Primary Tumors Of Heart Research Articles

Cardiac myxomas: an analysis of 39 patients

Objectives . Myxomas are the most common benign primary heart tumors. They have serious complications including intracardiac blood flow obstruction and embolic events. The aim of the study was to assess our experiences related to patients undergoing surgical resection for cardiac myxomas. Methods. The medical records of 39 patients, aged 16 to 76 years (mean, 47.5 years), who were operated on for primary cardiac myxomas between January 1994 and December 2016 at our clinic were retrospectively evaluated. Demographic, clinical, operative and postoperative data were obtained from these hospital medical records. Cardiac myxomas were diagnosed by transthoracic echocardiography. Preoperative coronary angiography was performed in patients over 40 years of age and those with symptoms of coronary disease. In routine follow-up after discharge the patients were checked by echocardiography. Long-term cumulative survival was analyzed using the Kaplan-Meier method. Results . There was no in-hospital mortality. The majority (61.5%) of patients were female. The most common encountered localization of myxoma was the left atrium (76.9%), and the classic posterior approach from interatrial groove was preferred in 32 (82.1%) patients. Mean follow-up was 6.05 ± 3.75 years (range, 1-10 years). Five (12.8%) patients were lost on long-term follow-up. Kaplan-Meier curves, cumulative proportion surviving of patients at 1-, 2-, 5-, and 10-year were 97.4%, 91.7%, 84.7%, and 84.7%, respectively. No hospital mortality was observed in any of the patients. There was no recurrence in our series. Conclusions . Myxoma is the disease that can lead to complications such as embolic events and intracardiac blood flow obstruction. It can be excised with a low rate of morbidity and mortality. S urgical resection should be performed promptly after diagnosis in order to prevent potential complications.

Postoperative Course and Long-Term Results after Primary Malignant Heart Tumor Resection: A Single-Center Experience

Postoperative Course and Long-Term Results after Primary Malignant Heart Tumor Resection: A Single-Center Experience

Хирургическое лечение первичной опухоли сердца

Представлено описание редкого случая первичной опухоли сердца, которая была подвергнута хирургическому лечению. Прижизненная диагностика этого заболевания сложна. Наиболее важным диагностическим исследованием у таких пациентов является эхокардиография, существенно расширяет возможности визуализации опухоли чреспищеводная 3D-эхокардиография, которая позволяет получать полнообъемные «живые» трехмерные изображения и трехмерное увеличение. HTML

Clinical manifestation and surgical treatment analysis of five cases with biatrial myxoma

BackgroundCardiac myxomas (CMs) are a major primary heart tumor which often causes unexpected symptoms or sudden death. Among CMs, biatrial myxomas are even rare. This study was designed to investigate the clinical characteristics and surgical treatment of 5 cases with biatrial myxoma, to summarize the treatment experience and the effect of short-to-mid-term prognosis. MethodsFive patients with biatrial myxoma were included in this study. The patients' relative literature, chest X-ray, body-surface electrocardiogram, and ultrasonic cardiogram (UCG) were used to investigate the clinical characteristics. The experience of surgical treatment and perioperative treatment were analyzed. ResultsAmong the 5 cases, patients had presented discomfort of precordial area and cardiac insufficiency symptoms such as dyspnea and chest discomfort. There were characteristic changes on echocardiography (ECG). All patients accepted resection of both tumor and its basement tissue. Their symptoms were all improved after surgery, no deaths occurred. ConclusionIn conjunction with clinical features, diagnostic clue and echocardiography, the detectable rate of biatrial myxoma could be significantly improved. Early diagnosis showed good effect on prognosis.

Epidemiological and pathological features of primary cardiac tumours in dogs from Poland in 1970-2014.

Primary heart tumours affect less than 1% of dogs. Due to their rare incidence, every research showing the frequency of cardiac tumours is valuable. Routine diagnostics is often complemented with immunohistochemical analysis. This study was conducted on 110 patient records from all veterinary faculties in Poland from dogs diagnosed with heart tumours between 1970 and 2014. The dogs' age, breed and sex with tumour localisation and histopathological diagnosis were analysed. Because of its most common incidence, samples of haemangiosarcoma underwent further examination with assessment of the expression of cell markers that have not been evaluated earlier (i.e. minichromosome maintenance proteins and beta-catenin). We noted 111 tumours including 88.3% malignant and 10.8% benign ones. Haemangiosarcoma and aortic body tumour were the most frequent cardiac neoplasms in the dogs examined (45.9% and 27.9% of all tumours, respectively). Immunohistochemical analysis of haemangiosarcoma showed a positive expression of all markers examined. CD31, vimentin, and beta-catenin showed a positive reaction in all 11 samples examined. At least one proliferative marker (Ki-67, MCM-3 or MCM-7) showed a positive reaction in each sample. MCM-3 showed a higher expression than the two other proliferative markers (P = 0.006), but only Ki-67 showed a positive correlation with the mitotic index (P > 0.05, r = 0.89). Although beta-catenin, MCM-3 and MCM-7 showed a positive reaction in the haemangiosarcomas examined, their usefulness as diagnostic and prognostic factors should be a topic of further research.

