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Jin C, Wang Y, Hu Z, Huang D, Lin S, Gu X, Jiang J. From Infarction to Angiosarcoma: Unraveling the Mystery of Pericardial Hematoma. JACC Case Rep 2025; 30:103874. [PMID: 40379368 PMCID: PMC12145000 DOI: 10.1016/j.jaccas.2025.103874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2025] [Revised: 02/11/2025] [Accepted: 03/03/2025] [Indexed: 05/19/2025]
Abstract
BACKGROUND Primary cardiac angiosarcomas are extremely rare, highly aggressive tumors characterized by rapid progression and high metastatic capability. CASE SUMMARY We present a case with unexplained pericardial hematoma after repeated right coronary infarction, combined with multimodality imaging and histopathologic examination, finally diagnosed as angiosarcoma. DISCUSSION There is no published case of angiosarcoma onset of pericardial hematoma after repeated myocardial infarction. Multimodality imaging contributes to early diagnosis and optimal preoperative planning.
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Affiliation(s)
- Chunna Jin
- Department of Cardiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Yuhua Wang
- Department of Cardiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Zhanglong Hu
- Department of Cardiovascular Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Dandan Huang
- Department of Cardiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Su Lin
- Department of Cardiology, Medical Treatment Center of Ningbo Lihuili Hospital, Ningbo, Zhejiang, China
| | - Xiaohong Gu
- Department of Cardiology, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
| | - Jun Jiang
- Department of Cardiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
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Tuonuur S, Shaikh N, Kumar R, Setarehaseman A, Nascimento AF, Akhondi H, Mohammadi A. Primary Atrial Leiomyosarcoma in a Patient with a Prior History of Uterine Leiomyoma and Ovarian Tumour. CJC Open 2025; 7:671-674. [PMID: 40433213 PMCID: PMC12105520 DOI: 10.1016/j.cjco.2025.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2024] [Accepted: 03/07/2025] [Indexed: 05/29/2025] Open
Affiliation(s)
- Solomon Tuonuur
- Department of Internal Medicine, Valley Health System, Las Vegas, Nevada, USA
| | - Nasreen Shaikh
- Department of Internal Medicine, Valley Health System, Las Vegas, Nevada, USA
| | - Radishma Kumar
- Department of Internal Medicine, Valley Health System, Las Vegas, Nevada, USA
| | - Alireza Setarehaseman
- Department of Pathology, University Hospitals Cleveland Medical Center and Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Alessandra F. Nascimento
- Department of Pathology, University Hospitals Cleveland Medical Center and Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Hossein Akhondi
- Department of Internal Medicine, Valley Health System, Las Vegas, Nevada, USA
| | - Abbas Mohammadi
- Department of Internal Medicine, Valley Health System, Las Vegas, Nevada, USA
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Imai T, Shimoi T, Kawai A, Yonemori K. Diagnosis and treatment of cardiac tumors. Med Oncol 2025; 42:110. [PMID: 40095104 PMCID: PMC11914324 DOI: 10.1007/s12032-025-02661-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2024] [Accepted: 03/04/2025] [Indexed: 03/19/2025]
Abstract
Cardiac tumors, though rare, present significant diagnostic and therapeutic challenges due to their diverse nature and potential severity. These tumors, which can be primary or metastatic, are often detected incidentally through imaging modalities such as echocardiography or CT scans. Differentiating between benign and malignant forms is crucial for guiding appropriate management strategies. This review synthesizes current diagnostic approaches and treatment modalities for cardiac tumors, with a focus on the role of imaging techniques like UCG, CT, MRI, and PET in tumor characterization. Multidisciplinary treatment plans are necessary, including surgical resection for benign tumors, chemotherapy, and radiotherapy for malignant tumors, and novel targeted therapies such as MDM2 inhibitors for selected cases. While primary malignant tumors like sarcomas and mesotheliomas exhibit rapid progression and poor prognosis, recent advances in multimodal therapy offer potential improvements in survival. The incidence of primary cardiac tumors is low, with an autopsy-reported occurrence rate of 0.02%. Benign cardiac tumors, such as myxomas and fibromas, generally have favorable outcomes with surgical resection. In contrast, primary malignant tumors like sarcomas and mesotheliomas exhibit rapid progression and poor prognosis, necessitating aggressive treatment including surgery, chemotherapy, and radiotherapy. Metastatic cardiac tumors occur in approximately 10% of cancer patients at autopsy and are managed according to the treatment plan for the primary malignancy. The management of cardiac tumors requires a multidisciplinary approach tailored to tumor type, location, and systemic effects. While benign tumors often respond well to surgical management, malignant and metastatic tumors demand more complex strategies to optimize patient outcomes.
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Affiliation(s)
- Toru Imai
- Department of Medical Oncology, National Cancer Center Hospital, Tsukiji 5-1-1, Chuo-ku, Tokyo, 104-0045, Japan
| | - Tatsunori Shimoi
- Department of Medical Oncology, National Cancer Center Hospital, Tsukiji 5-1-1, Chuo-ku, Tokyo, 104-0045, Japan.
| | - Akira Kawai
- Department of Musculoskeletal Oncology and Rehabilitation, National Cancer Center Hospital, Tsukiji 5-1-1, Chuo-ku, Tokyo, 104-0045, Japan
| | - Kan Yonemori
- Department of Medical Oncology, National Cancer Center Hospital, Tsukiji 5-1-1, Chuo-ku, Tokyo, 104-0045, Japan
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Odintsov I, Papke DJ, George S, Padera RF, Hornick JL, Siegmund SE. Genomic Profiling of Cardiac Angiosarcoma Reveals Novel Targetable KDR Variants, Recurrent MED12 Mutations, and a High Burden of Germline POT1 Alterations. Clin Cancer Res 2025; 31:1091-1102. [PMID: 39820259 DOI: 10.1158/1078-0432.ccr-24-3277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2024] [Revised: 12/04/2024] [Accepted: 01/14/2025] [Indexed: 01/19/2025]
Abstract
PURPOSE Cardiac angiosarcoma is a rare, aggressive malignancy with limited treatment options. Both sporadic and familial cases occur, with recent links to germline POT1 mutations. The genomic landscape of this disease is poorly understood. EXPERIMENTAL DESIGN We conducted comprehensive genomic profiling of cardiac angiosarcoma to assess the burden of germline predisposition and identify other recurrent genomic alterations of clinical significance. RESULTS Six patients were female, and four were male. The median age at presentation was 40 years (range, 21-69 years). All cases with available follow-up exhibited an aggressive clinical course (6/8 patients died of disease). KDR alterations, including novel structural variants, were found in 9/11 cases at a rate significantly higher than that in noncardiac angiosarcomas. POT1 mutations were present in 45.5% of cardiac angiosarcoma cases. In three of five POT1-mutant cases, the germline status was confirmed through testing of normal tissue, and in one additional case, the germline status was inferred with high probability through allele frequency analysis. Additionally, we identified novel recurrent MED12 exon 2 mutations in POT1 wild-type cardiac angiosarcoma, suggesting an alternative path to cardiac angiosarcoma oncogenesis. CONCLUSIONS Cardiac angiosarcoma demonstrates a unique genetic profile, distinct from noncardiac angiosarcoma. This study highlights the role of germline POT1 burden on cardiac angiosarcoma development and demonstrates recurrent MED12 alterations for the first time. The reported KDR variants provide a potential avenue for the treatment of this aggressive disease. Given the prevalence of germline POT1 mutations reported in this study, germline genetic testing should be considered in patients diagnosed with cardiac angiosarcoma.
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Affiliation(s)
- Igor Odintsov
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - David J Papke
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Suzanne George
- Sarcoma Division, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Robert F Padera
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Jason L Hornick
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Stephanie E Siegmund
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
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Singh A, Hammer MM. Imaging Features Differentiating Between Cardiac Sarcomas and Hematologic Neoplasms. J Comput Assist Tomogr 2025; 49:281-287. [PMID: 39379052 DOI: 10.1097/rct.0000000000001672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2024]
Abstract
PURPOSE The aim of the study is to assess the efficacy of computed tomography (CT) and positron emission tomography (PET)/CT findings in differentiating between cardiac sarcoma and cardiac hematologic neoplasms, which are rare but potentially lethal primary cardiac malignancies. MATERIALS AND METHODS We searched the electronic medical record for pathology-proven cases from 2012 to 2023, finding 69 patients (46 sarcomas, 23 cardiac hematologic neoplasms). Imaging features including tumor size, atrioventricular (AV) groove involvement, right coronary artery (RCA) encasement by 180°, pericardial effusion, lymphadenopathy, and metabolic activity on fluorodeoxyglucose PET were reviewed by a radiology fellow. Statistical analysis was performed using Fisher exact test and Wilcoxon test. RESULTS Cardiac sarcoma patients were younger (median age 49 years) compared to patients with cardiac hematologic malignancies (66 years, P = 0.006). While tumor size and chamber involvement were similar between the 2 categories, hematologic malignancies exhibited a notable predilection for AV groove involvement (70% vs 43%, P = 0.04) and RCA encasement (52% vs 26%, P = 0.02). Pulmonary metastases were more frequent in sarcoma cases (33% vs 4%, P = 0.006). There was no significant difference in fluorodeoxyglucose uptake. Lymphadenopathy was similar between the 2 disease groups. A decision tree constructed using AV groove involvement and patient age achieved 75% accuracy in predicting the diagnosis of the mass. CONCLUSIONS Overall, there is a substantial overlap in imaging features of cardiac sarcomas and hematologic malignancies involving the heart. Involvement of the AV groove and RCA encasement can allow a radiologist to favor hematologic malignancy. Ultimately, biopsy is required to establish a diagnosis.
