RESUMEN
BACKGROUND Cardiac calcified amorphous tumor (CCAT), a peculiar and uncommon non-neoplastic cardiac lesion, was initially characterized by Reynolds and colleagues in the medical literature in 1997. This distinctive entity is hallmarked by its unique feature of pedunculated and diffused calcifications, primarily infiltrating the cardiac structures, with a predilection for the mitral valve annulus initially, followed in sequence by the right atrium, right ventricle, left atrium, left ventricle, and tricuspid valve annulus. The nature of CCATs, despite being benign, poses diagnostic dilemmas, as they frequently masquerade as malignant tumors due to their clinical presentations, which resemble those caused by potential complications such as obstructive masses and thromboembolic events. CASE REPORT A 50-year-old man presented to our hospital with shortness of breath. He had been short of breath for more than 5 years after repeated activities. Transthoracic echocardiography showed a mobile high echogenic mass from the middle of the right ventricular wall and pericardial effusion and right heart insufficiency. The electrocardiogram (ECG) results demonstrated a sinus rhythm, complete right bundle branch block, and T-wave alterations. Additionally, the chest computed tomography (CT) scan revealed a slightly enlarged heart with a lack of density and calcification in the right ventricle. He had an uneventful postoperative recovery after the resection of the cardiac tumor. The mass had not continued to grow when we compared it with preoperative cardiac color doppler echocardiography, after 3 months follow-up. CONCLUSIONS CCAT is a rare non-neoplastic cardiac entity. Diagnosis of CCAT poses a challenge due to the absence of distinct clinical features and its frequent misidentification as a malignant tumor mimic. Surgical resection serves as the sole treatment for symptom relief.
Asunto(s)
Calcinosis , Neoplasias Cardíacas , Ventrículos Cardíacos , Humanos , Masculino , Persona de Mediana Edad , Calcinosis/diagnóstico por imagen , Neoplasias Cardíacas/diagnóstico , Neoplasias Cardíacas/diagnóstico por imagen , Neoplasias Cardíacas/cirugía , Diagnóstico Diferencial , Ecocardiografía , Tomografía Computarizada por Rayos XRESUMEN
Atrial Myxoma is the most common primary benign tumour of the heart, commonly found in the left atrium. It typically presents in young females with characteristic features such as, constitutional symptoms, chest pain, and cardiac murmurs. However, atypical presentations can occur; causing a diagnostic challenge. This case report describes a 75-year-old male who visited the cardiology outpatient department of Dow Institute of Cardiology, Karachi on 18th April, 2023 with a left-sided atrial myxoma in late adulthood without typical features including constitutional symptoms, chest pain, syncope, dizziness, digital clubbing or neurologic findings. Further discussed are the diagnostic techniques used to find the tumour and the treatment strategy. This case report highlights the need for cardiologists to consider Atrial Myxoma as a potential diagnosis, even in the absence of typical symptoms, in elderly male population.
Asunto(s)
Atrios Cardíacos , Neoplasias Cardíacas , Mixoma , Humanos , Mixoma/cirugía , Mixoma/diagnóstico , Masculino , Neoplasias Cardíacas/cirugía , Neoplasias Cardíacas/diagnóstico , Neoplasias Cardíacas/diagnóstico por imagen , Anciano , Atrios Cardíacos/diagnóstico por imagen , Atrios Cardíacos/patología , EcocardiografíaRESUMEN
RATIONALE: Approximately one-fifth ischemic stroke are attributed to cardioembolism. Patients with cardioembolic stroke often develop a more severe disability and a higher risk of stroke recurrence. Cardiac myxoma, although uncommon, can serve as a potentially curable cause of acute embolic strokes. PATIENT CONCERNS: A 55-year-old male patient presented to the emergency department with acute vertigo and unsteady gait, accompanied by left upper limb numbness. Concurrently, purple-like lesions on the left hand were noticed. DIAGNOSES: Brain magnetic resonance imaging showed multiple infarctions in the posterior circulation. Additionally, skin examination showed Janeway lesions, Osler nodes and splinter hemorrhages. There was no evidence of systemic infection. Subsequently, transthoracic echocardiogram revealed a left atrial myxoma. INTERVENTION: Early surgical resection of cardiac myxoma was performed. OUTCOMES: The patient recovered well from the surgery. No recurrent embolic event was reported at 3-month postoperatively. LESSONS: Clinicians should be vigilant for skin manifestations of cardiac embolism. In patients with acute ischemic strokes, the presence of cutaneous embolic phenomena could serve as a warning sign of cardioembolism.