Glandular myxoma of left atrium: An uncommon tumor

In the present day, there is an overall increase in the incidence of various tumors of the body though tumors of the heart are not common. Metastatic tumors of the heart are more common than primary tumors. Among primary tumors of the heart, myxoma is the most common tumor. However, glandular differentiation in myxoma is rare. Hereby, we present a rare case report of glandular differentiation in cardiac myxoma of the left atrium.

Hallazgos de imagen de las masas cardíacas (parte II): tumores malignos y lesiones pseudotumorales

Malignant heart tumors are less common than benign ones. They can be primary or secondary. Secondary or metastatic heart tumors are 20 to 40 times more common than primary malignant heart tumors, which have an estimated incidence of 0.05%. Non-neoplastic pseudotumors can present as cardiac masses, with imaging characteristics than can suggest the diagnosis of a tumor. The aim of this article is to describe and illustrate malignant heart tumors and pseudotumors, stressing the CT and MRI findings that make it possible to differentiate them from benign cardiac tumors.

76. Cardiac myxoma, surgical experience and results of 35 cases

Cardiac myxoma, the most common primary heart tumor, is located mainly in the left atrium. Approximately 80% of primary heart tumors are benign, and 50% of these are myxomas. We review our data from January 2004 to January 2014, 35 cases of cardiac myxoma resection done in Althawra general Hospital – Cardiac center and mean follow up 60 months. Total number was 35 cases, mean age 44.2 years (age range 22–65 years ) and female predominant accounting for 21 compared to 14 male, 3 were hypertensive, 5 smokers and one with positive hepatitis B virus, 48% of our patients were O+ve blood group and 28.5% were A+ve. The presenting symptoms were shortness of breath in 48.5%, palpitation in 22.5%, strock in 17%, syncope in 8.5%, and accidental finding in 6%. Resection of the myxoma done under total CBP and worm blood cardioplegic arrest, through the right atrial approach, and the resected mass sent for histopathological examination. In all cases Histopathological examinations confirm the diagnosis of Myxoma. Operative Mortality rate were 2.8% (one patient) and we have one patient with recurrent myxoma after 2 years interval representing 2.8%. No late death recorded during the followup period. Surgical resection of cardiac myxoma is the only cure and it is safe with low recurrent rate.

Treatment Strategies for Primary Tumors of the Heart in Children: A 10-Year Experience

The goal of this study was to determine the optimal treatment strategy for children with primary tumors of the heart. We reviewed 88 children with primary heart tumors in our center from January 2004 to December 2013. Operative patients were followed every 6 months in the first postoperative year and then regularly every 12 months; nonoperative patients were followed once a year after diagnosis. Demographic information of imaging, operative details, and postoperative data were obtained from medical records. Statistical analyses were carried out by means of Fisher's exact tests and Student's t test. Of the 23 patients who underwent surgical removal of the tumors (range, 12 days to 14.4 years; median, 1.3 years), 19 patients had stable postoperative hemodynamics, 4 had low cardiac output, and 2 patients died (mortality, 9%). The follow-up ranged from 6 months to 9 years; 2 patients had tumor recurrence, and 1 patient was lost to follow-up. The rest of the operative patients remained in normal sinus rhythm and had normal cardiac function. The 65 patients treated nonoperatively (range, 1 day to 14.4 years; median, 0.4 years) were followed closely for 1 month to 9.8 years; only 1 patient died (of unknown reasons), 1 patient received a cardiac transplant, and 9 patients were lost to follow-up. Operative resection is optimal for primary tumors of the heart in patients with obvious symptoms or hemodynamic changes. Rhabdomyomas have the potential for spontaneous regression, and nonoperative follow-up therefore is acceptable even if symptoms appear. Operative risk is greater in younger patients and in patients with cardiac valvular dysfunction.

