Primary cardiac synovial sarcoma mimicking SARS-CoV-2 associated pericarditis.

Primary cardiac synovial sarcoma is an extremely rare tumor with a higher incidence in young men. The mean age of occurrence is 32 years. Synovial sarcomas are tumors with high aggressiveness, proliferate rapidly and metastasize to regional and distant lymph nodes or surrounding organs. The typical location of synovial sarcoma of the heart is the atrial and ventricular septum. Its size, the degree of infiltration of the surrounding tissues and the presence of metastases influence clinical symptoms, which are very non-specific. The low specificity of the symptoms complicates the clinical diagnosis and in most cases the tumor is detected during its progression or incidentally. The final diagnosis is based on histological examination. The primary and only method of treatment is a surgical solution with an effort to completely resect the tumor, followed by aggressive palliative chemotherapy. In the following paper, we present a case report of a 32-year-old man who was diagnosed with synovial cardiac sarcoma only on the basis of exacerbation of non-specific subjective complaints due to the complication in the form of of aneurysmal bleeding of the tumor mass.

Gastric emptying of solids in children with H. pylori-positive and H. pylori-negative non-ulcer dyspepsia.

OBJECTIVE: There is currently no data available in children on possible relationships among Helicobacter pylori, gastric motility and gastric inflammation. This is a prospective study of gastric emptying (GE) in symptomatic children with and without H. pylori who met symptom-based criteria for non-ulcer dyspepsia (NUD). METHODS: 47 consecutive dyspeptic patients (23 males; age range, 7 to 18 years) were enrolled. All patients had extensive negative diagnostic investigations. Scintigraphic solid-phase gastric emptying was assessed. RESULTS: 21 H. pylori-positive and 26 H. pylori-negative patients were identified with non-ulcer dyspepsia. The groups were not different in clinical symptoms except that pain related to feeding was more frequent in infected children (P < 0.03). Nodular antral gastritis was found more frequently in the H. pylori positive group (P < 0.0001). The gastritis score was more severe in H. pylori infected than H. pylori negative patients in both fundic and body mucosa (P < 0.001). Within the H. pylori-positive NUD group, the mean half-time GE of a solid meal was significantly accelerated compared to the non-infected group (P < 0.05). There was no difference in the intragastric food distribution and curves of gastric emptying of both groups. A significant relationship was found between the degree of gastric body inflammation gastric emptying, but not antral inflammation. Gastric emptying rate did not differ by sex or age of the subjects in either group. CONCLUSIONS: In dyspeptic children with H. pylori, gastric emptying of a solid was significantly accelerated compared with symptomatic H. pylori uninfected patients. This suggests that H. pylori is able to induce gastric emptying acceleration. Our findings add more information on H. pylori infection and gastroduodenal disease.