of biventricular lipoma or lipomatous hypertrophy with multifocal fat in a non-tuberous sclerosis patient have ever been reported (4). Therefore, we here report a case of right ventricular (RV) lipomatous mass and multifocal fat infiltration in both ventricles, which were incidentally detected in a young woman showing an abnormal electrocardiogram (ECG) finding. CASE REPORT

Cardiac MR assessment of cardiac myxomas.

Cardiac myxomas are the most common benign primary cardiac tumour to present in adulthood. While most patients present with symptoms of cardiac obstruction, embolic phenomena or constitutional impairment, up to a fifth of patients remain asymptomatic and are incidentally diagnosed on imaging. Although echocardiography is usually the initial imaging modality used to evaluate these patients, cardiac MRI (CMR) has emerged over the past decade as the primary imaging modality in the assessment of patients with cardiac tumours. The superior tissue characterization capability of CMR means that it is able to determine the nature of some tumours pre-operatively and performs well in differentiating myxomas from thrombus. We present a pictorial review highlighting the key CMR features of myxomas and show how these lesions can be differentiated from thrombus and other cardiac masses.

Left Atrial Myxoma Presenting with Orthostatic Hypotension in a 30 Year Young Female: A Case Report and Review

Cardiac tumors are divided into primary and secondary tumors. Primary cardiac tumors are very rare, with an autopsy incidence of 0.001% to 0.03%. Most (>80%) primary cardiac tumors are benign, and myxoma is by far the most common. Myxoma constitutes about 50% of all benign cardiac tumors in adults. Most myxomas (>80%) are found in the left atrium. We report a rare case of a massive left atrial myxoma causing mitral valve obstruction and presenting as positional dizziness. Though cardiac myxomas are known to present with various non-specific clinical symptoms, orthostatic hypotension is not listed as a presenting symptom of atrial tumors in most textbooks of internal medicine or cardiology. So this case is rare in this sense.

Giant Lipoma Originating from the Right Ventricular Infundibulum - A Case Report

Known as a rare benign cardiac tumor, epicardial lipoma is often an asymptomatic condition discovered due to increasing use of diagnostic imaging techniques. We report a case of a 54-year old patient referred to our institution with mild dyspnea, chough and an enlarged cardiac siluette on a routine chest X-ray. A large intrapericardial mass suggestive for lipoma encompassing the left and right ventricles was detected by echocardiographic examination and computer tomography scan. Resection of a 650 g mass with right ventricular infundibulum origin was performed via sternotomy, with histopathological confirmation of epicardial lipoma.

Case Report of a Rare Benign Cardiac Tumor: Atrial Myxoma

We report a rare case of benign cardiac tumor - atrial myxoma - who completely recovered after surgery.

Cardiac myxoma: An uncommon cause of recurrent stroke in uncommon age

Atrial fibrillation is the most common cause of cardiogenic emboli in stroke, responsible for over 50% cases of total stroke patients. Myxoma is responsible only in few cases. A stroke caused by left atrial myxoma commonly occur in young females. This patient presented with the repeated attack of stroke in the age of 80 years. However, it is the most common benign cardiac tumor found more frequently. In young adults with stroke or transient ischemic attack than in older patients. Age of the patient and unusual cause of recurrent stroke make this case report interesting. An 80-year-old male with no other conventional vascular risk factors such as hypertension, diabetes, or hyperlipidemia presented with left hemiparesis. Infarction over the right middle cerebral artery was disclosed on a magnetic resonance imaging study. The patient was a known case of right hemiparesis 3 years back, which was improved. The cause of repeated attack of stroke was left atrial myxoma, diagnosed by two-dimensional echocardiography.

Cardiac masses due to tumors (diagnosis, clinical manifestations and surgical treatment)