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Affiliation(s)
- Aparna Singh
- Department of Radiology, Brigham and Women's Hospital, Boston, MA
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Guan T, Monteiro O, Chen D, Luo Z, Chi K, Li Z, Liang Y, Lu Z, Jiang Y, Yang J, Lin W, Yi M, Zhang K, Ou C. Long-term and short-term cardiovascular disease mortality among patients of 21 non-metastatic cancers. J Adv Res 2025; 69:215-224. [PMID: 38537701 PMCID: PMC11954795 DOI: 10.1016/j.jare.2024.03.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 03/05/2024] [Accepted: 03/23/2024] [Indexed: 04/04/2024] Open
Abstract
INTRODUCTION Previous studies on cardiovascular disease (CVD) death risk in cancer patients mostly focused on overall cancer, age subgroups and single cancers. OBJECTIVES To assess the CVD death risk in non-metastatic cancer patients at 21 cancer sites. METHODS A total of 1,672,561 non-metastatic cancer patients from Surveillance, Epidemiology, and End Results (SEER) datebase (1975-2018) were included in this population-based study, with a median follow-up of 12·7 years. The risk of CVD deaths was assessed using proportions, competing-risk regression, absolute excess risks (AERs), and standardized mortality ratios (SMRs). RESULTS In patients with localized cancers, the proportion of CVD death and cumulative mortality from CVD in the high-competing risk group (14 of 21 unique cancers) surpassed that of primary neoplasm after cancer diagnosis. The SMRs and AERs of CVD were found higher in patients with non-metastatic cancer than the general US population (SMR 1·96 [95 %CI, 1·95-1·97]-19·85[95 %CI, 16·69-23·44]; AER 5·77-210·48), heart disease (SMR 1·94[95 %CI, 1·93-1·95]-19·25[95 %CI, 15·76-23·29]; AER 4·36-159·10) and cerebrovascular disease (SMR 2·05[95 %CI, 2·02-2·08]-24·71[95 %CI, 16·28-35·96]; AER 1·01-37·44) deaths. In the high-competing risk group, CVD-related SMR in patients with localized stage cancer increased with survival time but followed a reverse-dipper pattern in the low-competing risk group (7 of 21 cancers). The high-competing risk group had higher CVD-related death risks than the low-competing risk group. CONCLUSION The CVD death risk in patients with non-metastatic cancer varied by cancer stage, site and survival time. The risk of CVD mortality is higher in 14 out of 21 localized cancers (high-competing cancers). Targeted strategies for CVD management in non-metastatic cancer patients are needed.
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Affiliation(s)
- Tianwang Guan
- Cancer Center, The Tenth Affiliated Hospital, Southern Medical University (Dongguan People's Hospital), Dongguan 523059, China; Guangdong Provincial Key Laboratory of Cardiac Function and Microcirculation, Guangzhou 510515, China
| | - Olivia Monteiro
- Faculty of Medicine, Medical Sciences Division, Macau University of Science and Technology, Avenida da Harmonia, Praia Park, Coloane, Macao 999078, China
| | - Dongting Chen
- Department of Clinical Medicine, Clinical Medical School, Guangzhou Medical University, Guangzhou 510180, China
| | - Zehao Luo
- Department of Clinical Medicine, Clinical Medical School, Guangzhou Medical University, Guangzhou 510180, China
| | - Kaiyi Chi
- Department of Clinical Medicine, Clinical Medical School, Guangzhou Medical University, Guangzhou 510180, China; Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
| | - Zhihao Li
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - Yinglan Liang
- Department of Clinical Medicine, Clinical Medical School, Guangzhou Medical University, Guangzhou 510180, China
| | - Zhenxing Lu
- The Tenth Affiliated Hospital, Southern Medical University (Dongguan People's Hospital), Dongguan 523059, China
| | - Yanting Jiang
- Department of Clinical Medicine, Clinical Medical School, Guangzhou Medical University, Guangzhou 510180, China
| | - Jinming Yang
- Department of Clinical Medicine, Clinical Medical School, Guangzhou Medical University, Guangzhou 510180, China
| | - Wenrui Lin
- Department of Clinical Medicine, Clinical Medical School, Guangzhou Medical University, Guangzhou 510180, China
| | - Min Yi
- Department of Endocrinology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 510180, China
| | - Kang Zhang
- Faculty of Medicine, Medical Sciences Division, Macau University of Science and Technology, Avenida da Harmonia, Praia Park, Coloane, Macao 999078, China; The Tenth Affiliated Hospital, Southern Medical University (Dongguan People's Hospital), Dongguan 523059, China.
| | - Caiwen Ou
- Guangdong Provincial Key Laboratory of Cardiac Function and Microcirculation, Guangzhou 510515, China; The Tenth Affiliated Hospital, Southern Medical University (Dongguan People's Hospital), Dongguan 523059, China.
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Prajapati K, Samaksh F, Charpuria PJ, Desai N, Sahoo S. Pericardial Synovial Sarcoma Masquerading as Hemangioma: A Diagnostic Challenge. Cureus 2025; 17:e81076. [PMID: 40271297 PMCID: PMC12015998 DOI: 10.7759/cureus.81076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2025] [Indexed: 04/25/2025] Open
Abstract
Pericardial synovial sarcoma (PSS) is a rare primary malignant tumor of the heart with an unclear prognosis. We present the case of a 26-year-old male patient with no significant medical history who presented with New York Heart Association (NYHA) Class II dyspnea and chest pain. Echocardiography and cardiac MRI revealed a large pericardial mass (93 × 70 × 45 mm) with hemorrhagic effusion and imaging features suggestive of hemangioma, including well-defined vascular channels and contrast enhancement. Histopathological analysis following thoracotomy showed spindle cell proliferation without classic features of malignancy (e.g., nuclear atypia and high mitotic activity), supporting the initial diagnosis of spindle cell hemangioma. However, six months later, a recurrent mass excision and immunohistochemistry (IHC) confirmed SS (transducin-like enhancer of split 1/FMS-like tyrosine kinase 1 (TLE1/FLT1) positive). Surgical resection was attempted but was not feasible due to the extensive involvement of critical cardiac structures. The patient was started on chemotherapy with ifosfamide and doxorubicin but succumbed to systemic complications within a year. This case underscores the diagnostic challenge of PSS and highlights the critical role of IHC and molecular diagnostics in distinguishing it from benign mimics, even when initial histopathology is inconclusive.
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Affiliation(s)
- Kesar Prajapati
- Internal Medicine, New York Medical College, Metropolitan Hospital Center, New York, USA
| | - Fnu Samaksh
- Internal Medicine, New York Medical College, Metropolitan Hospital Center, New York, USA
| | | | - Nisarg Desai
- Cardiology, U. N. Mehta Institute of Cardiology and Research Centre (UNMICRC), Ahmedabad, IND
| | - Sibasis Sahoo
- Cardiology, U. N. Mehta Institute of Cardiology and Research Centre (UNMICRC), Ahmedabad, IND
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Patel SK, Dhingra NK, Cusimano RJ. Surgical and multimodal approaches to right-sided cardiac tumours. Curr Opin Cardiol 2025; 40:63-71. [PMID: 39786180 DOI: 10.1097/hco.0000000000001197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2025]
Abstract
PURPOSE OF REVIEW Cardiac tumours present significant clinical challenges due to their wide differential, complex anatomical and physiological implications, as well as the potential for widespread invasion in the case of malignancies. This review synthesizes recent findings surrounding the diagnosis and management of specifically right-sided cardiac tumours, with a particular focus on surgical resection and reconstructive techniques. RECENT FINDINGS Management of cardiac tumours can be categorized into three key phases. First: early and accurate diagnosis is critical for improving outcomes, especially in malignancies. Advances in imaging modalities like MRI, CT, PET-CT, and biopsy techniques enhance diagnostic accuracy. Second: surgical resection is a cornerstone treatment for both benign and malignant right-sided cardiac tumours. Surgery is often curative for benign tumours, while for malignant tumours, R0 resection (complete microscopic removal) in appropriate candidates correlates with better survival. Third: managing cardiac malignancies necessitates a multidisciplinary approach, integrating additional therapies such as chemotherapy, radiation, and emerging immunotherapies tailored to patient and tumour characteristics. SUMMARY Managing right-sided cardiac tumours demands interdisciplinary expertise. Standardized protocols are limited by the rarity of cases and insufficient high-quality data. International collaboration and sharing of experiences through prospective registries and clinical studies are essential to advancing knowledge and improving patient outcomes.
