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1.
Einstein (Säo Paulo) ; 20: eRC6478, 2022. tab, graf
Article in English | LILACS | ID: biblio-1364801

ABSTRACT

ABSTRACT Primary cardiac tumors are rare, with an incidence between 0.0017 and 0.19%, and are asymptomatic in up to 72% of cases. Approximately 75% of tumors are benign, and nearly 50% of these are myxomas. Concerning location, 75% of myxomas are in the left atrium, 15 to 20% in the right atrium, and more rarely in the ventricles. The finding of cardiac myxomas usually implies immediate surgical excision to prevent embolic events and sudden cardiac death. Reports with documented growth rate are rare, and the actual growth rate remains a controversial issue. We report the rapid growth rate of a right atrial myxoma in an oligosymptomatic 69-year-old patient, with negative previous echocardiographic history in the last two years, who refused surgery upon diagnosis, enabling monitoring of myxoma growth.


Subject(s)
Humans , Aged , Heart Neoplasms/surgery , Heart Neoplasms/diagnostic imaging , Myxoma/surgery , Myxoma/diagnostic imaging , Echocardiography , Incidence , Heart Atria/pathology , Heart Atria/diagnostic imaging
3.
Rev. bras. cir. cardiovasc ; 36(1): 112-115, Jan.-Feb. 2021. tab, graf
Article in English | LILACS | ID: biblio-1155784

ABSTRACT

Abstract A 71 year-old male with a history of multiple excisions of an initial Clark's level V melanoma of the breast followed by combined radiation and interferon treatment, as well as a recurrence, 3 years later, of a BRAF-positive tumor of the shoulder, with subsequent therapy with dabrafenib and trametinib, presented again with progressive intracardiac masses causing significant right ventricular outflow obstruction. Additionally, the patient complained of dyspnea and fatigue on exertion, thus he was scheduled for surgical resection.


Subject(s)
Humans , Male , Aged , Skin Neoplasms/surgery , Heart Neoplasms/surgery , Heart Neoplasms/diagnostic imaging , Melanoma/surgery , Melanoma/drug therapy , Mutation , Neoplasm Recurrence, Local
5.
Rev. bras. cir. cardiovasc ; 35(5): 770-780, Sept.-Oct. 2020. tab
Article in English | SES-SP, LILACS, SES-SP | ID: biblio-1137353

ABSTRACT

Abstract Objective: To understand the current evidence and guidelines behind the appropriate management of cardiac tumours. Methods: A comprehensive electronic literature search has been performed in major databases - PubMed, Embase, Scopus, Ovid, and Google Scholar. All articles that discussed all different forms of cardiac tumours, their clinical presentation, diagnosis, and management methods have been critically appraised in this narrative review. Results: All relevant studies have been summarized in appropriate sections within our review. Cardiac tumours are rare but can be catastrophic and life-threatening if not identified and managed on timely manner. Utilization of all the available imaging methods can be of equivocal importance, relevant to each cardiac tumour. Surgical excision is the ultimate treatment method, however histopathological results can guide the adjunct treatment. Conclusion: Early detection of cardiac tumours has significant effect on planning the method of intervention. Technological advancements and increased availability of imaging modalities have enabled earlier and more accurate detection of these tumours. Novel medical therapies, recommendations for screening, and operative techniques have all contributed to overall improving knowledge of these tumours and ultimately patient outcomes.


Subject(s)
Humans , Male , Female , Infant, Newborn , Child , Middle Aged , Aged , Early Detection of Cancer , Heart Neoplasms/surgery , Heart Neoplasms/diagnostic imaging
6.
Rev. chil. cardiol ; 39(2): 147-153, ago. 2020. graf
Article in Spanish | LILACS | ID: biblio-1138527

ABSTRACT

Abstract: A 49-year-old woman presented with dyspnea and palpitations, leading to Functional Class III.An echocardiogram showed a heterogeneous mass adhered to the right heart cavities. This was confirmed by NMR. A large right coronary artery was occluded in relation to the tumor, which was hyper vascularized. Resection of the tumor was performed; the right ventricular wall was sutured, and an atrial defect was closed using pericardial tissue. Post operative course was uneventful and she was asymptomatic 4 years after surgery.