Asunto(s)
Atrios Cardíacos , Neoplasias Cardíacas , Accidente Cerebrovascular Isquémico , Mixoma , Humanos , Masculino , Mixoma/complicaciones , Mixoma/diagnóstico , Mixoma/cirugía , Persona de Mediana Edad , Neoplasias Cardíacas/complicaciones , Neoplasias Cardíacas/diagnóstico , Neoplasias Cardíacas/cirugía , Accidente Cerebrovascular Isquémico/etiología , Atrios Cardíacos/diagnóstico por imagen , Endocarditis/complicaciones , Endocarditis/diagnóstico , EcocardiografíaRESUMEN
ABSTRACT: Lipomatous hypertrophy of the interatrial septum (LHIS) is a rare but benign cardiac tumor that can be found on cardiac imaging such as echocardiogram, or during surgery or an autopsy. Cardiac MRI is the best imaging modality to determine the borders of the tumor and its extension into the intraventricular septum and ventricular free wall. Patients require close monitoring because LHIS may cause right or left outflow tract obstruction or superior vena cava obstruction, requiring cardiac surgical intervention. This article describes a patient with LHIS who underwent cardiac surgery because of her increasing symptomatology.
Asunto(s)
Tabique Interatrial , Neoplasias Cardíacas , Lipomatosis , Humanos , Femenino , Tabique Interatrial/diagnóstico por imagen , Tabique Interatrial/patología , Neoplasias Cardíacas/diagnóstico por imagen , Neoplasias Cardíacas/cirugía , Neoplasias Cardíacas/diagnóstico , Neoplasias Cardíacas/patología , Lipomatosis/diagnóstico por imagen , Lipomatosis/diagnóstico , Lipomatosis/cirugía , Imagen por Resonancia Magnética , Hipertrofia , Ecocardiografía , Persona de Mediana Edad , Lipoma/cirugía , Lipoma/diagnóstico por imagen , Lipoma/diagnósticoRESUMEN
Primary cardiac angiosarcoma is a rare, aggressive malignancy that commonly metastasizes to various organs. The presenting symptoms are typically nonspecific, so a comprehensive examination is required to confirm the diagnosis promptly. This case report describes the presentation of an older patient with a history of neoplasms. Echocardiography and biopsy were performed, but despite surgical intervention to resect a large right atrial mass, the patient died. A final diagnosis of primary angiosarcoma was made based on the resected specimen.
Asunto(s)
Neoplasias Cardíacas , Hemangiosarcoma , Humanos , Neoplasias Cardíacas/diagnóstico , Neoplasias Cardíacas/cirugía , Anciano , Hemangiosarcoma/diagnóstico , Hemangiosarcoma/cirugía , Resultado Fatal , Biopsia , Masculino , Atrios Cardíacos/patología , Atrios Cardíacos/diagnóstico por imagen , Atrios Cardíacos/cirugía , Ecocardiografía , Procedimientos Quirúrgicos Cardíacos/métodosRESUMEN
ST-segment elevation on the electrocardiogram typically indicates acute myocardial infarction but can mimic ST-segment elevation myocardial infarction in various conditions. We present a case of a patient with an intramyocardial mass and anterior ST-segment elevation without significant myocardial biomarker elevation. Multimodality imaging was crucial in revealing cardiac metastasis as the attributable cause.