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Affiliation(s)
| | - Nitish K Dhingra
- Division of Cardiac Surgery, Peter Munk Cardiac Centre, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Robert J Cusimano
- Division of Cardiac Surgery, Peter Munk Cardiac Centre, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada
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Wang X, Luan X, Yin W, Wang Y, Li X, Chen R, Zhang G, Zhao R, Dong X, Zhang Z, Fan Y, Li Z, Chu X, Wang S. Advancements in Diagnosis and Treatment of Cardiac Sarcomas: A Comprehensive Review. Curr Treat Options Oncol 2025; 26:103-127. [PMID: 39885109 DOI: 10.1007/s11864-024-01287-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2024] [Indexed: 02/01/2025]
Abstract
OPINION STATEMENT Cardiac sarcomas are rare, aggressive malignancies originating from various cardiac cell types, presenting significant challenges in both diagnosis and treatment. This comprehensive review explores recent advancements in diagnosis and treatment of cardiac angiosarcoma, fibrosarcoma, leiomyosarcoma, and rhabdomyosarcoma. And we briefly discuss the exceedingly rare occurrence of cardiac osteosarcoma and present our perspectives on its treatment. Development of these tumors is influenced by genetic mutations, environmental factors, and chromosomal abnormalities, necessitating a multidisciplinary approach for accurate diagnosis and management. Advanced imaging techniques, biomarkers, and immunohistochemical analysis assist in confirming the diagnosis and guiding treatment decisions. Surgical resection, adjuvant therapies, and personalized treatment strategies based on genetic profiling offer promising avenues for improving patient outcomes. Emerging therapeutic approaches, such as targeted therapies and immunotherapies, have shown promising progress in recent years. Despite these advancements, the prognosis for patient with cardiac sarcomas remains poor, highlighting the urgent need for continued research to refine treatment methods and enhance long-term survival outcomes. Ongoing efforts and clinical trials are essential for advancing the management of these rare and aggressive tumors, ultimately improving quality of life for affected patients.
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Affiliation(s)
- Xuezhe Wang
- Department of Cardiology, The Affiliated Hospital of Qingdao University, Qingdao, China
- School of Basic Medicine, Qingdao University, Qingdao, Shandong, China
| | - Xinchi Luan
- Department of Oncology, Key Laboratory of Cancer Molecular and Translational Research, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Wenwen Yin
- Department of Pulmonology, The Sixth Affiliated Hospital of Qingdao University, Weihai, Shandong, China
| | - Yilin Wang
- School of Basic Medicine, Qingdao University, Qingdao, Shandong, China
| | - Xiaoxuan Li
- Department of Oncology, Key Laboratory of Cancer Molecular and Translational Research, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Ruolan Chen
- Department of Cardiology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Guoliang Zhang
- Department of Cardiology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Ruizhe Zhao
- School of Basic Medicine, Qingdao University, Qingdao, Shandong, China
| | - Xue Dong
- School of Basic Medicine, Qingdao University, Qingdao, Shandong, China
| | - Zhishang Zhang
- Department of Joint Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yuchen Fan
- School of Basic Medicine, Qingdao University, Qingdao, Shandong, China
| | - Zhaodong Li
- School of Basic Medicine, Qingdao University, Qingdao, Shandong, China
| | - Xianming Chu
- Department of Cardiology, The Affiliated Hospital of Qingdao University, Qingdao, China.
| | - Shuang Wang
- School of Basic Medicine, Qingdao University, Qingdao, Shandong, China.
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Zhuang S, Chang L, Feng X, Hu W, Yang Z, Zhang Y. Primary cardiac lymphoma: a clinicopathological study of 121 cases. Front Oncol 2025; 14:1509100. [PMID: 39839800 PMCID: PMC11746027 DOI: 10.3389/fonc.2024.1509100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2024] [Accepted: 12/10/2024] [Indexed: 01/23/2025] Open
Abstract
Background Primary cardiac lymphoma (PCL) is an exceedingly uncommon type of lymphoma that primarily affects the heart and/or pericardium, or manifests through cardiac symptoms due to myocardial infiltration. The infrequency of PCL, coupled with its non-specific clinical presentations, often complicates early diagnosis. This study aims to fill the existing gap in clinical knowledge regarding PCL by detailing a case of PCL and examining its clinical features, auxiliary examinations, treatment approaches, and prognostic outcomes, thereby facilitating early detection and enhancing patient care. Methods A thorough search of the PubMed and Chinese National Knowledge Infrastructure (CNKI) database was performed using keywords "heart" and "lymphoma" or "primary cardiac lymphoma". This search encompassed publications from January 1, 2014, to November 1, 2024. Results The review included 121 cases. These cases usually present with atypical symptoms, mainly circulatory and respiratory, including chest tightness, dyspnea, and edema, along with occasional neurological and gastrointestinal symptoms. Echocardiography served as the primary diagnostic method in 92.6% of cases, while a definitive diagnosis was achieved through pathological examination in all cases (100%). Treatment strategies predominantly included surgical intervention (44.6%) and chemotherapy (76.0%). Although surgery did not have a significant effect on survival rates, chemotherapy proved to be critical in improving patient survival. Conclusions PCL, which arises in the cardiac or pericardial areas, is generally associated with a poor prognosis. It is essential for clinicians to develop a greater awareness and understanding of the characteristics of PCL to enhance early diagnosis. The timely initiation of chemotherapy is vital for improving survival rates and the overall quality of life for patients with PCL.
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Affiliation(s)
- Shuhui Zhuang
- Department of Hematology, Linyi People’s Hospital, Linyi, Shandong, China
| | - Liudi Chang
- Department of Hematology, Linyi People’s Hospital, Linyi, Shandong, China
- School of Clinical Medicine, Shandong Second Medical University, Weifang, Shandong, China
| | - Xiaoxi Feng
- Department of Hematology, Linyi People’s Hospital, Linyi, Shandong, China
- School of Clinical Medicine, Shandong Second Medical University, Weifang, Shandong, China
| | - Weiwen Hu
- Department of Hematology, Linyi People’s Hospital, Linyi, Shandong, China
- School of Clinical Medicine, Shandong Second Medical University, Weifang, Shandong, China
| | - Zhaobo Yang
- Spine surgery, Linyi People’s Hospital, Shandong University, Linyi, Shandong, China
| | - Yuanyuan Zhang
- Department of Hematology, Linyi People’s Hospital, Linyi, Shandong, China
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11
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Mundra P, Whitlock R, Ibrahim O, Cirne F. Recurrent Pericardial Effusions and Thrombi Secondary to Angiosarcoma: Adding to the Differential of Pericardial Diseases. Can J Cardiol 2024; 40:2272-2274. [PMID: 38679319 DOI: 10.1016/j.cjca.2024.04.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Revised: 04/16/2024] [Accepted: 04/22/2024] [Indexed: 05/01/2024] Open
Affiliation(s)
- Paul Mundra
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
| | - Richard Whitlock
- Population Health Research Institute. Division of Cardiac Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Omar Ibrahim
- Division of Cardiology, Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Filipe Cirne
- Division of Cardiology, Department of Medicine, McMaster University, Hamilton, Ontario, Canada
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12
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Pérez-Cualtán CE, Vargas-Acevedo C, Sánchez-Posada J, Castro-Páez C, Gutiérrez-Vargas R, Forero-Melo JF, Pérez JM, Briceño JC, Medina HM, Umaña JP, Navarro-Rueda J, Guerrero-Chalela CE. Surgical planning aided with 3D technologies for management of complex paracardiac tumors. J Cardiothorac Surg 2024; 19:548. [PMID: 39342312 PMCID: PMC11438039 DOI: 10.1186/s13019-024-03096-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2024] [Accepted: 09/15/2024] [Indexed: 10/01/2024] Open
Abstract
BACKGROUND Accurate diagnosis and treatment of complex cardiac tumors poses challenges, particularly when surgical resection is considered. 3D reconstruction and printing appear as a novel approach to allow heart teams for optimal surgical and post operative care. METHODS We report two patients with uncommon masses including a cardiac angiosarcoma (CAS) and a IgG4-related disease (IgG4-RD) with exclusive cardiac involvement. In both cases, three-dimensional (3D) reconstruction and 3D-printed models were utilized to aid the surgical team achieve optimal pre-operative planning. Both patients underwent ECG-gated cardiac computed tomography angiography (CCTA) imaging and, due to the complex anatomy of the masses, their large dimensions, proximity to vital cardiac and vascular structures, and unclear etiology, computational and 3D-printed models were created for surgical planning. An exploratory literature review of studies using 3D-printed models in surgical planning was performed. RESULTS In case 1 (CAS), due to the size and extension of the mass to the right ventricular free wall, surgical intervention was not considered curative and, during thoracotomy, an open biopsy confirmed the imaging suspicion of CAS which guided the initiation of optimal medical treatment with chemotherapy and, after clear tumor retraction, the patient underwent a second surgical intervention, and during the 18 months of follow-up showed no signs of recurrence. In Case 2 (IgG4-RD), the patient underwent uncomplicated total surgical resection; this allowed directed treatment and, at 12 months follow-up, there are no signs of recurrence. Computational and 3D-printed models were used to plan the surgery and to confirm the findings. Limited studies have explored the use of 3D printing in the surgical planning of tumors. CONCLUSIONS We present two patients with uncommon cardiac tumors, highlighting the significant value of 3D models in the anatomical characterization and assessment of their extension. These models may be essential in surgical planning for complex cardiovascular cases and could provide more information than conventional imaging modalities. Further studies are needed to demonstrate the impact of 3D technologies in studying cardiac tumors.
