Cardiac tumors: three decades of experience from a tertiary center: are we changing diagnostic work-up with new imaging tools?

Mendes, G Sa; Abecasis, João; Ferreira, António Miguel; Ribeiras, Regina; Abecasis, Miguel; Gouveia, Rosa; Andrade, Maria João; Mendes, Miguel; Ramos, Sância; Saraiva, Carla; Neves, José Pedro

doi:10.1016/j.carpath.2020.107242

Cited by 14 publications

(13 citation statements)

References 13 publications

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“…In practice, echocardiography can usually distinguish between the three intracardiac masses, namely tumor, thrombus, and vegetation, with an accuracy 80% (41)(42)(43). A presumptive TTE diagnosis can be made for primary cardiac neoplasm, including CM, for some distinctive features (21).…”

Section: Discussionmentioning

confidence: 99%

Developing a Novel Positronium Biomarker for Cardiac Myxoma Imaging

Moskal

Kubicz

Grudzień

et al. 2021

Preprint

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Here, positronium imaging is presented to determine cardiac myxoma (CM) extracted from patients undergoing urgent cardiac surgery due to unexpected atrial masses. Positronium is an atom build from an electron and a positron, produced copiously in intra-molecular voids during the PET imaging. CM, the most common cardiac tumor in adults, accounts for 50-75% of benign cardiac tumors. We aimed to assess if positronium serves as a biomarker for diagnosing CM. Perioperative examinations and histopathology staining in six patients confirmed the primary diagnosis of CM. We observed significant differences in the mean positronium lifetime between tumor and normal tissues, with an average value of 1.92(02) ns and 2.72(05) ns for CM and the adipose tissue, respectively. Our findings, combined with positronium lifetime imaging, reveals the novel emerging positronium biomarker for cardiovascular imaging.One-Sentence SummaryPositronium may serve as an imaging biomarker for cancer diagnostics.

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Section: Discussionmentioning

confidence: 99%

Developing a Novel Positronium Biomarker for Cardiac Myxoma Imaging

Moskal

Kubicz

Grudzień

et al. 2021

Preprint

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“…In general, the etiological approach to a mass suspected of being a cardiac tumour is based on transthoracic echocardiography (TTE). This allows the size of the tumour, its location, mobility and haemodynamic consequences to be assessed [15]. Once the diagnosis of a cardiac mass has been confirmed, magnetic resonance imaging (MRI) will improve the results of TTE by specifying the degree of infiltration of the cardiac tissues by the tumour as well as the extension to neighbouring structures, and will also make it possible to predict the tumour grade [4].…”

Section: Discussionmentioning

confidence: 99%

Primary Cardiac Sarcoma of the Left Atrium, A Case Report and Literature Review

Negamiyimana¹,

Bagorane²,

Adjade³

et al. 2022

Glob Acad J Med Sci

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Primary malignant cardiac tumours are extremely rare. They count for a quarter of all possible cardiac tumors, and are mostly sarcomas. For a long time, their diagnosis was made post mortem, and they were only reported through autopsy series. Since then, diagnostic and therapeutic advances have been made, making clinical diagnosis of this entity more accessible ante mortem. Nevertheless, due to their rarity, cardiac sarcomas suffer from a lack of therapeutic guidelines. Their treatment is modelled on that of sarcomas developed in other organs of the body. We report an interesting case of a 74-year-old female patient operated on for an infiltrating sarcomatous tumour of the left atrium revealed by dyspnoea associated with cardiac palpitations. Thoracic angioscan and transthoracic echocardiography led to the diagnosis of a cardiac tumour, and the thoracic-abdominal-pelvic Computed Tomography (CT) scan did not reveal any other extracardiac lesions except for a minimal non-neoplastic bilateral pleural effusion. The patient underwent an incomplete surgical procedure with R2 resection followed by adjuvant chemotherapy with doxorubicin monotherapy. The evolution under this treatment was marked by a locoregional progression of the disease with further progression in the atria, mediastinum and dorsal spine after 4 courses. A second line of chemotherapy with Dacarbazine monotherapy was initiated, but the patient died shortly after receiving two courses of the new treatment.

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“…TEE improves image quality and provides more morphological information than TTE [15]. Computed tomography and cardiac magnetic resonance provide additional information on topographic relationships and tissue characteristics, and may detect other pathological conditions within the thorax [16,17]. Assessment of cardiac tumors by CMR is more accurate than echocardiography and can reliably distinguish between benign and malignant cardiac tumors [18][19][20].…”

Section: Discussionmentioning

confidence: 99%

Accuracy of Transthoracic Echocardiography in Diagnosis of Cardiac Myxoma: Single Centre Experience

Prokšelj

Kacar

Pavšič

et al. 2021

Preprint

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The differential diagnosis of cardiac myxomas (CM), the most common benign primary cardiac tumors, is broad and a thorough diagnostic workup is required to establish accurate diagnosis prior to surgical resection. Transthoracic echocardiography (TTE) is usually the first imaging modality used for diagnosis of suspected CM. Purpose In a single tertiary centre study, we sought to determine the accuracy, sensitivity, and specificity of TTE in the diagnosis of CM and to determine echocardiographic characteristics indicative of CM. Methods and results We retrospectively analyzed clinical, echocardiographic, and pathohistological findings of 73 patients consecutively admitted for suspected CM. After diagnostic workup, 53 (73%) patients were treated surgically at our institution. Based on preoperative TTE, patients were divided into a CM group (n=45, 85%) and non-myxoma (NM) group. Of the 53 pathohistological specimens obtained during surgery, 39 (73%) were CM. The sensitivity and specificity of preoperative echocardiography were 97% and 50%, respectively. The overall accuracy was 85%. All NM tumors were found in an atypical location and 72% of CM were found in a typical position in the left atrium (p<0.001). Tumors in NM group were significantly smaller than CM (24.3±13.2 mm vs 37.9±18.3 mm, p=0.017). Conclusion Our study confirms very good accuracy of TTE in the diagnosis of CM. The most important echocardiographic characteristics to differentiate between CM and tumors of different etiology are tumor location and size. Smaller tumors presenting at an atypical location are less likely to be diagnosed as CM, and these require additional imaging modalities for accurate diagnosis.

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Cardiac tumors: three decades of experience from a tertiary center: are we changing diagnostic work-up with new imaging tools?

Cited by 14 publications

References 13 publications

Developing a Novel Positronium Biomarker for Cardiac Myxoma Imaging

Developing a Novel Positronium Biomarker for Cardiac Myxoma Imaging

Primary Cardiac Sarcoma of the Left Atrium, A Case Report and Literature Review

Accuracy of Transthoracic Echocardiography in Diagnosis of Cardiac Myxoma: Single Centre Experience

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