Asunto(s)
Electrocardiografía , Neoplasias Cardíacas , Infarto del Miocardio con Elevación del ST , Humanos , Infarto del Miocardio con Elevación del ST/diagnóstico , Diagnóstico Diferencial , Neoplasias Cardíacas/secundario , Neoplasias Cardíacas/diagnóstico por imagen , Neoplasias Cardíacas/diagnóstico , Masculino , Persona de Mediana EdadRESUMEN
Cardiac myxoma is extremely rare in children. However, if not treated immediately, it may cause varying symptoms until sudden death. A-9-years old male Javanese child was brought to the emergency department of Prof. Soekandar General Hospital, Mojokerto with progressive dyspnoea since one month which got worse in the left decubitus position. There was no significant past medical history. Physical examination revealed hypotension, mitral stenosis, tricuspid regurgitation, and pulmonary congestion. Transthoracic echocardiography revealed a round pedunculated 3x3.3 cm mass in the Left Atrium that swingingly moved to the Left Ventricle during diastole. This was diagnosed provisionally as Myxoma with a differential of thrombus. After stabilization, he was referred to a tertiary hospital for emergency excision. Histopathology confirmed the myxoma. There were no symptoms and activity limitations during the 6 months follow-up. To the best of our knowledge, this is the first paediatric cardiac myxoma with Acute Heart Failure symptoms reported in Indonesia. Echocardiography is imperative for diagnosing myxoma. Appropriate and timely management results in an excellent outcome.
Asunto(s)
Ecocardiografía , Insuficiencia Cardíaca , Neoplasias Cardíacas , Mixoma , Humanos , Mixoma/complicaciones , Mixoma/cirugía , Mixoma/diagnóstico , Neoplasias Cardíacas/complicaciones , Neoplasias Cardíacas/cirugía , Neoplasias Cardíacas/diagnóstico , Neoplasias Cardíacas/diagnóstico por imagen , Masculino , Insuficiencia Cardíaca/etiología , Niño , Disnea/etiología , Atrios Cardíacos/diagnóstico por imagen , Atrios Cardíacos/patología , Enfermedad AgudaAsunto(s)
Neoplasias Cardíacas , Hemangioma , Propranolol , Rabdomioma , Esclerosis Tuberosa , Humanos , Propranolol/administración & dosificación , Propranolol/uso terapéutico , Rabdomioma/complicaciones , Rabdomioma/tratamiento farmacológico , Rabdomioma/diagnóstico , Esclerosis Tuberosa/complicaciones , Neoplasias Cardíacas/complicaciones , Neoplasias Cardíacas/tratamiento farmacológico , Neoplasias Cardíacas/diagnóstico , Lactante , Hemangioma/tratamiento farmacológico , Hemangioma/complicaciones , Antagonistas Adrenérgicos beta/uso terapéutico , Antagonistas Adrenérgicos beta/administración & dosificación , Neoplasias Cutáneas/tratamiento farmacológico , Neoplasias Cutáneas/complicaciones , Neoplasias Cutáneas/patología , Neoplasias Cutáneas/diagnóstico , Femenino , MasculinoAsunto(s)
Linfoma no Hodgkin , Humanos , Linfoma no Hodgkin/diagnóstico , Linfoma no Hodgkin/complicaciones , Masculino , Eosinofilia/diagnóstico , Eosinofilia/complicaciones , Ecocardiografía , Persona de Mediana Edad , Fibrosis Endomiocárdica/diagnóstico , Fibrosis Endomiocárdica/complicaciones , Biopsia , Neoplasias Cardíacas/diagnóstico , Neoplasias Cardíacas/complicaciones , FemeninoRESUMEN
BACKGROUND: Carney syndrome is an uncommon autosomal disorder closely linked to mutations in the PRKAR1A gene. Skin lesions are the most pronounced feature of Carney syndrome, affecting over 80% of individuals with this condition. This syndrome is characterized by a triad of myxomas, skin pigmentation, and endocrine hyperfunction, featuring multiple endocrine neoplasms with skin and cardiac involvement. Dilated cardiomyopathy, a primary cardiomyopathy, is defined as the dilation and impaired systolic function of the left or both ventricles. Its clinical presentation varies from being asymptomatic to heart failure or sudden cardiac death, making it a leading global cause of heart