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Affiliation(s)
- Camilo E Pérez-Cualtán
- Department of Biomedical Engineering, Universidad de los Andes, Bogotá, Colombia
- Center for 3D Modeling and Printing, Fundación Cardioinfantil - LaCardio, Bogotá, Colombia
| | | | | | - Camila Castro-Páez
- Department of Biomedical Engineering, Universidad de los Andes, Bogotá, Colombia
- Center for 3D Modeling and Printing, Fundación Cardioinfantil - LaCardio, Bogotá, Colombia
| | - Roberto Gutiérrez-Vargas
- Center for 3D Modeling and Printing, Fundación Cardioinfantil - LaCardio, Bogotá, Colombia
- School of Medicine, Universidad del Rosario, Bogotá, Colombia
| | - Julián F Forero-Melo
- Center for 3D Modeling and Printing, Fundación Cardioinfantil - LaCardio, Bogotá, Colombia
- Department of Radiology and Diagnostic Imaging, Fundación Cardioinfantil - Instituto de Cardiología, Bogotá, Colombia
| | - Juan Manuel Pérez
- Center for 3D Modeling and Printing, Fundación Cardioinfantil - LaCardio, Bogotá, Colombia
- Department of Radiology and Diagnostic Imaging, Fundación Cardioinfantil - Instituto de Cardiología, Bogotá, Colombia
| | - Juan Carlos Briceño
- Department of Biomedical Engineering, Universidad de los Andes, Bogotá, Colombia
- Center for 3D Modeling and Printing, Fundación Cardioinfantil - LaCardio, Bogotá, Colombia
| | - Héctor M Medina
- Department of Cardiac Imaging, The Texas Heart Institute, Baylor College of Medicine, Houston, TX, USA
| | - Juan Pablo Umaña
- Department of Cardiac Surgery, Cleveland Clinic, Weston, FL, USA
| | - Javier Navarro-Rueda
- Center for 3D Modeling and Printing, Fundación Cardioinfantil - LaCardio, Bogotá, Colombia
- Department of Industrial Engineering, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Carlos Eduardo Guerrero-Chalela
- Center for 3D Modeling and Printing, Fundación Cardioinfantil - LaCardio, Bogotá, Colombia.
- Fundación Cardioinfantil - Instituto de Cardiología, Calle 163A # 13B - 60 Bogotá, Bogotá, 1113111, Colombia.
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13
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Lai Y, Guan T, Zhang H, Zhang Y, Zhang S, Yang Z, Liu C. Association of marital status with cardiovascular death risk in patients with lung cancer: A population-based study. Prev Med Rep 2024; 45:102846. [PMID: 39211728 PMCID: PMC11357874 DOI: 10.1016/j.pmedr.2024.102846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Revised: 07/31/2024] [Accepted: 08/01/2024] [Indexed: 09/04/2024] Open
Abstract
Background To investigate the association of marital status on cardiovascular death risk in lung cancer patients. Methods Using data from the Surveillance, Epidemiology, and End Results (SEER) database in the United States from 2011 to 2015 (N = 118,293), the association between marital status and cardiovascular death (CVD) risk in patients with lung cancer was assessed by competing-risks regression models. Results Unmarried status was associated with increased risk of cardiovascular death in lung cancer patients [hazard ratio (HR) = 1.398, 95 % confidence interval (CI): 1.268-1.542], which remained significant even after adjusting for potential covariates (HR = 1.407, 95 % CI: 1.276-1.551). Further unmarried subgroups analysis showed that the different unmarried status were associated with increased cardiovascular death risk as follows: single (HR = 1.397, 95 % CI: 1.236-1.1.580), separated (HR = 1.630, 95 % CI: 1.153-2.305), divorced (HR = 1.318, 95 % CI: 1.158-1.500), and widowed (HR = 1.561, 95 % CI: 1.393-1.749). Further subgroup analysis by sex revealed that compared to male lung cancer patients with married, CVD risk was significant increased in their counterparts with widowed (adjusted HR = 1.509, 95 % CI: 1.291-1.764, P<0.001), single (adjusted HR = 1.361, 95 % CI: 1.168-1.585, P<0.001) and divorced (adjusted HR = 1.353, 95 % CI: 1.177-1.555, P<0.001) rather than those with separated. However, similar phenomena was only observed in female lung cancer patients with widowed (adjusted HR = 1.414, 95 % CI: 1.220-1.640, P<0.001) and single (adjusted HR = 1.438, 95 % CI: 1.195-1.730, P<0.001). Conclusion Unmarried status was associated with increased cardiovascular death risk in patients with lung cancer, which highlighted that more attention and humanistic/supportive care should be offered to unmarried lung cancer patients for improving the prognosis.
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Affiliation(s)
- Yanxian Lai
- Department of Cardiology, Guangzhou First People’s Hospital, Guangzhou Medical University, Guangzhou 510180, China
- Department of Cardiology, Guangzhou First People’s Hospital, South China University of Technology, Guangzhou 510180, China
| | - Tianwang Guan
- Department of Cardiology, Guangzhou First People’s Hospital, Guangzhou Medical University, Guangzhou 510180, China
| | - Haifeng Zhang
- Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China
| | - Yingyuan Zhang
- Department of Cardiothoracic Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - Shenghui Zhang
- Department of Cardiology, Guangzhou First People’s Hospital, South China University of Technology, Guangzhou 510180, China
- Department of Cardiology, The Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangzhou 510180, China
| | - Zhengxia Yang
- Department of Electronic Business, School of Economics and Finance, South China University of Technology, Guangzhou 510006, China
| | - Cheng Liu
- Department of Cardiology, Guangzhou First People’s Hospital, Guangzhou Medical University, Guangzhou 510180, China
- Department of Cardiology, Guangzhou First People’s Hospital, South China University of Technology, Guangzhou 510180, China
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14
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Siegel S, Claus L, Kamphausen T, Feld K. Lethal complication of a rare cardiac tumor. Forensic Sci Med Pathol 2024; 20:1045-1048. [PMID: 37715931 PMCID: PMC11525416 DOI: 10.1007/s12024-023-00703-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2023] [Indexed: 09/18/2023]
Abstract
Cardiac tumors, especially malignant ones, are rare and diagnosis is challenging since symptoms manifest late and are often non-specific. Achieving a histological diagnosis prior to resection is also difficult because biopsies often fail to yield conclusive results. Due to the low frequency, no standard treatment protocol exists and the prognosis is poor. We present a case of a cardiac sarcoma, which was found during an autopsy performed with regard to medical malpractice, because the patient died due to a medical intervention. To report cases like this is important to gain more knowledge about possible complications regarding rare diseases.
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Affiliation(s)
- S Siegel
- Institut für Rechtsmedizin des Universitätsklinikum Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany.
| | - L Claus
- Institut für Pathologie am St. Elisabeth-Krankenhaus Köln, Cologne, Germany
| | - T Kamphausen
- Institut für Rechtsmedizin der Uniklinik Köln, Cologne, Germany
| | - K Feld
- Institut für Rechts- und Verkehrsmedizin des Universitätsklinikum Heidelberg, Heidelberg, Germany
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15
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Ritter E, Itach T, Paran D, Gaskin A, Havakuk O, Ablin JN. Cardiac Sarcoma Mimicking Libman-Sacks Endocarditis in a Patient with Systemic Lupus Erythematosus (SLE): A Case Report and Literature Review. J Clin Med 2024; 13:4345. [PMID: 39124611 PMCID: PMC11313092 DOI: 10.3390/jcm13154345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2024] [Revised: 07/16/2024] [Accepted: 07/23/2024] [Indexed: 08/12/2024] Open
Abstract
We present the case of a 39-year-old woman who was diagnosed with SLE and antiphospholipid antibodies 8 years ago. The chief manifestations of her disease included low-grade fever and polyarthritis. Eight months before presentation, she experienced symptoms attributed to a flare of SLE, leading to an increase in immunomodulatory treatment with no improvement. She presented to the emergency room with acute onset of dyspnea. Clubbing of her fingers and toes was noted. When questioned, she reported the onset of clubbing 5 months earlier. A CTA was performed to rule out pulmonary embolism, which was excluded, although it revealed a severely damaged mitral valve with severe insufficiency and a large mass on the valve, protruding into the left atrium. Antibiotics were started, with a working diagnosis of infectious endocarditis; however, the severe mitral valve dysfunction lead to emergency mitral valve replacement, revealing an organized thrombus. She was treated with anticoagulation, with a working diagnosis of Libman-Sacks endocarditis, with no improvement. Additional immunosuppression failed to improve her symptoms. Enlargement of the thrombotic mass and an increased gradient across the prosthetic mitral valve led to repeat surgery, culminating in a diagnosis of high-grade sarcoma within the left atrial mass. We further discuss cardiac sarcoma and describe the occurrence of clubbing in patients with sarcoma. This case highlights the importance of interdisciplinary collaboration and the need for vigilant monitoring in refractory cases, particularly when atypical presentations arise.