Subject(s)
Humans , Female , Middle Aged , Paraganglioma/surgery , Heart Neoplasms/surgery , Paraganglioma/complications , Paraganglioma/diagnostic imaging , Angiography , Magnetic Resonance Spectroscopy , Dyspnea/etiology , Heart Neoplasms/complications , Heart Neoplasms/diagnostic imaging
7.
Rev. bras. cir. cardiovasc ; 35(3): 399-401, May-June 2020. tab, graf
Article in English | SES-SP, LILACS, SES-SP | ID: biblio-1137256

ABSTRACT

Abstract Primary malignant neoplasms of the heart are rare. Cardiac rhabdomyosarcoma is the second most common primary sarcoma. We report a rare case of a 49-year-old woman with a huge biatrial cardiac rhabdomyosarcoma treated by performing surgical resection followed by salvage chemotherapy for local recurrence. Cardiac sarcoma that occupy both atria are extremely rare. Although the prognosis of cardiac rhabdomyosarcoma is dismal, surgical resection should be recommended as a first line therapy to clarify the diagnosis and to relieve symptoms associated with the tumor.


Subject(s)
Humans , Female , Middle Aged , Rhabdomyosarcoma/surgery , Rhabdomyosarcoma/diagnostic imaging , Heart Neoplasms/surgery , Heart Neoplasms/diagnostic imaging , Heart Atria/surgery , Heart Atria/diagnostic imaging , Neoplasm Recurrence, Local
10.
Rev. bras. cir. cardiovasc ; 34(6): 772-774, Nov.-Dec. 2019. tab, graf
Article in English | LILACS | ID: biblio-1057492

ABSTRACT

Abstract The most common cardiac tumour in the pediatric age group is rhabdomyoma. These are usually located in the ventricles, either in the ventricular septum or free wall. Cardiac tumours in early infancy may lead to severely compromised blood flow due to inflow or outflow tract obstruction. The diagnosis of cardiac rhabdomyoma can be established by transthoracic echocardiography (TTE). Rhabdomyomas have a natural history of spontaneous regression; surgical intervention is reserved for patients with symptoms of severe obstruction or hemodynamic instability. In this study, a case of two-year old child who presented with failure to thrive and underwent excision of pedunculated mass from the right ventricular outflow tract was reported.


Subject(s)
Humans , Child, Preschool , Rhabdomyoma/surgery , Ventricular Outflow Obstruction/surgery , Heart Neoplasms/surgery , Rhabdomyoma/diagnostic imaging , Magnetic Resonance Imaging , Ventricular Outflow Obstruction/diagnostic imaging , Echocardiography , Heart Neoplasms/diagnostic imaging , Heart Ventricles/diagnostic imaging
11.
Rev. bras. cir. cardiovasc ; 34(4): 499-502, July-Aug. 2019. tab, graf
Article in English | LILACS | ID: biblio-1020485

ABSTRACT

Abstract Cardiac papillary fibroelastoma are rare, benign cardiac tumors that may lead to lethal complications from embolization or valvular dysfunction if left untreated. When working up symptomatic tumors with concomitant angina, traditional diagnostic studies such as cardiac catheterization may predispose the patient to embolic complications if the mass is located in the path of the catheter. Newer, non-invasive diagnostic testing, such as cardiac magnetic resonance imaging or dynamic computed tomography angiography, may be considered in lieu of invasive approaches to avoid potentially devastating complications. We herein present a case report of a 77-year-old female with a symptomatic aortic valve tumor and describe our diagnostic strategy and management.


Subject(s)
Humans , Female , Aged , Aortic Valve/diagnostic imaging , Heart Neoplasms/diagnostic imaging , Computed Tomography Angiography/methods , Heart Neoplasms/surgery , Heart Neoplasms/pathology , Heart Valve Diseases/surgery , Heart Valve Diseases/diagnostic imaging
12.
Rev. bras. cir. cardiovasc ; 34(1): 22-27, Jan.-Feb. 2019. tab, graf
Article in English | LILACS | ID: biblio-985231