failure. Currently, Dilated cardiomyopathy has an estimated prevalence of 1/2500-1/250 individuals, predominantly affecting those aged 30-40 years, with a male-to-female ratio of 3:1. This case report describes a heart failure patient with cardiac myxoma caused by Carney syndrome combined with dilated cardiomyopathy. The patient was successfully treated for heart failure by heart transplantation. CASE PRESENTATION: Herein, we report a case of heart failure due to Carney syndrome that resulted in cardiac myxoma combined with dilated cardiomyopathy. A 35-year-old male was admitted to the hospital three years ago because of sudden chest tightness and shortness of breath. Echocardiography indicated myxoma, and a combination of genetic screening and physical examination confirmed Carney syndrome with cardiac myxoma. Following symptomatic management, he was discharged. Surgical interventions were not considered at the time. However, the patient's chest tightness and shortness of breath symptoms worsened, and he returned to the hospital. A New York Heart Association grade IV heart function was confirmed, and echocardiography indicated the presence of dilated cardiomyopathy accompanied by cardiac myxoma. Ultimately, the patient's heart failure was successfully treated with heart transplantation. CONCLUSIONS: Cardiac myxoma caused by Carney syndrome combined with heart failure caused by dilated cardiomyopathy can be resolved by heart transplantation.
Asunto(s)
Cardiomiopatía Dilatada , Complejo de Carney , Insuficiencia Cardíaca , Neoplasias Cardíacas , Trasplante de Corazón , Mixoma , Humanos , Cardiomiopatía Dilatada/cirugía , Cardiomiopatía Dilatada/etiología , Cardiomiopatía Dilatada/diagnóstico , Cardiomiopatía Dilatada/diagnóstico por imagen , Masculino , Complejo de Carney/genética , Complejo de Carney/diagnóstico , Complejo de Carney/cirugía , Complejo de Carney/complicaciones , Adulto , Mixoma/complicaciones , Mixoma/cirugía , Mixoma/diagnóstico por imagen , Mixoma/diagnóstico , Mixoma/genética , Insuficiencia Cardíaca/etiología , Insuficiencia Cardíaca/diagnóstico , Insuficiencia Cardíaca/cirugía , Neoplasias Cardíacas/cirugía , Neoplasias Cardíacas/complicaciones , Neoplasias Cardíacas/diagnóstico por imagen , Neoplasias Cardíacas/diagnóstico , Neoplasias Cardíacas/genética , Resultado del Tratamiento , Subunidad RIalfa de la Proteína Quinasa Dependiente de AMP Cíclico/genéticaRESUMEN
Cardiac tumors, due to the various clinical scenarios and their histological subtypes, are still challenging for clinicians. They are differentiated into primary and secondary. The latest are more common and are usually lung and breast cancers, melanomas, and lymphoma metastasis. We present a case of a 73-year-old woman, with a history of breast cancer 10 years earlier, admitted to Cath lab for an elevation of the ST-segment of the electrocardiogram, myocardial infarction. Echocardiogram showed a curious abnormality in the myocardial wall. Thanks to a multimodality imaging strategy, including contrast-enhanced echocardiography and cardiac magnetic resonance, characterization of the underlying pathology was clear and, thus, the appropriate management and therapy.
This is the case of a cardiac metastatic tumor, whose certain diagnosis can only be made by myocardial biopsy an invasive sample of heart tissue unfortunately not available in our case. Alternatively, we puzzled data from two second-level imaging techniques: contrast-enhanced cardiac ultrasound and cardiac magnetic resonance, which allowed us to better evaluate the nature of this cardiac mass. The former gave information about its blood supply, the latter gave information about tissue characterization. In this paper, we show how a complete integration of data from clinical and a stepwise multimodality imaging-based approach may allow a diagnosis in a complex clinical case.
