Perioperative outcomes of patients who underwent open-heart surgery for primary cardiac tumors: Brief report

@#Primary cardiac tumors are extremely rare, occurring in 0.001% to 0.3% of autopsies.1 Most cardiac tumors are metastatic, and they are usually diagnosed in approximately 10% of patients with non-cardiac primary tumors at autopsy.2 3 4 About 75% of primary cardiac tumors are benign and are predominantly myxomas.5 Only 25% of these tumors are malignant, and the most common types in both children and adults, are sarcomas (75%).1 6 7 In a retrospective study done among 255 patients with cardiac tumors in the Philippine Heart Center from 1976 to 2006, the incidence of benign tumors was 91.8% while malignant tumors were reported in 8.2% of cases. Eighty-nine percent of the patients were adults, and 11% were from the pediatric age group.8 As in other similar studies,5 9 the most common cardiac tumors in the Philippine study were myxoma among the adult participants and rhabdomyoma among the pediatric participants.

Boerhaave’s syndrome presenting with hematemesis: Case report

@#The clinical presentation of Boerhaave’s syndrome (BS), a rare condition of the gastrointestinal tract characterized by a spontaneous rupture of the esophagus most often caused by vomiting after excessive alcohol drinking or after consuming a large meal, mimics other less serious illnesses, often leading to a missed or delayed diagnosis. The Mackler triad, which is rare and pathognomonic of BS, includes lower thoracic or chest pain, subcutaneous emphysema, and vomiting. Diagnosis is made through computed tomography scan and esophageal contrast studies. Treatment of BS is geared towards control of mediastinitis and sepsis, and repair of the perforation or reestablishment of the continuity of the gastrointestinal tract. We report the case of a 46-year-old male with BS, who was initially managed with a conservative resection of the perforated esophagus 48 hours after the onset of symptoms. When the mediastinitis persisted we decided to do a subtotal esophagectomy and subsequent esophageal reconstruction.

Ectopia cordis totalis: Case in images

@#Ectopia cordis (EC) is a rare congenital malformation characterized by a complete or partial extrathoracic presentation of the heart,1 2 with an incidence of only 6 to 8 in a million live births globally.3 4 It occurs due to failure of maturation of the midline mesoderm and improper formation of the chest and abdomen during embryonic development.5 6 Depending on the heart’s ectopic location, EC is classified into four types—i.e., thoracic (65% of cases), thoracoabdominal (20%), abdominal (10%), and cervical (5%).1 2 4 7 Only two cases of EC, one thoracic and one thoracoabdominal, from the Philippines had been reported in literature.8 Cantrell’s pentalogy—findings of bifid sternum, absence of the diaphragm, defect of anterior diaphragmatic pericardium, defect of the anterior abdominal wall, and intracardiac defects—usually accompanies the thoracoabdominal type of EC.