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Affiliation(s)
- Einat Ritter
- Department of Gastroenterology and Liver Diseases, Tel Aviv Sourasky Medical Center, Tel Aviv 64239, Israel
| | - Tamar Itach
- Department of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv 64239, Israel
| | - Daphna Paran
- Department of Rheumatology, Tel Aviv Sourasky Medical Center, Tel Aviv 64239, Israel
- Tel Aviv University Faculty of Medicine, Tel Aviv 69978, Israel
| | - Aleksandr Gaskin
- Department of Internal Medicine H, Tel Aviv Sourasky Medical Center, Tel Aviv 64239, Israel;
| | - Ofer Havakuk
- Department of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv 64239, Israel
- Tel Aviv University Faculty of Medicine, Tel Aviv 69978, Israel
| | - Jacob Nadav Ablin
- Tel Aviv University Faculty of Medicine, Tel Aviv 69978, Israel
- Department of Internal Medicine H, Tel Aviv Sourasky Medical Center, Tel Aviv 64239, Israel;
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16
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Guerra-Raygada M, Saavedra-Sanchez AJ, Hidalgo-Avendaño D, Bermudez-Pelaez MF, Guevara-Lazo D, Nombera-Aznaran N. From dyspnea to diagnosis, unmasking undifferentiated cardiac sarcoma: a case report. Egypt Heart J 2024; 76:86. [PMID: 38970752 PMCID: PMC11227480 DOI: 10.1186/s43044-024-00520-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 07/01/2024] [Indexed: 07/08/2024] Open
Abstract
BACKGROUND Sarcomas are the most common type of cardiac malignancy, but they are extremely rare. Within this group, angiosarcomas have the highest frequency, followed by undifferentiated sarcomas. This type of tumor has a poor prognosis and a high recurrence rate. Information about these tumors is limited, relying mainly on case reports and autopsy series. The purpose of this case report is to detail the multifaceted approach to diagnosing and managing an undifferentiated cardiac sarcoma and contribute to the literature. CASE PRESENTATION A 28-year-old man presented with dyspnea and chest pain, which had developed progressively over several weeks. Physical examination revealed low blood pressure, elevated heart rate, and diminished heart sounds. Imaging, including a CT scan, identified a hypodense mass in the right ventricle. Further evaluation through echocardiograms and contrast angiotomography confirmed a mass causing right ventricular obstruction. Part of the tumor was surgically removed and diagnosed as cardiac sarcoma. Histopathological analysis of the mass showed an undifferentiated cardiac sarcoma. CONCLUSION This case underscores the significance of including cardiac tumors as a potential cause when diagnosing cardiac masses. It also demonstrates the poor prognosis and tendency for recurrence, while revealing the absence of established management guidelines.
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Affiliation(s)
- Mauricio Guerra-Raygada
- Hospital Nacional Arzobispo Loayza, Lima, Peru
- Department of Medical Specialties, Cardiology and Coronary Care Service, Lima, Peru
| | | | - Diego Hidalgo-Avendaño
- Alberto Hurtado Faculty of Human Medicine, Universidad Peruana Cayetano Heredia, Jirón Nicolas Poussin 101, San Borja, Lima, Peru.
| | - Milagros F Bermudez-Pelaez
- Alberto Hurtado Faculty of Human Medicine, Universidad Peruana Cayetano Heredia, Jirón Nicolas Poussin 101, San Borja, Lima, Peru
| | - David Guevara-Lazo
- Alberto Hurtado Faculty of Human Medicine, Universidad Peruana Cayetano Heredia, Jirón Nicolas Poussin 101, San Borja, Lima, Peru
| | - Natalia Nombera-Aznaran
- Alberto Hurtado Faculty of Human Medicine, Universidad Peruana Cayetano Heredia, Jirón Nicolas Poussin 101, San Borja, Lima, Peru
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17
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Totaro P, Musto M. Overall approaches to cardiac tumors: Still an unsolved enigma? World J Clin Cases 2024; 12:3654-3656. [PMID: 38994279 PMCID: PMC11235461 DOI: 10.12998/wjcc.v12.i19.3654] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 05/02/2024] [Accepted: 05/16/2024] [Indexed: 06/29/2024] Open
Abstract
Cardiac tumors are neoplasms involving heart structures at any level, meaning the myocardium, valves, and cardiac chambers. When considering cardiac masses, it is not uncommon for surgeons to be surprised when they diagnose one. The real incidence of this complex group of diseases has been explored only after cardiac diagnostic tools became more appropriate. Despite differential diagnosis being relevant, surgical indication is usually requested for all malignant cardiac tumors and also for many types of benign tumors. The development of cardiac imaging techniques, therefore, has been the key point for a better understanding of the history of cardiac tumors and especially of the relevance of surgical indication in such conditions. Systematic and combined applications of echocardiography, cardiac computed tomography and magnetic resonance allow in the majority of case a clear definition of the nature of a newly discovered cardiac mass. The presence of a Li-Fraumeni syndrome seems to be the trigger aspect in accelerating the propensity of developing a cardiac tumor. Despite the revolutionary usefulness of the cardiac imaging techniques available, it is still considered a hazard to diagnose a malignant cardiac mass just with radiological imaging; the mainstay of the final diagnosis stands in surgical excision of the mass and histopathological report.
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Affiliation(s)
- Pasquale Totaro
- Division of Cardiac Surgery, Hospital Foundation "San Matteo", Pavia 27100, Italy
| | - Martina Musto
- Division of Cardiac Surgery, Hospital Foundation "San Matteo", Pavia 27100, Italy
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18
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Talbot S, Bandaru V, Nguyen T, Arif D, Sethi P. Rapid Development of Primary Right Atrial Angiosarcoma. Cureus 2024; 16:e64273. [PMID: 39131000 PMCID: PMC11315593 DOI: 10.7759/cureus.64273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2024] [Indexed: 08/13/2024] Open
Abstract
Cardiac angiosarcomas are rare and generally followed by a high level of metastasis with poor median survival outcomes. Echocardiograms, CT scans, and MRIs are the standard methods for finding sites of cardiac tumors; however, immunohistochemical confirmation is necessary for a definitive diagnosis of angiosarcoma. A 58-year-old male presented to the emergency room with one week of dyspnea on moderate exertion accompanied by chest pain and alleviated with rest. A workup done to evaluate mass found a single 5 x 3.5 x 4.8 cm mass heavily vascularized by the right coronary artery and left circumflex involving the free wall of the right atrium with no extension to the tricuspid valve. Surgical resection was performed, and immunohistochemistry was consistent with a primary cardiac angiosarcoma. An exudative fluid analysis on pericardial and pleural fluid analysis may warrant screening for malignancy more frequently in concurrence with a patient's history and presentation. Although the time from onset of symptoms to diagnosis of cardiac angiosarcoma is not well established, further investigation of such correlation may offer insight into survival post-treatment.
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Affiliation(s)
- Sophie Talbot
- Cardiology, Texas Tech University Health Sciences Center, Lubbock, USA
| | - Vishal Bandaru
- Cardiology, Texas Tech University Health Sciences Center, Lubbock, USA
| | - Tung Nguyen
- Cardiology, Texas Tech University Health Sciences Center, Lubbock, USA
| | - Dauod Arif
- Pathology, Texas Tech University Health Sciences Center, Lubbock, USA
| | - Pooja Sethi
- Cardiology, Texas Tech University Health Sciences Center, Lubbock, USA
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19
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Terui Y, Suzuki H, Chikata A, Hanaki Y, Komatsu Y, Ota H, Fujishima F, Umezawa R, Ouchi K, Sato H, Satoh T, Miyamichi-Yamamoto S, Yaoita N, Hayashi H, Nochioka K, Takahama H, Nogami A, Saiki Y, Yasuda S. Intractable Ventricular Tachycardia Prior to an Overt Cardiac Tumor Mass of Metastatic Cardiac Rhabdomyosarcoma (Spindle-cell Type). Intern Med 2024; 63:1725-1731. [PMID: 37926544 PMCID: PMC11239244 DOI: 10.2169/internalmedicine.2568-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 09/06/2023] [Indexed: 11/07/2023] Open
Abstract
We herein report a 37-year-old man who experienced recurrence of metastatic cardiac rhabdomyosarcoma along with intractable ventricular tachycardia (VT) 7 years after resection of rhabdomyosarcoma in his right elbow. At 36 years old, he developed VT unresponsive to radiofrequency catheter ablation (RFCA). Initially, the cardiac tumor was not detected, but it gradually grew in size at the RFCA site. A surgical biopsy confirmed the diagnosis of metastatic cardiac rhabdomyosarcoma. Despite radiation therapy, cardiac tumor progression and VT instability could not be prevented. Ultimately, the patient died 27 months after the initial documentation of VT.
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Affiliation(s)
- Yosuke Terui
- Departments of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Hideaki Suzuki
- Departments of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Akio Chikata
- Department of Cardiology, Toyama Prefectural Central Hospital, Japan
| | - Yuichi Hanaki
- Department of Cardiology, Institute of Medicine, University of Tsukuba, Japan
| | - Yuki Komatsu
- Department of Cardiology, Institute of Medicine, University of Tsukuba, Japan
| | - Hideki Ota
- Department of Diagnostic Radiology, Tohoku University Graduate School of Medicine, Japan
| | | | - Rei Umezawa
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Japan
| | - Kota Ouchi
- Department of Clinical Oncology, Tohoku University Graduate School of Medicine, Japan
| | - Haruka Sato
- Departments of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Taijyu Satoh
- Departments of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan
| | | | - Nobuhiro Yaoita
- Departments of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Hideka Hayashi
- Departments of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Kotaro Nochioka
- Departments of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Hiroyuki Takahama
- Departments of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Akihiko Nogami
- Department of Cardiology, Institute of Medicine, University of Tsukuba, Japan
| | - Yoshikatsu Saiki
- Division of Cardiovascular Surgery, Tohoku University Graduate School of Medicine, Japan
| | - Satoshi Yasuda
- Departments of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan
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20
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Kump DS. Mechanisms Underlying the Rarity of Skeletal Muscle Cancers. Int J Mol Sci 2024; 25:6480. [PMID: 38928185 PMCID: PMC11204341 DOI: 10.3390/ijms25126480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Revised: 06/04/2024] [Accepted: 06/05/2024] [Indexed: 06/28/2024] Open
Abstract
Skeletal muscle (SKM), despite comprising ~40% of body mass, rarely manifests cancer. This review explores the mechanisms that help to explain this rarity, including unique SKM architecture and function, which prohibits the development of new cancer as well as negates potential metastasis to SKM. SKM also presents a unique immune environment that may magnify the anti-tumorigenic effect. Moreover, the SKM microenvironment manifests characteristics such as decreased extracellular matrix stiffness and altered lactic acid, pH, and oxygen levels that may interfere with tumor development. SKM also secretes anti-tumorigenic myokines and other molecules. Collectively, these mechanisms help account for the rarity of SKM cancer.