Asunto(s)
Ecocardiografía , Electrocardiografía , Neoplasias Cardíacas , Imagen por Resonancia Cinemagnética , Imagen Multimodal , Infarto del Miocardio con Elevación del ST , Humanos , Femenino , Anciano , Imagen Multimodal/métodos , Neoplasias Cardíacas/diagnóstico , Neoplasias Cardíacas/secundario , Infarto del Miocardio con Elevación del ST/diagnóstico , Ecocardiografía/métodos , Diagnóstico Diferencial , Imagen por Resonancia Cinemagnética/métodos , Neoplasias de la MamaRESUMEN
BACKGROUND: Cardiac myxomas are the most common type of primary cardiac tumors in adults, but they can have variable features that make them difficult to diagnose. We report two cases of atrial myxoma with calcification or ossification, which are rare pathological subgroups of myxoma. CASE PRESENTATION: A 47-year-old woman and a 35-year-old man presented to our hospital with different symptoms. Both patients had a history of chronic diseases. Transthoracic and transesophageal echocardiography revealed a mass in the left or right atrium, respectively, with strong echogenicity and echogenic shadows. The masses were suspected to be malignant tumors with calcification or ossification. Contrast transthoracic echocardiography(cTEE) showed low blood supply within the lesions. The patients underwent surgical resection of the atrial mass, and the pathology confirmed myxoma with partial ossification or massive calcification. CONCLUSION: We report two rare cases of atrial myxoma with calcification or ossification and analyze their ultrasonographic features. Transthoracic echocardiography and cTEE can provide valuable information for the diagnosis and management of such mass. However, distinguishing calcification and ossification in myxoma from calcification in malignant tumors is challenging. More studies are needed to understand the pathogenesis and imaging characteristics of these myxoma variants.
Asunto(s)
Calcinosis , Atrios Cardíacos , Neoplasias Cardíacas , Mixoma , Osificación Heterotópica , Humanos , Mixoma/diagnóstico , Mixoma/cirugía , Mixoma/complicaciones , Neoplasias Cardíacas/diagnóstico , Neoplasias Cardíacas/cirugía , Neoplasias Cardíacas/complicaciones , Neoplasias Cardíacas/patología , Neoplasias Cardíacas/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Calcinosis/diagnóstico por imagen , Calcinosis/diagnóstico , Calcinosis/cirugía , Atrios Cardíacos/patología , Atrios Cardíacos/diagnóstico por imagen , Femenino , Adulto , Osificación Heterotópica/diagnóstico , Osificación Heterotópica/complicaciones , Osificación Heterotópica/cirugía , Ecocardiografía , Ecocardiografía TransesofágicaRESUMEN
BACKGROUND: Cardiac hemangiomas are very uncommon benign primary tumors. They are usually located preferentially in the right atrium and their location in the interatrial septum is extremely rare. CASE PRESENTATION: We report the case of a 41-year-old patient who was admitted due to a stroke. The transthoracic echocardiogram revealed a large mass in the right atrium adhered to the interatrial septum. Suspecting an atrial myxoma, surgical intervention was performed confirming that the mass extended within the thickness of the interatrial septum, protruding into the right atrial cavity. The histologic report confirmed a hemangioma. CONCLUSIONS: Cardiac hemangiomas are rare primary tumors and are usually misdiagnosed as other cardiac tumors. Histopathological examination is essential for a definitive diagnosis.
Asunto(s)
Tabique Interatrial , Ecocardiografía , Neoplasias Cardíacas , Hemangioma , Adulto , Humanos , Tabique Interatrial/diagnóstico por imagen , Tabique Interatrial/cirugía , Tabique Interatrial/patología , Diagnóstico Diferencial , Atrios Cardíacos/diagnóstico por imagen , Atrios Cardíacos/patología , Neoplasias Cardíacas/cirugía , Neoplasias Cardíacas/diagnóstico , Neoplasias Cardíacas/diagnóstico por imagen , Neoplasias Cardíacas/patología , Hemangioma/diagnóstico , Hemangioma/cirugía , Hemangioma/diagnóstico por imagenRESUMEN
Spindle cell lesions of the pleura and pericardium are rare. Distinction from sarcomatoid mesothelioma, which has a range of morphologic patterns, can be difficult, but accurate diagnosis matters. This article provides practical guidance for the diagnosis of pleural spindle cell neoplasms, focusing on primary lesions.