Diffuse cerebral embolism as the first manifestation of the right atrial myxoma

Abstract Introduction Neurological complications in patients with diagnosed atrial myxoma occur in approximately 30% of cases. Aim The aim of this paper is to present the case of a female patient with right atrial myxoma and demonstrate neurological complications. Case study This paper presents the case of a 51-year-old female patient who was admitted to the hospital due to dizziness, nausea, vomiting and gait disorders lasting for two days. Head computed tomography (CT) showed vascular changes in the cerebellum and magnetic resonance imaging (MRI) of the brain revealed numerous synchronous, recent vascular diffuse foci in the left occipital lobe and left cerebellar hemisphere. Transthoracic echocardiography examination (TTE) detected the myxoma in the right atrium with the suspicion of atrial septal defect secundum (ASD2). The patient underwent a successful surgery to remove the right atrial myxoma. The procedure also revealed ASD2. Results and discussion Myxoma is one of the most common primary heart tumors and it accounts for about 50% of benign heart tumors; three out of four cases involve women. Most myxomas are localized in the left atrium and only approximately 18% are found in the right one. The symptoms of brain damage usually appear when the tumor is localized in the left atrium and rarely occur when the tumor involves the right atrium. In the presented case, during the procedure, the coexistence of ASD2, which may lead to crossed embolism, was confirmed. Conclusions The right atrial myxoma may manifest with neurological symptoms due to diffuse cerebral embolism.

Primary malignant tumors of the heart: Outcomes of the surgical treatment.

Malignant cardiac tumors are rare and have an extremely poor prognosis even when complete resection is attempted. The aim of this study was to review the experience of primary malignant cardiac tumors in 2 Italian academic hospitals. The hospital records were searched to identify patients with primary malignant cardiac tumors who underwent surgery between January 1979 and December 2012. Secondary cardiac tumors, whether metastatic or invasive, were excluded as were primary sarcomas of the great arteries. Fourteen patients selected from our institution's surgical series were identified. Eleven (78.6%) were men and 3 (21.4%) were women, and the mean age at surgery was 47.4 years. The most common histological type was angiosarcoma (28.6%). The mean survival was 28.8 ± 28 months and it was better in men than in women (30.5 ± 8.7 vs. 21.1 ± 3.2 months). Patients with a radical resection at the first surgery had a longer survival compared to patients with a partial resection (39.9 ± 23.2 vs. 24 ± 4 months). The treatment outcome for patients affected by primary malignant heart tumors remains poor. Aggressive surgery alone does not provide good results in terms of survival rate. A new multidisciplinary approach is mandatory to improve long-term survival.

Risk factors for embolism in cardiac myxoma: a retrospective analysis.

BackgroundMyxomas are the most common primary heart tumors and are closely associated with embolic events. Cardiac myxomas typically arise from the interatrial septum at the border of the fossa ovalis in the left atrium. Any other location is considered atypical. Embolism, one of the complications of myxoma, is associated with high morbidity and mortality. The aim of this study was to investigate the risk factors for embolism in patients with cardiac myxoma.Material/MethodsIn this retrospective study, a cohort of 162 patients with cardiac myxomas was surgically treated between January 1998 and June 2014 at 3 cardiac centers in China. Preoperative data, including platelet count, sex, age, and the tumor (size, location, surface, and attachment), were compared between embolic and non-embolic groups of patients.ResultsNo significant differences in vascular risk factors were seen between the 2 groups. However, the percentage of higher platelet count (>300×109/L) and mean platelet volume in the embolic group were significantly higher than in the non-embolic group (P=0.0356, and 0.0113, respectively). Irregular surface and atypical location of the myxomas were also independently associated with increased risk of embolic complications.ConclusionsTumor location, macroscopic appearance, mean platelet volume, and high platelet count are strong risk factors for embolic events in patients with cardiac myxomas.

A rare case of a big left ventricular myxoma presenting with a cerebrovascular stroke

Abstract Introduction Cardiac myxomas are by far the most common primary tumors of the heart. Left ventricular (LV) myxomas are extremely rare with only 37 cases reported in the literature up to 1996. Patients with myxomas can have a wide range of symptoms. Embolic event and/or cerebrovascular stroke can be the presenting scenario. Case presentation A 35-year-old Asian male patient presented with a clinical picture of an acute cerebrovascular stroke. A routine trans-thoracic echocardiography showed a big left ventricular grape-like mass attached to the inferior septum and bulging through the aortic valve during systole. Surgical resection of the tumor done successfully and the histo-pathological examination of the resected tumor confirmed the diagnosis of myxoma. After surgery, the patient showed complete improvement of his neurological status and went home three weeks later free from any neurological deficit. Conclusion Left ventricular (LV) myxomas are extremely rare. Cerebrovascular stroke can be the presenting symptom. Surgical resection is the treatment of choice.