ABSTRACT

Abstract Objective: To disclose the relationships between the anatomic features of cardiac myxomas and plasma interleukin (IL)-6 levels. Methods: Twelve patients undergoing cardiac myxoma resection at The First Hospital of Putian, Teaching Hospital, Fujian Medical University were enrolled into this study. Pre- and postoperative IL-6 levels were determined by an enzyme-linked immunosorbent assay method, and correlations between cardiac myxoma dimension or volume and plasma IL-6 levels were analyzed. C-reactive protein (CRP) levels were also evaluated. Results: IL-6 and CRP levels were significantly decreased one month after cardiac myxoma resection in comparison to preoperative values. IL-6 and CRP levels did not differ between patients with a cardiac myxoma of irregular appearance and those with a myxoma of regular gross appearance, or between patients with a pedicled or a sessile myxoma. Decrement of IL-6 of patients with irregular cardiac myxomas was much higher than that of patients with regular ones, while no intergroup difference was noted in decrement of CRP. A close direct correlation was noted between IL-6 levels and maximal dimension (length) or volume of cardiac myxomas, whereas CRP levels only correlated with maximal dimension of cardiac myxomas. Conclusion: Anatomic features of cardiac myxomas (sessile, irregular appearance, maximal dimension, and volume) could be determinants of the patients' circulating IL-6 levels. IL-6 was likely to be a more sensitive biomarker than CRP in predicting the inflammatory status of patients with cardiac myxoma. Sessile and irregular cardiac myxomas might predict more severe inflammatory conditions for their more abundant endothelial cells and IL-6 overproduction.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , C-Reactive Protein/analysis , Interleukin-6/blood , Heart Neoplasms/blood , Myxoma/blood , Postoperative Period , Reference Values , Enzyme-Linked Immunosorbent Assay , Biomarkers, Tumor/blood , Retrospective Studies , Tumor Burden , Preoperative Period , Heart Neoplasms/surgery , Heart Neoplasms/pathology , Myxoma/surgery , Myxoma/pathology
13.
Rev. méd. Chile ; 147(2): 243-246, Feb. 2019. graf
Article in Spanish | LILACS | ID: biblio-1004338

ABSTRACT

Embolic stroke secondary to cardiac tumors is uncommon. However, 25-30% of cardiac tumors may cause systemic emboli. We report a 29-year-old male consulting for a sudden episode of aphasia and right hemiparesis, compatible with infarct of the left middle cerebral artery territory. Transthoracic echocardiography reported an ovoid tumor of 8 × 7 × 7 mm in relation to the sub valvular apparatus of the mitral valve. After neurologic stabilization, surgical treatment was performed. Approached by median sternotomy and in cardiopulmonary bypass, the mitral valve was explored. A macroscopic tumor consistent with a papillary fibroelastoma curled in sub valvular chordae was found. It was deployed and resected from its base, while the anterior mitral leaflet was preserved intact. Histopathological examination confirmed the intraoperative macroscopic diagnosis. The patient recovered uneventfully postoperatively and was discharged on the fifth day after surgery. He currently is in functional capacity I without cardiovascular symptoms at five years follow-up.


Subject(s)
Humans , Male , Adult , Infarction, Middle Cerebral Artery/etiology , Fibroma/complications , Heart Neoplasms/complications , Heart Valve Diseases/complications , Papillary Muscles , Echocardiography , Sternotomy , Fibroma/surgery , Fibroma/pathology , Fibroma/diagnostic imaging , Heart Neoplasms/surgery , Heart Neoplasms/pathology , Heart Neoplasms/diagnostic imaging , Heart Valve Diseases/surgery , Heart Valve Diseases/diagnostic imaging , Mitral Valve
14.
Rev. Assoc. Med. Bras. (1992) ; 64(12): 1077-1080, Dec. 2018. graf
Article in English | LILACS | ID: biblio-976813

ABSTRACT

SUMMARY Cardiac myxoma is a benign neoplasm, which corresponds to the most common primary heart tumour, responsible for about 50% of the cases. In general, 75-80% of myxomas are located in the left atrium, 18% in the right atrium, and more rarely in the ventricles or multicentric. Right atrial myxoma, in particular, can obstruct the tricuspid valve, causing symptoms of right heart failure, peripheral oedema, hepatic congestion, and syncope. Systemic embolization occurs in 30% of cases, by either tumour fragmentation or total tumour detachment. In the present report, we present a case of a symptomatic patient, who showed a large right intra-atrial lesion, with consequent superior vena cava syndrome, and then underwent surgical resection at admission.


RESUMO O mixoma cardíaco é uma neoplasia benigna, que corresponde ao tumor primário mais comum do coração, responsável por cerca de 50% dos casos. De modo geral, 75 a 80% dos mixomas estão localizados no átrio esquerdo, 18% no átrio direito, e mais raramente, nos ventrículos ou multicêntricos. O mixoma atrial direito, em particular, pode obstruir a válvula tricúspide, causando sintomas de insuficiência cardíaca direita, edema periférico, congestão hepática e síncope. A embolização sistêmica ocorre em 30% dos casos, quer pela fragmentação do tumor ou pelo desprendimento total do mesmo. No presente relato, apresentamos um caso de uma paciente sintomática, que evidenciou grande lesão intra-atrial direita, com consequente síndrome da veia cava superior, sendo, então, submetida a ressecção cirúrgica na internação.