Asunto(s)
Pericardio , Neoplasias Pleurales , Humanos , Pericardio/patología , Neoplasias Pleurales/patología , Neoplasias Pleurales/diagnóstico , Diagnóstico Diferencial , Neoplasias Cardíacas/patología , Neoplasias Cardíacas/diagnóstico , Mesotelioma/patología , Mesotelioma/diagnóstico , Sarcoma/patología , Sarcoma/diagnóstico , Biomarcadores de Tumor/análisis , Pleura/patologíaRESUMEN
OBJECTIVE: Pediatric cardiac tumors are rare and, among them, 90% are benign. Cardiac fibroma is the second most frequent tumor, after rhabdomyoma. The objective of this study is to report a case of cardiac fibroma diagnosed incidentally in a patient admitted with acute viral bronchiolitis. CASE DESCRIPTION: A 5-month-old male infant was admitted to the pediatric emergency department with acute viral bronchiolitis requiring hospitalization. He presented a detectable respiratory syncytial virus in oropharyngeal swab, blood test with lymphocytosis and a chest radiography revealed cardiomegaly. Further cardiologic testing was performed detecting elevation of cardiac biomarkers, an electrocardiogram with alteration of left ventricular repolarization and echocardiogram with a heterogeneous mass in the left ventricular, with areas of calcification. A chest angiotomography suggested rhabdomyosarcoma or cardiac fibroma and a magnetic resonance showed a mass, with characteristics suggesting fibroma. The final diagnosis was made after two cardiac catheterizations for biopsy of the lesion, confirming cardiac fibroma by anatomopathological examination. Because the patient had moderate to severe systolic dysfunction, he was submitted to heart transplant. COMMENTS: One third of cardiac fibromas are asymptomatic, generally diagnosed late through tests ordered for other reasons. The gold-standard test for definitive diagnosis is biopsy. Cardiac fibroma usually does not present spontaneous regression and, in most cases, partial or total surgical resection is necessary. When tumors are unresectable, heart transplantation should be indicated. It is essential to have detailed characterization of the cardiac mass to establish the most appropriate therapeutic approach for each patient.
Asunto(s)
Bronquiolitis Viral , Fibroma , Neoplasias Cardíacas , Hallazgos Incidentales , Humanos , Masculino , Neoplasias Cardíacas/diagnóstico , Neoplasias Cardíacas/complicaciones , Fibroma/diagnóstico , Fibroma/complicaciones , Lactante , Bronquiolitis Viral/diagnóstico , Enfermedad AgudaRESUMEN
Primary cardiac lymphoma is an exceedingly rare malignant tumor, with diffuse large B-cell lymphoma (DLBCL) being the most prevalent histological subtype. This disease has non-specific clinical manifestations, making early diagnosis crucial. However, DLBCL diagnosis is commonly delayed, and its prognosis is typically poor. Herein, we report the case of a 51-year-old male patient with DLBCL who presented with recurrent chest tightness for 4 months as the primary clinical symptom. The patient was admitted to the hospital and diagnosed with acute myocardial infarction and left ventricular hypertrophy with heart failure. Echocardiography revealed a progression from left ventricular thickening to local pericardial thickening and adhesion in the inferior and lateral walls of the left ventricle. Finally, pathological analysis of myocardial biopsy confirmed the diagnosis of DLBCL. After treatment with the R-CHOP chemotherapy regimen, the patient's chest tightness improved, and he was discharged. After 2 months, the patient succumbed to death owing to sudden ventricular tachycardia, ventricular fibrillation, and decreased blood pressure despite rescue efforts. Transthoracic echocardiography is inevitable for the early diagnosis of DLBCL, as it can narrow the differential and guide further investigations and interventions, thereby improving the survival of these patients.