Fetal arrhythmias associated with cardiac rhabdomyomas

Primary heart tumors in fetuses are rare and mainly represent rhabdomyomas. The tumors have a variable expression and can be associated with arrhythmias, including both wide and narrow QRS tachycardia. Although multiple Doppler techniques exist to assess fetal heart rhythm, it can be difficult to record precise electrophysiological abnormalities in fetal life. Investigations defining precise electrophysiological diagnosis were performed by using fetal magnetocardiography (fMCG). In addition to routine fetal echocardiography, fMCG was used to investigate electrophysiological rhythm patterns in a series of 10 fetuses with cardiac rhabdomyomas. The mean gestational age of the fetuses was 28.6 ± 4.7 weeks. The multiple rhabdomyomas were mainly located in the right and left ventricles as well as around the atrioventricular groove. Arrhythmias or conduction abnormalities were diagnosed in all 10 patients, although only 6 of them were referred due to that indication. Remarkably, 80% (8 of 10) had associated Wolff-Parkinson-White pre-excitation. In addition, we found prominent P waves in 4 fetuses. In fetuses with rhabdomyomas, a disease where rhythm pathology is common, precise electrophysiological diagnosis can now be made by fMCG. fMCG is complimentary to echocardiography for rhythm assessment and can detect conduction abnormalities that are not possible to diagnose prenatally with M-mode or pulsed Doppler ultrasound. Risk factor assessment using fMCG can support pregnancy management and postnatal treatment and follow-up.

Left ventricular myxoma: a case report.

Cardiac myxoma, the most common primary heart tumor, is located mainly in the left atrium. We reported a rare case of left ventricular myxoma incidentally found on echocardiography in an asymptomatic 60-year-old male. The tumor was carefully resected without fragmentation. The patient had an uneventful recovery and was discharged home on the 4th postoperative day. Surgical resection of this type of cardiac myxoma is recommended due to the rarity of tumor location.

Left ventricular mycotic mass and diffuse mycotic myocarditis in a patient with hemophagocytic syndrome – case report

ygomicosis is a fungal disease caused by fungi from the Zygomycota order that are usually airborne spread, with pulmonary and rhinocerebral involvement being the most common. Once in the bloodstream, spores tend to accumulate in vascular tissues leading to thrombosis, infarction, and necrosis of involved tissues. In immunocompromised patients, such as those with hemophagocytic syndrome, zygomicosis is frequently characterized by fulminant disseminated disease, with a 80% mortality rate. We present a 45-year old patient with hemophagocytic syndrome who was treated with steroids, etoposide, and cyclosporine. Two months after the initial treatment, the patient was admitted for a respiratory infection, and was treated with antibiotics and antiviral drugs with a good clinical and laboratory response to the therapy. On the tenth day there was a sudden clinical deterioration with signs of left-sided heart failure, elevated troponin levels, and ECG showing a complete AV block. Right-sided hemiparesis and elevated inflammatory parameters were also present. A temporary pacemaker was placed. A brain MDCT was performed and multiple ischemic and hemorrhagic lesions were found. Emergency echocardiography study showed a semi-mobile, peduncular mass in the left ventricle. It originated from the anterior mitral leaflet, measuring 4x2 cm and protruding to the LV cavity. There were no disorders of myocardial contractility, and ejection fraction was 60% (Figure 1). Echocardiographic features of the mass resembled a myxoma. The patient died three hours later from multiple organ dysfunc- tion syndrome. Autopsy showed disseminated zygomicosis infecting the heart with a mycotic mass in left ventricle. The leptomeninges, brain, and lungs were also infected. Primary heart tumors are rare, accounting for 0.0017-0.19% on unselected biopsies. In immunocompromised patients with a new heart mass, a mycotic mass as a sign of disseminated mycosis should be considered before a primary heart tumor in order to start appropriate treatment. Mortality of patients with disseminated zygomycosis and heart mass is very high and survival is only possible with a combined surgical and antimicrobial approach. The diagnosis of disseminated zygomycosis was considered however due to the patient’s abrupt clinical deterioration, and fulminant course cardiothoracic treatment could not to be arranged.