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Affiliation(s)
- David S Kump
- Department of Biological Sciences, Winston-Salem State University, 601 Martin Luther King Jr. Dr., Winston-Salem, NC 27110, USA
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21
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Lima NA, Cwikla K, Byers-Spencer K, Crumm I, Patel D, Huffman C, McGoff TN, Young J, Melgar TA, Helmstetter N. Malignant cardiac neoplasms and associated malignancies over 16 years in the USA. J Cardiol 2024; 83:377-381. [PMID: 37714265 DOI: 10.1016/j.jjcc.2023.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 09/05/2023] [Accepted: 09/08/2023] [Indexed: 09/17/2023]
Abstract
BACKGROUND Malignant cardiac neoplasms (MCNs), both primary and metastatic, are rare with few epidemiologic studies. METHODS This retrospective study used the Healthcare Utilization Project/Nationwide Inpatient Sample database from 2002 to 2018 to evaluate the co-occurrences with other malignancies, and mortality of MCNs in the USA. RESULTS The data contained 7207 weighted discharges of MCN. Median patient age was 51.4 years, 52.29 % were male, in-hospital mortality was 10.51 %, mean cost of hospitalization was $34,280 USD. Lung, mediastinum, and airways were the most common primary cancers associated with metastatic MCN. CONCLUSIONS MCN are rare in the USA, however they carry a high in-hospital mortality, high morbidity, and hospital cost.
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Affiliation(s)
- Neiberg A Lima
- Department of Internal Medicine, Division of Cardiology, Wayne State University, Detroit, MI, USA.
| | - Kamil Cwikla
- Department of Internal Medicine, Loyola University Medical Center, Maywood, IL, USA
| | - Kristina Byers-Spencer
- Departments of Internal Medicine and Pediatrics, Spectrum Health/Michigan State University, Grand Rapids, MI, USA
| | - Ian Crumm
- Departments of Pediatrics, Adolescent and Internal Medicine, Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, MI, USA
| | - Dhruvil Patel
- Wayne State University, School of Medicine, Detroit, MI, USA
| | - Cuyler Huffman
- Department of Epidemiology and Biostatistics, Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, MI, USA
| | - Theresa N McGoff
- Department of Biomedical Informatics, Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, MI, USA
| | - Jeffrey Young
- Department of Biomedical Informatics, Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, MI, USA
| | - Thomas A Melgar
- Departments of Pediatrics, Adolescent and Internal Medicine, Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, MI, USA
| | - Nicholas Helmstetter
- Departments of Pediatrics, Adolescent and Internal Medicine, Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, MI, USA
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22
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Evbayekha E, Rao AK, Leidenfrost J, Reiss CK. Isolated primary cardiac angiosarcoma. Curr Probl Cardiol 2024; 49:102472. [PMID: 38369202 DOI: 10.1016/j.cpcardiol.2024.102472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 02/15/2024] [Indexed: 02/20/2024]
Abstract
Cardiac angiosarcoma (CAS) is the most prevalent malignant primary cardiac tumor in adults, often affecting young males. We present a case of this rare entity in a young female, highlighting the multidisciplinary team's role and multimodality imaging in the diagnosis and management.
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Affiliation(s)
- Endurance Evbayekha
- St. Luke's Hospital, 232 S Woods Mill Rd, Suite 400 South, Chesterfield, MO 63017, USA.
| | - Anupama K Rao
- St. Luke's Hospital, 232 S Woods Mill Rd, Suite 400 South, Chesterfield, MO 63017, USA
| | - Jeremy Leidenfrost
- St. Luke's Hospital, 232 S Woods Mill Rd, Suite 400 South, Chesterfield, MO 63017, USA
| | - Craig K Reiss
- St. Luke's Hospital, 232 S Woods Mill Rd, Suite 400 South, Chesterfield, MO 63017, USA
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23
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Huffaker T, Pak S, Asif A, Otchere P. Tricuspid mass-curious case of Li-Fraumeni syndrome: A case report. World J Clin Cases 2024; 12:1936-1939. [PMID: 38660548 PMCID: PMC11036521 DOI: 10.12998/wjcc.v12.i11.1936] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 12/30/2023] [Accepted: 02/18/2024] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND Li-Fraumeni syndrome (LFS) is a rare autosomal dominant cancer-predisposing syndrome, which can manifest as a polymorphic spectrum of malignancies. LFS is associated with an early onset in life, with the majority of cases occurring prior to the age of 46. Notwithstanding the infrequency of primary cardiac tumors, it behooves clinicians to remain vigilant in considering the differential diagnosis of such tumors in LFS patients who present with a cardiac mass. This is due to the markedly elevated risk for malignancy in this particular population, far surpassing that of the general populace. CASE SUMMARY Herein, we present a case of a 30-year-old female with LFS who was found to have a tricuspid valve leaflet mass. CONCLUSION This case exemplifies valuable learning points in the diagnostic approach for this exceptionally rare patient population.
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Affiliation(s)
- Tyler Huffaker
- Department of Cardiology, University of Texas Health San Antonio, San Antonio, TX 78701, United States
| | - Stella Pak
- Department of Neurology, Albany Medical Center, Albany, NY 12208, United States
| | - Anum Asif
- Department of Cardiology, University of Texas Health San Antonio, San Antonio, TX 78701, United States
| | - Prince Otchere
- Department of Cardiology, University of Texas Health San Antonio, San Antonio, TX 78701, United States
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Elmalki H, Berkane MT, Moutaouekkil M. A Giant Primary Angiosarcoma Invading the Right Heart in a Young Male: An Emergency Surgery. Cureus 2024; 16:e56309. [PMID: 38629001 PMCID: PMC11019469 DOI: 10.7759/cureus.56309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2024] [Indexed: 04/19/2024] Open
Abstract
Primary cardiac angiosarcoma is very rare. In this report, we describe an interesting case of a 25-year-old male with a giant primary angiosarcoma invading the right heart. He was urgently admitted to the hospital for respiratory distress. Once the diagnosis was suspected by chest x-ray, echocardiography, and CT scan, and given the patient's hemodynamic and respiratory instability, an emergency open-heart surgery was necessary to prevent complications. Through a right atriotomy and a pulmonary infundibulotomy, the tumor was resected. Invaded by the tumoral process, the tricuspid valve was replaced with a biological prosthesis. The postoperative course was marked by severe right ventricular dysfunction with multiorgan failure. Histopathologic examination of the surgical specimen confirmed a primary cardiac angiosarcoma.
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Affiliation(s)
- Hicham Elmalki
- Cardiothoracic Surgery, Faculty of Medicine and Pharmacy, Laboratory of Anatomy, Microsurgery and Surgery Experimental and Medical Simulation (LAMCESM) Mohammed First University, Oujda, MAR
| | | | - Mehdi Moutaouekkil
- Cardiothoracic Surgery, Faculty of Medicine and Pharmacy, Laboratory of Anatomy, Microsurgery and Surgery Experimental and Medical Simulation (LAMCESM) Mohammed First University, Oujda, MAR
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25
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Li T, Zhang S, Liu C, Peng X, Gong S, Pan W, Wang Y. Long-Term Efficacy Analysis of Surgical Resection of 70 Primary Right Heart Tumors. Cardiology 2024; 149:147-154. [PMID: 38417418 PMCID: PMC10994591 DOI: 10.1159/000535656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 12/01/2023] [Indexed: 03/01/2024]
Abstract
INTRODUCTION The aim of the study was to investigate the clinical characteristics, surgical treatment, and long-term efficacy of primary right heart tumors. METHODS This study is retrospective analysis of the clinical data of 70 patients with primary right heart tumors admitted to our department between 1980 and 2022 (observation group) and 70 patients with left heart tumors during the same period (control group). The surgical treatment was performed under cardiopulmonary bypass after differential diagnosis by echocardiography, cardiac CTA, and PET-CT before the surgery. The perioperative characteristics, recurrence rate, and long-term survival rates of right heart tumor versus left heart tumor were compared. RESULTS The most common pathological types of right heart tumors were myxoma (60%), lipoma (8.57%), and papillary elastofibroma (7.14%). During the perioperative period, there were 1 case of systemic embolism in the observation group, compared with 6 in the control group (p = 0.026), 13 cases of malignant tumor in the observation group versus 1 in the control group (p = 0.01). During the follow-up period, there were 15 cases of tumor recurrence and 17 cases of death in the observation group versus 4 (p = 0.002) and 7 in the control group (p = 0.006), comparatively. CONCLUSION Compared with left heart tumors, primary right heart tumors had a higher incidence of malignant tumors and a lower risk of systemic embolism during perioperative period. During the follow-up period, primary right heart tumors had a higher rate of tumor recurrence and a lower long-term survival rate.
