Primary neoplasms of the heart. Clinical and histological presentation of 50 cases

Fernandes, Fábio; Soufen, Helena Nogueira; Ianni, Bárbara Maria; Arteaga, Edmundo; Ramires, Felix José Alvarez; Mady, Charles

doi:10.1590/s0066-782x2001000300006

Cited by 50 publications

(42 citation statements)

References 7 publications

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“…Unlike the pattern observed in the literature [1][2][3] , this is a male patient in the second decade of life. The clinical classification of the case, class II, also contradicts the most common classification, in which 70% of patients have signs and symptoms of heart failure.…”

Section: Discussionmentioning

confidence: 50%

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Mixoma atrial gigante simulando estenose mitral grave em paciente jovem

Vilela¹,

Moura²,

Pepe³

et al. 2010

Arq. Bras. Cardiol.

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KeywordsMyxoma; giant cell tumors; mitral valve stenosis; adolescent.The echocardiogram of a twenty-year-old man, previously healthy, suffering from paroxysmal nocturnal dyspnea and fatigue after moderate exertion that intensified over a period of about ten days, showed the left atrium myxoma working as severe mitral stenosis. A physical examination revealed blood pressure of 110X70 mmHg, regular two-beat heart rhythm, systolic murmur in mitral area and without any changes in the rest of the physical examination. The electrocardiogram revealed a right bundle branch block. The echocardiogram showed a large mass that occupied almost the entire left atrium (4.3 x 8.0 cm in size). This mass was stuck to the posterior superior wall of the left atrium. The diameter of the left atrium was 5.6 cm and the estimated volume was 98 cm³. Part of the mass protruded through the mitral valve to the left ventricle during the atrial systole (the estimated valve area was 1 cm²), causing a restriction of the mitral flow that was compatible with severe stenosis (severe mitral stenosis). Then, surgery was indicated for removal of the tumor. Giant Atrial Myxoma Mimicking Severe Mitral Stenosis in Young PatientIn preoperative examinations, the only change found was microcytic and hypochromic anemia. Then, the exeresis of the tumor was performed with resection of the fossa ovalis and atrioseptoplasty was performed with the use of bovine pericardium. The histopathology of the specimen confirmed the diagnosis of left atrial myxoma. There were no complications in the postoperative period and the patient was discharged five days after surgery.

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Section: Discussionmentioning

confidence: 50%

“…The size, location and mobility of the myxoma will determine the symptomatology and severity of the valve obstruction 2 . In only 10% of patients, this obstruction will cause severe mitral stenosis [3][4][5] .…”

Section: Introductionmentioning

confidence: 99%

Mixoma atrial gigante simulando estenose mitral grave em paciente jovem

Vilela¹,

Moura²,

Pepe³

et al. 2010

Arq. Bras. Cardiol.

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“…This difference is caused by the time of evaluation, whereas the CLSG registry presents the incidence at the time of initial lymphoma diagnosis, published reports operated with data from autopsies of patients who died due to lymphoma (advanced and recurrent) [8,26]. Primary cardiac lymphomas involving heart and pericardium are very uncommon -less than 2% of primary cardiac tumors [27]. There is no clear definition of primary cardiac lymphoma and the WHO classification of tumors and hematopoietic and lymphoid tissues does not acknowledge primary cardiac lymphoma as a distinct entity [3].…”

Section: Discussionmentioning

confidence: 99%

An anaplastic cardiac large cell lymphoma: A case report and analysis of cardiac involvement in newly diagnosed non-Hodgkin’s lymphoma from the Czech Lymphoma Study Group (CLSG) database

Lobello¹,

Janíková²,

Křen³

et al. 2017

J Cancer Res Ther.

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We report a rare case of anaplastic large cell ALK+ lymphoma (ALCL) with initial asymptomatic cardiac involvement. A 59-year-old male with infiltration of the right ventricular wall underwent standard combined chemotherapy (CHOP) and achieved remission without significant cardiac impairment. Additionally, we report the actual incidence of cardiac lymphoma in newly diagnosed non-Hodgkin Lymphomas (NHLs). In total, 16 patients with cardiac lymphoma were found (0.1% NHLs) in the Czech Lymphoma Study Group database. DLBCL was the most frequent histology subtype (50%), and ALCL was identified in 12.5% of cases. At initial diagnosis, the median age was 55.5 (range 21-74) years and 59% were men. None of the 16 patients with cardiac involvement had isolated heart lymphoma. The response to first-line therapy was 79% in 14/16 evaluable patients. The median progression-free survival and overall survival were nearly the sameapproximately 3.5 years (range; 0.05-16.7ys), while the median follow up was 4 years.