Aim. To summarize the experience on the diagnosis and surgical treatment of primary benign and malignant cardiac tumors. Methods. The paper describes 37 clinical observations of endocavitary primary benign and malignant cardiac tumors: 26 (70.3%) cases of cardiac myxoma, 5 (13.5%) - rhabdomyosarcoma, 2 (5.4%) - angiosarcoma, 1 (2.7% ) - leiomyosarcoma, 1 (2.7%) - fibrosarcoma, 1 (2.7%) - liposarcoma. Patients were 15 (40.5%) males and 22 (59.5%) females aged 18 to 65 years. Endocavitary cardiac tumors were diagnosed by noninvasive tests: echocardiography, computed tomography, magnetic resonance imaging. Results. Patients with primary benign and malignant cardiac tumors had variable clinical manifestations. Symptoms of astenoneurotic syndrome, auscultatory and cardiophonographic signs simulating acquired or congenital valvular heart diseases, which often have a positional relationship; low-grade fever of unknown origin, weight loss were registered. Paraneoplastic syndrome was characterized by an increase in erythrocyte sedimentation rate, leukocytosis, monocytosis, dysproteinemia, polycythemia, hypochromic anemia, increased levels of C-reactive protein. Surgical excision of 25 cardiac myxomas and 8 malignant tumors of the heart was performed with cardiopulmonary bypass, pharmacological cardioplegia and general hypothermia. In 1 case the tumor resection was combined with coronary artery bypass grafting. In 3 patients suffering from malignant tumors, explorative thoracotomy was performed. Surgical revision, emergency and planned microscopic studies of removed cardiac tumors allowed to establish the final clinical diagnosis. Hospital mortality among patients operated for cardiac myxomas was 4.0%, for cardiac malignant tumors - 27.3%. Conclusion. Timely surgical treatment of patients with primary cardiac benign tumors (myxomas) leads to recovery and is accompanied by a relatively low mortality; better results of patients with cardiac endocavitary tumors treatment depend on the early detection and timely radical surgical excision.

The mysterious pathways of cardiac myxomas: a review of histogenesis, pathogenesis and pathology.

Cardiac myxoma is the most common benign cardiac tumour, localized generally in the left atrium. The majority of cardiac myxomas occur sporadically, while a relatively small proportion of cases develop as a part of Carney complex syndrome. Currently, the histogenesis of myxoma is poorly understood; however, the mesenchymal and endothelial properties of myxoma cells suggest that a clearer understanding of tumour origins can be achieved through a detailed investigation of heart development and endocardial histogenesis. Growing evidence appears to indicate the reactivated expression in cardiac myxoma of genes encoding heart precursor markers, although the exact mechanisms have not yet been described. In this paper we review the most recent scientific literature concerning cardiac embryology and relate this to recent advances in our understanding of the histogenesis of cardiac myxoma. Moreover, given that much of the literature regarding myxoma is of single case reports, we review progress in our knowledge of the pathology and pathogenesis of this condition.

Incidental finding of cardiac papillary fibroelastoma of the left ventricular outflow tract, associated with rheumatic mitral and tricuspid stenosis

Cardiac papillary fibroelastomas (CPFs) are one of the most common benign cardiac tumours. However, due to their location and pedunculated nature, they are associated with substantial complications secondary to systemic embolization or coronary ostial obstruction. Surgical resection should be offered to all patients when the mass is >1 cm in diameter. Valve-sparing excision produces good long-term results in most instances. We present the case of a young female scheduled for elective mitral and tricuspid valve replacement and maze procedure for chronic atrial fibrillation. A CPF was incidentally discovered during routine intraoperative transoesophageal echocardiography with an unusual location; at the left ventricular outflow tract.

Benign neoplasm of the heart increases the risk of first ischemic stroke: a population-based cohort study.

The study aims to investigate the incidence of first ischemic stroke in patients with benign cardiac tumors who did or did not undergo operations. We used the National Health Insurance Research Database of Taiwan to conduct the research. The exposure cohort comprised 587 adult patients with benign cardiac tumors. Each patient was randomly frequency matched by age, index month, and index year with 10 participants from the general population who exhibited no history of benign cardiac tumors before the index date (control group). Cox's proportion hazard regression analyses were conducted to determine the relation between benign cardiac tumors and the risk of ischemic stroke. Based on clinical diagnoses, the prevalence of benign cardiac tumors was 0.004%. Patients with benign cardiac tumors exhibited an increased risk of first ischemic stroke [adjusted hazard ratio: 1.77; (95% confidence interval, 1.20-2.63)], particularly at young ages (adjusted hazard ratio: 22.9, 95% confidence interval: 4.17-126.0). We observed no significant difference in the risk of ischemic stroke between men with and without benign cardiac tumors (adjusted hazard ratio: 1.29, 95% confidence interval: 0.63-2.63). Among patients with benign cardiac tumors, the adjusted hazard ratio of first ischemic stroke was 0.48 (95% confidence interval: 0.23-1.04) in the operation group compared with the nonoperation group. Younger patients (<50 years) with benign cardiac tumors exhibit an increased risk of first ischemic stroke.