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Affiliation(s)
- Tianbo Li
- Center of Cardiovascular Surgery, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Si Zhang
- Department of Radiology, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Chencheng Liu
- Center of Cardiovascular Surgery, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Xiaobo Peng
- Center of Cardiovascular Surgery, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Siming Gong
- Department of Ultrasound, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Wencheng Pan
- Center of Cardiovascular Surgery, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Yong Wang
- Center of Cardiovascular Surgery, Xinqiao Hospital, Army Medical University, Chongqing, China
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26
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Xiao W, Qin J, Feng J, Jiang F, Chen X, Cao X, Xue Q, Shi J. Case Report: Giant left atrial cystic tumor: myxoma or intracardiac blood cyst? Front Cardiovasc Med 2024; 11:1323890. [PMID: 38420261 PMCID: PMC10899463 DOI: 10.3389/fcvm.2024.1323890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 02/05/2024] [Indexed: 03/02/2024] Open
Abstract
Background Primary cardiac tumors are uncommon, with the majority being benign myxomas. Cystic myxoma, a particularly rare type of benign cardiac tumor, demands cautious differential diagnosis from other cardiac tumors. Case summary A 43-year-old male patient presenting with intermittent dyspnea was referred to our department for surgical evaluation. Transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) unveiled an intra-left atrial cyst, which was subsequently found to be blood-filled during a video-assisted microinvasive heart surgery. Pathological examination depicted a cyst wall filled with small stellate and fat spindle cells, along with a mucoid matrix, indicating a diagnosis of cystic myxoma. Conclusions We herein presented a rare case of an adult patient with cystic myxoma, initially misdiagnosed as an intracardiac blood cyst (CBC) prior to surgery, and ultimately verified via pathological findings.
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Affiliation(s)
- Weizhang Xiao
- Department of Cardiothoracic Surgery, Affiliated Hospital and Medical School of Nantong University, Nantong, China
| | - Jing Qin
- Department of Echocardiography, Affiliated Hospital and Medical School of Nantong University, Nantong, China
| | - Jia Feng
- Department of Pathology, Affiliated Hospital and Medical School of Nantong University, Nantong, China
| | - Feng Jiang
- Department of Echocardiography, Affiliated Hospital and Medical School of Nantong University, Nantong, China
| | - Xinming Chen
- Department of Cardiothoracic Surgery, Affiliated Hospital and Medical School of Nantong University, Nantong, China
| | - Xiang Cao
- Department of Cardiothoracic Surgery, Affiliated Hospital and Medical School of Nantong University, Nantong, China
| | - Qun Xue
- Department of Cardiothoracic Surgery, Affiliated Hospital and Medical School of Nantong University, Nantong, China
| | - Jiahai Shi
- Department of Cardiothoracic Surgery, Affiliated Hospital and Medical School of Nantong University, Nantong, China
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Affiliation(s)
- Gurleen Kaur
- From the Department of Medicine (G.K., M.S.S., Y.-P.S., J.L.), TIMI Study Group, Division of Cardiovascular Medicine (M.S.S.), and the Department of Pathology (I.-M.S.), Brigham and Women's Hospital, Boston
| | - Marc S Sabatine
- From the Department of Medicine (G.K., M.S.S., Y.-P.S., J.L.), TIMI Study Group, Division of Cardiovascular Medicine (M.S.S.), and the Department of Pathology (I.-M.S.), Brigham and Women's Hospital, Boston
| | - Inga-Marie Schaefer
- From the Department of Medicine (G.K., M.S.S., Y.-P.S., J.L.), TIMI Study Group, Division of Cardiovascular Medicine (M.S.S.), and the Department of Pathology (I.-M.S.), Brigham and Women's Hospital, Boston
| | - Yee-Ping Sun
- From the Department of Medicine (G.K., M.S.S., Y.-P.S., J.L.), TIMI Study Group, Division of Cardiovascular Medicine (M.S.S.), and the Department of Pathology (I.-M.S.), Brigham and Women's Hospital, Boston
| | - Joseph Loscalzo
- From the Department of Medicine (G.K., M.S.S., Y.-P.S., J.L.), TIMI Study Group, Division of Cardiovascular Medicine (M.S.S.), and the Department of Pathology (I.-M.S.), Brigham and Women's Hospital, Boston
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28
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Awoyemi T, Gustafson A, Sekhon S, Rytych J, Narang A, Akhter N. Stepwise Use of Multimodality Imaging in a Rare Cardiac Intimal Sarcoma. CASE (PHILADELPHIA, PA.) 2023; 7:409-415. [PMID: 37970486 PMCID: PMC10635890 DOI: 10.1016/j.case.2023.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2023]
Abstract
•CISs are rare and aggressive primary cardiac tumors. •CIS presents with diverse pathology and is challenging to manage due to mass effect. •Multimodality cardiac imaging is valuable in diagnosis, surveillance, and management. •Because of limited therapeutic options, earlier diagnosis of CIS is essential.
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Affiliation(s)
| | - Andrew Gustafson
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Shaundeep Sekhon
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Jennifer Rytych
- Department of Pathology, Northwestern University, Chicago, Illinois
| | - Akhil Narang
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois
- Division of Cardiology, Northwestern University, Chicago, Illinois
| | - Nausheen Akhter
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois
- Division of Cardiology, Northwestern University, Chicago, Illinois
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29
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Appiah D, Goodart CR, Kothari GK, Ebong IA, Nwabuo CC. Reduced Risk of All-Cause, Cancer-, and Cardiovascular Disease-Related Mortality among Patients with Primary Malignant Cardiac Tumors Receiving Chemotherapy in the United States. Curr Oncol 2023; 30:8488-8500. [PMID: 37754533 PMCID: PMC10529023 DOI: 10.3390/curroncol30090618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 09/12/2023] [Accepted: 09/14/2023] [Indexed: 09/28/2023] Open
Abstract
Primary malignant cardiac tumors (PMCTs) are rare but lethal neoplasms. There are limited evidence-based treatment guidelines for PMCTs. We evaluated the relation of chemotherapy with mortality outcomes in patients with PMCTs in the United States. Data were from patients aged ≥ 20 years from the Surveillance, Epidemiology, and End Results program who were diagnosed with PMCTs from 2000 to 2020. Cox regression, competing risk, and propensity score analyses were performed to estimate hazard ratios (HR) and confidence intervals (CI). About 53% of the 563 patients with PMCTs received chemotherapy as the first course of treatment. During a mean follow-up of 24.7 months (median: 10), 458 deaths occurred with 81.7% and 9.4% due to cancer and cardiovascular disease (CVD), respectively. In models adjusted for sociodemographic and clinico-pathophysiological factors including histology, receipt of chemotherapy was associated with low risk for all-cause (HR: 0.56, 95%CI: 0.45-0.69), cancer (HR: 0.63, 95%CI: 0.50-0.80) and CVD mortality (HR: 0.27, 95%CI: 0.12-0.58). Patients who had both chemotherapy and surgery had the lowest risk for all-cause and cancer mortality. This study suggests that the subpopulations of patients with PMCTs who receive chemotherapy may have better prognosis than those who do not receive this therapy regardless of histology.
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Affiliation(s)
- Duke Appiah
- Department of Public Health, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
| | - Carina R. Goodart
- School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
| | - Grishma K. Kothari
- Department of Public Health, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
| | - Imo A. Ebong
- Division of Cardiovascular Medicine, University of California, Davis, Sacramento, CA 95616, USA
| | - Chike C. Nwabuo
- Department of Pathology, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA;
- Ronin Institute, Montclair, NJ 07043, USA
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30
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Chambergo-Michilot D, De la Cruz-Ku G, Sterner RM, Brañez-Condorena A, Guerra-Canchari P, Stulak J. Clinical characteristics, management, and outcomes of patients with primary cardiac angiosarcoma: A systematic review. J Cardiovasc Thorac Res 2023; 15:1-8. [PMID: 37342661 PMCID: PMC10278191 DOI: 10.34172/jcvtr.2023.30531] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 02/10/2023] [Indexed: 06/23/2023] Open
Abstract
Primary cardiac angiosarcomas (PCA) are highly aggressive malignant heart tumors. Previous reports have shown a poor prognosis regardless of management, and no consensus or guidelines exist. It is necessary to clarify this information since patients with PCA have a short survival. Therefore, we aimed to systematically review clinical manifestations, management, and outcomes. We systematically searched in PubMed, Scopus, Web of Science, and EMBASE. We intended to include cross-sectional studies, case-control studies, cohort studies, and case series that reported clinical characteristics, management, and outcomes of patients with PCA. As a methodological approach, we used the Joanna Briggs Institute Critical Appraisal Checklist for Case Series and the Newcastle-Ottawa Scale for cohorts. We included six studies (five case series, one cohort). The mean/median age ranged from 39 to 48.9 years. Male sex was predominant. The most frequent manifestations were dyspnea (range: 50%-80%), pericardial effusion (29% & 56%), and chest pain (10%-39%). The mean tumor size ranged from 5.8 to 7.2 cm, with the majority of these localized in the right atrium (70-100%). The most common locations of metastasis were the lung (20%-55.6%), liver (10%-22.2%), and bone (10%-20%). Resection (22.9%-94%), and chemotherapy as neoadjuvant or adjuvant (30%-100%) were the most commonly used methods of treatment. Mortality ranged from 64.7% to 100%. PCA often presents late in its course and usually results in poor prognosis. We strongly recommend performing multi-institutional prospective cohorts to better study disease course and treatments to develop consensus, algorithms, and guidelines for this type of sarcoma.