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“…Clinical experiences at two of the largest Brazilian institutions (InCor-USP and Dante Pazzanese Institute of Cardiology) demonstrate the wide prevalence of the heart myxomas as primary heart tumors. At InCor-USP, in a series of 50 patients treated over a period of 18 years, 84% of the myxomas were of the histological type 2 . At the Dante Pazzanese Institute of Cardiology, the experience was similar.…”

Section: A Case Of Left Atrial Myxoma Is Reported In a 14-yearold Femmentioning

confidence: 99%

Left atrial myxoma as the cause of syncope in an adolescent

Nogueira

Bontempo

Menardi

et al. 2003

Arq. Bras. Cardiol.

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In agreement with classical data from the Institute of Pathology of the Armed Forces (Washington, DC), primary tumors of the heart, benign or malign, are found in 0.001% -0.28% of all of autopsies, and the myxomas represent 50% of the benign tumors of the heart 1 . Clinical experiences at two of the largest Brazilian institutions (InCor-USP and Dante Pazzanese Institute of Cardiology) demonstrate the wide prevalence of the heart myxomas as primary heart tumors. At InCor-USP, in a series of 50 patients treated over a period of 18 years, 84% of the myxomas were of the histological type 2 . At the Dante Pazzanese Institute of Cardiology, the experience was similar. Over a period of 28 years, with a series of 52 patients with heart tumors, 82.7% of the tumors were myxomas 3 . At the Ribeirão Preto Heart Hospital, over a period of 23 years, surgeons at the CECORP -Ribeirão Preto Specialized Heart and Lung Center operated on 7 patients for removal of heart tumors, 6 patients with myxomas and 1 patient with leiomyosarcoma metastasis. Among the 6 patients with heart myxomas, the age varied from 14 to 78 years, 4 were females, and all tumors were located at the left atrium. Although syncope is a symptom thoroughly described, resulting from myxoma left ventricular inflow obstruction, its incidence in the adolescent is rare, creating difficulties for the clinical evaluation of syncope in this age group. A unique case was reported in the literature of syncope as a consequence of left ventricle outflow obstruction, caused by a myxoma localized in this cardiac chamber 4 . A case of ischemic stroke in an 8-year-old female child has been reported in the Brazilian literature 5 . These data justify this case report of syncope in an adolescent caused by the presence of a left atrial heart myxoma that intermittently obstructed the mitral valve. Case ReportA 14-year-old female, resident of São Simão (SP), had a clinical cardiology appointment in April 2000 because of 3 episodes of syncope over the previous 3 months. During this interval of time, she was evaluated by a neurologist, without any diagnostic conclusion about the syncope. She was then directed to the cardiologist due to the presence of palpitations experienced at rest.During the first cardiology consultation, a syncope diagnosis was the main focus of the investigation. The clinical anamnesis revealed palpitations, a heart rate of 130 bpm, and low corporal weight with accentuated loss in the prior 3 months. The heart auscultation, by this time, did not show evidence of a heart murmur. With the clinical hypothesis of hyperthyroidism, thyroid hormone dosages and an electrocardiogram were requested. The hormonal function was normal. The electrocardiogram identified a sinus tachycardia and a possible left atrium enlargement. The diagnostic

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Primary neoplasms of the heart. Clinical and histological presentation of 50 cases

Abstract: Primary cardiac tumors are a rare entity with diverse clinical and histologic findings, requiring, therefore, a high level of clinical suspicion.

Cited by 50 publications

References 7 publications

Mixoma atrial gigante simulando estenose mitral grave em paciente jovem

Mixoma atrial gigante simulando estenose mitral grave em paciente jovem

An anaplastic cardiac large cell lymphoma: A case report and analysis of cardiac involvement in newly diagnosed non-Hodgkin’s lymphoma from the Czech Lymphoma Study Group (CLSG) database

Left atrial myxoma as the cause of syncope in an adolescent

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