Myxoma in the right atrium – case report

3. Sheppard MN, Mohiaddin R. Tumors of the heart. Future Cardiol. 2010;6(2):181-93. Background: Myxomas are most frequent primary benign heart tumors that consist half of the total number of primary benign tumors. In 75% of cases they are localized in the left atrium, and the rest 25% are in the right atrium, very rarely in chambers. They could be bigger than 10 cm, with gelatinous consistence and covered with thrombocyte mass that makes them source of embolism. Case report: The case of 59-year old woman who complains of tiredness, suffocation and languor is presented. She has had these sufferings during the last two years, gradually intensifying and got referral to our department. Clinical diagnosis: BP=140/100 mmHg; EKG: normal sinus rhythm, HR= 85/min. At auscultation systolic murmur above triscupid valve 3/6. Laboratory: SE 38/, WBC 7.9, RBC 4.82, PLT 195, HB 14.4 g/dl, fasting plasma glucose 6.5 mmol/L, urea 7.8 mmo/L, creatinine 63 mmol/L, total cholesterol 3.6 mmol/L, triglycerides 0.6 mmol/L, AST 30 U/L, AL=19 U/L, bilirubin 15.1 mmol/L. Echocardiography: Presence of large tumor formation in the right atrium with unhomogeneous structure and dimensions 75x55mm which is mobile and in diastole makes obstructuions of tricuspid ostium; mild tricuspid regurgitation is registered; EF 61%, RV 30 mm, RAd 46 mm, LVIDd 42 mm, LVIDs 28 mm, LA 34 mm, Ao 26 mm, IVSd 10 mm. Other valvular apparatus is in good condition. Patient is sent to urgent surgery (with previously performed heart catetherisation) and six days after operation is discharged in good health condition. Conclusion: Myxomas surgery treatment should be performed immediately in order to prevent embolic cases. Longtime prognosis after surgery treatment is excellent, only if the diagnose is made in time.

Atrial fi brillation as a fi rst clinical manifestation of right atrial cavernous haemangioma

Primary heart tumours are rare with an incidence of 0.02% in reported autopsy series. One of the most uncommon is haemangioma. We describe the case of a 51-year-old woman, who presented with a giant cavernous haemangioma, but with no clinical manifestations other than atrial fi brillation. Performed echocardiography showed a giant (6.5 × 7.5 cm) tumour located in the right atrium, modelling other heart chambers. In order to improve atrial haemodynamics, a large portion of the tumour was removed via sternotomy. Examination after 12 months showed no further growth of the unremoved part of the tumour

Clinical and Histopathological Analysis of 66 Cases with Cardiac Myxoma

Cardiac myxoma is a major primary heart tumor which often causes unexpected symptoms or sudden death. This present study was designed to investigate its clinical pathological features and biological behavior. A retrospective analysis of the clinical pathologic and immunohistochemical features of 66 cases with cardiac myxoma was conducted. In 66 patients with cardiac myxoma, 61 cases had involvement of the left atrium, one case in both the right ventricular and left atria. The female: male ratio was 2.7:1. Patients had symptoms of blood flow obstruction and systemic alterations with performance of arterial embolization. Tumors were spherical, lobulated or irregular in shape, and soft and brittle. Immunohistochemical markers of vimentin and CD34 in tumor cells were positive. Cardiac myxoma always exists in the left atrium and is more common in women, with diverse clinical manifestations and pathomorphism. Although proliferative activity and the recurrence rate are low, in addition to thorough surgical resection, strengthened review is important for young patients.

Primary Fibro Sarcoma of the Heart

Primary malignant heart tumors represent rare entities where fibro sarcoma represents about 3% of all. Introducing the patient: A 15 years old patient with cardiac insufficiency (heart failure) symptoms, such as weakness, cyanosis, palpitations and breathing difficulties; enlargement of upper mediastinum and pleural effusion. Through echocardiography a pericardial effusion and intracavitary thrombus in atrium was diagnosed. With computed tomography is diagnosed a tumoral mass in right atrium which is also spread in the right ventricle of the heart. Tumor is completely removed; pat histology result showed primary fibro sarcoma of the heart. At that time no metastasis was found. Conclusion. Primary malignant heart tumors may manifest like cardiac insufficiency or like systemic diseases. Fibrosarcomas are rare and have bad prognosis. On average patients can live around six months after initial symptoms appeared and diagnosis of the tumor was done. In the case of cardiac insufficiency with differential diagnosis we should also think of heart tumors, which could certainly be proved for or eliminated by echocardiography.