Pediatric cardiac tumors: clinical and imaging features.

Cardiac tumors in children are rare, are more commonly benign, and differ in types when compared with those in adults. Rhabdomyoma, teratoma, and fibroma are the most common cardiac tumors in fetuses and neonates. In infants and children, the most common cardiac tumors are rhabdomyoma and fibroma, which are benign primary cardiac tumors, whereas in adults, thrombus is the most common cardiac mass and myxoma is the most common primary cardiac tumor. Sarcomas are the most common primary malignant cardiac tumors in both children and adults. Metastatic cardiac tumors are less common in children than in adults and include sarcoma, lymphoma, testicular cancer, and Wilms tumor. Patients with cardiac tumors can be asymptomatic or may present with murmur, arrhythmia, heart failure, or sudden death. Echocardiography is the primary modality for initial evaluation of symptomatic patients. Cardiac magnetic resonance imaging provides further characterization of cardiac masses and tumors for diagnostic purposes and can be used to assess cardiac and extracardiac involvement for treatment planning. Treatment varies from conservative management or surgical resection to transplantation, depending on the diagnosis and the patient's symptoms. Rhabdomyoma typically regresses spontaneously during early childhood and does not require surgical intervention if asymptomatic. However, fibroma is generally resected because it does not regress. An understanding of the types of cardiac tumors that occur in infants and children, their clinical implications and associations, and their imaging appearances will facilitate patient management.

Molecular Basis of Cardiac Myxomas

Cardiac tumors are rare, and of these, primary cardiac tumors are even rarer. Metastatic cardiac tumors are about 100 times more common than the primary tumors. About 90% of primary cardiac tumors are benign, and of these the most common are cardiac myxomas. Approximately 12% of primary cardiac tumors are completely asymptomatic while others present with one or more signs and symptoms of the classical triad of hemodynamic changes due to intracardiac obstruction, embolism and nonspecific constitutional symptoms. Echocardiography is highly sensitive and specific in detecting cardiac tumors. Other helpful investigations are chest X-rays, magnetic resonance imaging and computerized tomography scan. Surgical excision is the treatment of choice for primary cardiac tumors and is usually associated with a good prognosis. This review article will focus on the general features of benign cardiac tumors with an emphasis on cardiac myxomas and their molecular basis.

Right Atrial Myxoma Complicated by Pulmonary Thromboembolism: A Case Report and Review of Literature

Primary cardiac tumors are rare with myxoma being the most common benign cardiac tumor. They are usually sporadic, affecting left atri um and frequently occur in women. They are known to cause valvular obstruction, thromboembolism and arrhythmias. We present a case of right atrial myxoma complicated by pulmonary embolism. The atrial myxoma was diagnosed on autopsy.

Benign cardiac tumours associated with sudden death

Sudden cardiac death (SCD) accounts for 50% of cardiovascular mortality with an estimated annual toll of 300 000 deaths in the USA and 60 000 deaths in the UK. Benign primary cardiac tumours are extremely rare, and although many of these entities are clinically silent, a few can cause significant morbidity or even sudden death. The objective of the study is to raise awareness of benign primary cardiac tumours as a possible cause of SCD so that more cases are identified by pathologists during life. Between 1994 and 2012, the hearts of more than 1600 people who had SCD were referred for pathological assessment to ascertain the precise aetiology of SCD. Eleven cases of SCD associated with benign cardiac tumours were identified; four were cystic tumours of the atrioventricular (AV) node, three lipomas, two rhabdomyomas, one haemangioma, and one myxoma. This study highlights that benign cardiac tumours are exceptionally uncommon yet potentially lethal. Careful examination of the heart will identify most of these lesions. A major exception, however, is cystic tumour of the AV node, the most common primary cardiac tumour causing sudden death. Since the gross findings of this lesion may be minimal, we recommend taking a routine section of the conducting system, including the AV node, in all cases of sudden death.