Subject(s)
Humans , Female , Superior Vena Cava Syndrome/etiology , Heart Neoplasms/complications , Myxoma/complications , Superior Vena Cava Syndrome/surgery , Superior Vena Cava Syndrome/diagnostic imaging , Heart Neoplasms/surgery , Heart Neoplasms/diagnostic imaging , Middle Aged , Myxoma/surgery , Myxoma/diagnostic imaging
17.
Rev. bras. cir. cardiovasc ; 33(2): 162-168, Mar.-Apr. 2018. tab, graf
Article in English | LILACS | ID: biblio-958391

ABSTRACT

Abstract Objective: Primary cardiac tumors are rare lesions with different histological type. We reviewed our 17 years of experience in the surgical treatment and clinical results of primary non-myxoma cardiac tumors. Methods: Between July 2000 and February 2017, 21 patients with primary cardiac tumor were surgically treated in our institution. The tumors were categorized as benign non-myxomas and malignants. Data including the demographic characteristics, details of the tumor histology and grading, cardiac medical and surgical history, surgical procedure of the patients were obtained from the hospital database. Results: Eleven patients were diagnosed with benign non-myxoma tumor (male/female:7/4), ranging in age from 10 days to 74 years (mean age 30.9±26.5 years). Papillary fibroelastoma was the most frequent type (63.6%). There were two early deaths in benign group (all were rhabdomyoma), and mortality rate was 18%. The mean follow-up period was 69.3±58.7 months (range, 3 to 178 months). All survivals in benign group were free of tumor-related symptoms and tumor relapses. Ten patients were diagnosed with malignant tumor (sarcoma/lymphoma:8/2, male/female:3/7), ranging in age from 14 years to 73 years (mean age 44.7±18.9 years). Total resection could be done in only three (30%) patients. The mean follow-up period was 18.7±24.8 months (range, 0-78 months). Six patients died in the first 10 months. Conclusion: Complete resection of the cardiac tumors, whenever possible, is the main goal of surgery. Surgical resection of benign cardiac tumors is safe, usually curative and provides excellent long-term prognosis. On the contrary, malignant cardiac tumors still remain highly lethal.


Subject(s)
Humans , Male , Female , Infant, Newborn , Child, Preschool , Child , Adult , Middle Aged , Aged , Heart Neoplasms/surgery , Heart Neoplasms/pathology , Rhabdomyoma/surgery , Rhabdomyoma/mortality , Rhabdomyoma/pathology , Sarcoma/surgery , Sarcoma/mortality , Sarcoma/pathology , Time Factors , Retrospective Studies , Treatment Outcome , Tumor Burden , Kaplan-Meier Estimate , Fibroma/surgery , Fibroma/mortality , Fibroma/pathology , Heart Neoplasms/mortality , Angiomatosis/surgery , Angiomatosis/mortality , Angiomatosis/pathology , Lymphoma/surgery , Lymphoma/mortality , Lymphoma/pathology
18.
Rev. bras. cir. cardiovasc ; 33(1): 104-106, Jan.-Feb. 2018. tab, graf
Article in English | LILACS | ID: biblio-897986

ABSTRACT

Abstract Cardiac angiosarcomas are extremely rare in childhood, they are rapidly progressive tumours that often present themselves as diagnostic dilemmas, resulting in delayed diagnosis. Also, extracardiac manifestations, including abdominal pain, are extremely rare in patients with intracardiac tumors. We herein present the case of a 15-year-old girl who presented with abdominal pain. Echocardiography and thoracic computed tomography showed right atrial mass. The patient underwent surgery, chemotherapy, and radiotherapy. Eight months after treatment, abdominal recurrence was detected. The abdominal mass was resected, and radiotherapy and new chemotherapy protocol were given. The present case illustrates a rare case of primary cardiac angiosarcoma posing a diagnostic dilemma in an adolescent girl.