Primary cardiac tumours in a paediatric population: An experience from a tertiary centre with a review of literature

To observe the histopathological spectrum of primary cardiac tumours in paediatric population those came in Pathology Department over a period of last 16 years. During the time period of 16 years (1995-2010), we had received 16 cases of primary cardiac tumours in paediatric patients. The tumour diagnosis and subtyping was done by histopathological examination along with cytochemistry and immunohistochemistry. Benign cardiac tumours were much more common (15 cases) than the malignant tumours. Among these, myxoma was the most frequent (13 cases). The other benign cardiac tumours were rhabdomyoma (one case) and fibroma (one case). A primary malignant cardiac tumour was diagnosed in one case and was labelled as undifferentiated sarcoma. The present study reveals the pathological spectrum of surgically excised cardiac tumours in the paediatric population in northern India. Although the diagnosis of cardiac masses can be made by routine imaging techniques, but the role of pathologist is important for exact characterisation of tumour subtype.

An unusual case of hemoptysis

An unusual case of hemoptysis

Multiple cardiac rhabdomyomas, wolff-Parkinson-white syndrome, and tuberous sclerosis: an infrequent combination.

Cardiac rhabdomyomas are benign cardiac tumours and are often associated with tuberous sclerosis. They are often asymptomatic with spontaneus regresion but can cause heart failure, arrhythmias, and obstruction. There have also been a few isolated reports of Wolff-Parkinson-White syndrome occurring in association with tuberous sclerosis and the great majority has been detected in patients with concomitant rhabdomyomas. We report a 12-day-old infant girl with tuberous sclerosis who presented with intraparietal and intracavitary rhabdomyomas with a Wolff-Parkinson-White syndrome (WPW). She represents one of the few published cases of WPW syndrome and tuberous sclerosis and particularly interesting because of intramural rhabdomyomas regression with persistent intracavitary rhabdomyomas after two years of followup.

Cryoglobulinemic Vasculitis Preceding Diagnosis of Carney Complex

Carney complex (CNC) is a disorder characterized by skin pigmentary abnormalities and benign cardiac, endocrine, skin and neuronal tumors. We present a previously healthy 12-year-old boy with recurrent pain and swelling of the feet. One year later he presented with stiffness of the fingers and the toes were painful with no swelling. Rheumatoid factor, ANCA and ANA were all negative but cryoglobulins were positive. Unusual lentigines were noted. The monthly attacks with pain and joint swelling were treated sufficiently with prednisolone and azathioprine. Two years later he was admitted with classical symptoms of a stroke. MRI revealed small middle cer - ebral artery infarctions but no signs of schwannomas or vasculitis on the angiography. An echocardi- ography revealed an obstructive tumor in the left atrium, 5-6 centimeters in diameter, diagnosed as myxoma, which was surgically removed. The lentigines and myxoma led to the suggestion of Carney Complex and the diagnosis was con - firmed by a PRKAR1A mutation found in the child as well as the mother.

Coexistence of atrial myxoma and lung cancer on fluorodeoxyglucose positron emission tomography/computed tomography: The impact of distinct fluorodeoxyglucose uptake pattern on differential diagnosis.

The information regarding fluorodeoxyglucose (FDG) uptake in benign and malignant cardiac tumors is limited in the literature and most of the currrently available data were derived from single case reports. Herein we reported coexistence of atrial myxoma and lung cancer on FDG positron emission tomography/computed tomography with the aim of emphasizing the importance of distinct FDG uptake pattern on differential diagnosis.

Coexistent of giant left atrial myxoma and severe coronary artery disease presenting with paroxysmal atrial fibrillation and syncope

Introduction: Large intracardiac mass is a rare condition but it brings extremely high-risk of hemodynamic and embolic complications [1]. Presentation is usually heart failure, syncope or embolic events, but occasionally it may have atypical symptoms even may be asymptomatic. case report: Herein we are discussing a case of a 69-year-old male with syncope due to giant left atrial myxoma and coronary artery disease. conclusion: Although atrial myxomas are the most common type of benign cardiac tumors coexistent with significant coronary artery stenosis is very rare and only a few cases available in literature. surgery performed safely despite patient age, mass size and coronary artery disease coexistence and ultimate prognosis is good. Myxomas may be symptom free despite the coexistent of severe coronary artery disease, older age and large size of the mass until a contributing factor, such as atrial fibrillation episode as in our case, bring out the symptoms. Once the myxomas are detected before any complication surgery