Subject(s)
Humans , Female , Adolescent , Abdominal Pain/etiology , Heart Neoplasms/complications , Hemangiosarcoma/complications , Tomography, X-Ray Computed , Abdominal Pain/diagnostic imaging , Rare Diseases , Heart Neoplasms/surgery , Heart Neoplasms/diagnostic imaging , Hemangiosarcoma/surgery , Hemangiosarcoma/diagnostic imaging
19.
Medicina (B.Aires) ; 77(6): 481-485, dic. 2017. ilus, tab
Article in Spanish | LILACS | ID: biblio-894525

ABSTRACT

Los fibroelastomas papilares cardíacos son pequeños tumores benignos con potencial embolígeno. Con la incorporación de la ecocardiografía y la mejoría en la resolución de las imágenes, el diagnóstico clínico es cada vez más frecuente, y en series recientes su frecuencia supera a la del mixoma cardíaco. Nuestro objetivo fue analizar las características de una serie de casos de fibroelastoma papilar cardíaco con confirmación histológica operados en nuestro hospital. Analizamos retrospectivamente los tumores cardíacos y las características clínicas de los pacientes operados desde junio de 1992 a febrero de 2017. De 108 operados, 18 presentaron fibroelastoma papilar. La edad media del grupo con fibroelastoma papilar fue 58 años (22-77); 10 eran varones. Las localizaciones más frecuentes fueron la válvula aórtica (7) y la válvula mitral (5). Ninguno presentó disfunción valvular significativa. Por ecografía transesofágica, el tamaño (diámetro mayor) fue 13.33 ± 5.55 mm (6.6-28.0). Cuatro pacientes eran sintomáticos; uno presentaba disnea, otro aleteo auricular, dos con fibroelastoma en válvula aórtica habían sufrido un accidente cerebrovascular. Los restantes, asintomáticos, fueron intervenidos preventivamente. En 15 pacientes el tumor se extirpó sin necesidad de reemplazo valvular. No hubo mortalidad quirúrgica ni recidiva tumoral en el seguimiento de 2.6 años. Se concluye que los fibroelastomas papilares cardíacos pueden ser extirpados con buenos resultados a mediano plazo y, en su mayoría, con preservación valvular. Sin embargo, no existen aún estudios aleatorizados que avalen la escisión quirúrgica en pacientes asintomáticos. Por el momento, esta última depende de la experiencia del grupo quirúrgico tratante.


Papillary ibroelastomas are small benign intracardiac tumors known for their embolic potential. Since the introduction of echocardiography with improved resolution and transesophageal imaging techniques, they are being increasingly detected in clinical practice. In recent series, papillary fibroelastoma is considered the most frequent benign tumor of the heart. Our objective was to analyze characteristics and midterm surgical outcome of histologically-confirmed cases of papillary fibroelastoma. We conducted a retrospective study on patients with cardiac tumors submitted to surgical excision between June 1992 and February 2017. Out of 108 patients, 18 had papillary fibroelastomas. Their mean age was 58 years (22-77); 10 were men. The most frequent localizations were the aortic valve (7) and the mitral valve (5). None had significant valvular dysfunction. By transesophageal echocardiography, the tumor size (larger diameter) was 13.33 ± 5.55 mm (6.6-28.0). Two patients, both with tumor in the aortic valve, had suffered a stroke; other two had dyspnoea and atrial flutter, respectively. The remaining 14 patients were asymptomatic and their tumors were incidental findings. In 15 patients the valve was preserved. There was neither surgical mortality nor recurrence after 2.6 years of follow-up. In conclusion, most papillary fibroelastomas can be surgically removed with valve preservation and favorable clinical outcome. However, until the results of randomized trials support the decision, an aggressive surgical approach in asymptomatic patients needs to be defined in the context of surgical expertise.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Young Adult , Papillary Muscles/pathology , Fibroma/pathology , Heart Neoplasms/pathology , Retrospective Studies , Fibroma/surgery , Heart Neoplasms/surgery
20.
Rev. bras. cir. cardiovasc ; 32(5): 438-441, Sept.-Oct. 2017. tab, graf
Article in English | LILACS | ID: biblio-897935

ABSTRACT

Abstract The median sternotomy remains the standard approach in cardiovascular surgery but, in some conditions, it can be considered difficult to perform, especially in patients with history of esophagectomy. This case report describes a successful resection of a left atrial myxoma through a right anterolateral thoracotomy approach in a patient with a previous retrosternal gastric tube reconstruction. The decision for the best surgical approach was made after a heart surgery team discussion. Through this surgical access, a safe and excellent exposure of the left atrium was possible, and a complete resection of the myxoma was performed without any injury to the gastric tube.


Subject(s)
Humans , Male , Aged , Heart Neoplasms/surgery , Myxoma/surgery , Thoracotomy , Gastrostomy , Treatment Outcome , Heart Atria/surgery , Heart Atria/pathology
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