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Affiliation(s)
- Diego Chambergo-Michilot
- Universidad Científica del Sur, Lima, Perú
- Department of Cardiology Research, Torres de Salud National Research Center, Lima, Perú
| | - Gabriel De la Cruz-Ku
- Universidad Científica del Sur, Lima, Perú
- Department of Surgery, Mayo Clinic, Rochester, MN, USA
- Department of Surgery of the University of Massachusetts Medical School, Worcester, MA, USA
| | | | - Ana Brañez-Condorena
- Universidad Nacional Mayor de San Marcos, Facultad de Medicina, Lima, Perú
- Asociación de Investigación Estudiantil en Ciencias de la Salud, Lima, Perú
| | - Pedro Guerra-Canchari
- Universidad Nacional Mayor de San Marcos, Facultad de Medicina, Lima, Perú
- Sociedad Científica de San Fernando, Lima, Perú
| | - John Stulak
- Department of Surgery, Mayo Clinic, Rochester, MN, USA
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31
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(Cardiac tamponade as severe manifestation of angiosarcoma). COR ET VASA 2023. [DOI: 10.33678/cor.2022.082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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32
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Wang Q, Jiang Y, Lin L, Li S, Lv J, Chen J. Clinical characteristics of primary atrial tumor and their diagnostic value: A retrospective study of 10 years. Front Surg 2023; 10:1097287. [PMID: 36865623 PMCID: PMC9971564 DOI: 10.3389/fsurg.2023.1097287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 01/17/2023] [Indexed: 02/16/2023] Open
Abstract
Background Primary atrial tumors are relatively rare and predominantly benign. However, some atrial tumors may be malignant and are associated with poor outcome. Currently, it is hard to determine the malignance of atrial tumors by preoperative clinical presentation or by echocardiography. We aimed to report the difference in the clinical characteristics of patients with benign and malignant atrial tumor. Methods This was a single-center retrospective study. A total of 194 patients with primary atrial tumor admitted to our center between 2012 and 2021 were included. The clinical characteristics of patients with benign and malignant tumor were compared. Results Benign and malignant tumor accounted for 93% (n = 180) and 7% (n = 14) of the total patients, respectively. Malignant atrial tumor tended to occur in younger patients (P < 0.05), was more likely to be located at the right atrium (P < 0.05), and tended to attach to the atrial wall or valve instead of the atrial septum. Fever symptoms were more common in patients with malignant tumors than in patients with benign tumors (P < 0.05). Compared to benign tumor, patients with malignant atrial tumor also demonstrated higher rates of fever, lower rates of increasing fibrinogen, increased blood glucose (P < 0.05), significantly longer prothrombin time, and lower prothrombin activity (P < 0.05). Patients with malignant primary atrial tumor had higher mortality rate, tumor metastasis rate, and tumor recurrence rate than patients with benign primary atrial tumor (P < 0.05). Conclusion We compared the clinical characteristics of patients with benign and malignant atrial tumor. These findings provide valuable information to preoperatively determine the malignance of atrial tumor and thus guide surgical treatment.
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Affiliation(s)
- Qian Wang
- Department of Internal Medicine, Division of Cardiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yue Jiang
- Department of Internal Medicine, Division of Cardiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Li Lin
- Department of Internal Medicine, Division of Cardiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Sheng Li
- Department of Internal Medicine, Division of Cardiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jiagao Lv
- Department of Internal Medicine, Division of Cardiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jun Chen
- Division of Cardiothoracic and Vascular Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China,Correspondence: Jun Chen
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Medeiros P, Coelho AR, Magalhães J, Salomé N, Pereira V. A Rare Subtype of a Rare Tumor. Arq Bras Cardiol 2023; 120:e20220486. [PMID: 36856243 PMCID: PMC9972779 DOI: 10.36660/abc.20220486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 12/14/2022] [Indexed: 02/16/2023] Open
Affiliation(s)
- Paulo Medeiros
- Departamento de CardiologiaHospital de BragaBragaPortugal Departamento de Cardiologia, Hospital de Braga, Braga – Portugal
| | - Ana Rita Coelho
- Departamento de PatologiaCentro Hospitalar e Universitário de São JoãoPortoPortugalDepartamento de Patologia, Centro Hospitalar e Universitário de São João, Porto – Portugal
| | - João Magalhães
- Departamento de PatologiaCentro Hospitalar e Universitário de São JoãoPortoPortugalDepartamento de Patologia, Centro Hospitalar e Universitário de São João, Porto – Portugal
| | - Nuno Salomé
- Departamento de CardiologiaHospital de BragaBragaPortugal Departamento de Cardiologia, Hospital de Braga, Braga – Portugal
| | - Vítor Pereira
- Departamento de CardiologiaHospital de BragaBragaPortugal Departamento de Cardiologia, Hospital de Braga, Braga – Portugal ,Universidade do MinhoBragaPortugalUniversidade do Minho, Braga – Portugal
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Chi K, Zhou R, Luo Z, Zhao H, Jiang Y, He B, Li Y, Chen D, Feng M, Liang Y, Yang W, Liu R, Yao D, Lin X, Xu X. Non-cancer-specific survival in patients with primary central nervous system lymphoma: A multi-center cohort study. Front Oncol 2023; 13:1096027. [PMID: 36845683 PMCID: PMC9945279 DOI: 10.3389/fonc.2023.1096027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 01/26/2023] [Indexed: 02/10/2023] Open
Abstract
Objective The study aimed to evaluate the non-cancer-specific death risk and identify the risk factors affecting the non-cancer-specific survival (NCSS) in patients with primary central nervous system lymphoma (PCNSL). Methods This multi-center cohort study included 2497 patients with PCNSL in the Surveillance, Epidemiology and End Results (SEER) database from 2007 to 2016, with a mean follow-up of 4.54 years. The non-cancer-specific death risk in patients with PCNSL and primary central nervous system diffuse large B-cell lymphoma (PCNS-DLBCL) was evaluated using the proportion of deaths, standardized mortality ratio (SMR), and absolute excess risk (AER). Univariate and multivariate competing risk regression models were utilized to identify the risk factors of NCSS. Results PCNSL was the most frequent cause of death in PCNSL patients (75.03%). Non-cancer-specific causes constituted a non-negligible portion of death (20.61%). Compared with the general population, PCNSL patients had higher risks of death from cardiovascular disease (CVD) (SMR, 2.55; AER, 77.29), Alzheimer's disease (SMR, 2.71; AER, 8.79), respiratory disease (SMR, 2.12; AER, 15.63), and other non-cancer-specific diseases (SMR, 4.12; AER, 83.12). Male sex, Black race, earlier year of diagnosis (2007-2011), being unmarried, and a lack of chemotherapy were risk factors for NCSS in patients with PCNSL and PCNS-DLBCL (all P < 0.05). Conclusion Non-cancer-specific causes were important competing causes of death in PCNSL patients. More attention is recommended to non-cancer-specific causes of death in the management of PCNSL patients.
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Affiliation(s)
- Kaiyi Chi
- Department of Clinical Medicine, The Second Clinical College of Guangzhou Medical University, Guangzhou, China,Cardiovascular Medicine and Cardio-Oncology Group, Medical Exploration and Translation Team, Guangzhou, China
| | - Ruoyun Zhou
- Cardiovascular Medicine and Cardio-Oncology Group, Medical Exploration and Translation Team, Guangzhou, China,Department of Clinical Medicine, The Third Clinical College of Guangzhou Medical University, Guangzhou, China
| | - Zehao Luo
- Cardiovascular Medicine and Cardio-Oncology Group, Medical Exploration and Translation Team, Guangzhou, China,Department of Clinical Medicine, The Sixth Clinical College of Guangzhou Medical University, Guangzhou, China
| | - Hongjun Zhao
- Cardiovascular Medicine and Cardio-Oncology Group, Medical Exploration and Translation Team, Guangzhou, China,Department of Clinical Medicine, The Sixth Clinical College of Guangzhou Medical University, Guangzhou, China
| | - Yanting Jiang
- Cardiovascular Medicine and Cardio-Oncology Group, Medical Exploration and Translation Team, Guangzhou, China,Department of Clinical Medicine, The Sixth Clinical College of Guangzhou Medical University, Guangzhou, China
| | - Baixin He
- Department of Clinical Medicine, The Second Clinical College of Guangzhou Medical University, Guangzhou, China,Cardiovascular Medicine and Cardio-Oncology Group, Medical Exploration and Translation Team, Guangzhou, China
| | - Yemin Li
- Cardiovascular Medicine and Cardio-Oncology Group, Medical Exploration and Translation Team, Guangzhou, China,Department of Clinical Medicine, The First Clinical College of Guangzhou Medical University, Guangzhou, China
| | - Dongting Chen
- Department of Clinical Medicine, The Second Clinical College of Guangzhou Medical University, Guangzhou, China,Cardiovascular Medicine and Cardio-Oncology Group, Medical Exploration and Translation Team, Guangzhou, China
| | - Manting Feng
- Department of Clinical Medicine, The Second Clinical College of Guangzhou Medical University, Guangzhou, China,Cardiovascular Medicine and Cardio-Oncology Group, Medical Exploration and Translation Team, Guangzhou, China
| | - Yinglan Liang
- Cardiovascular Medicine and Cardio-Oncology Group, Medical Exploration and Translation Team, Guangzhou, China,Department of Anesthesiology, The Second Clinical College of Guangzhou Medical University, Guangzhou, China
| | - Wenting Yang
- Cardiovascular Medicine and Cardio-Oncology Group, Medical Exploration and Translation Team, Guangzhou, China,Department of Medical Imageology, The Second Clinical College of Guangzhou Medical University, Guangzhou, China
| | - Ruisi Liu
- Cardiovascular Medicine and Cardio-Oncology Group, Medical Exploration and Translation Team, Guangzhou, China,Department of Medical Imageology, The Second Clinical College of Guangzhou Medical University, Guangzhou, China
| | - Dunchen Yao
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Xiaozhen Lin
- Department of Cardiology, Guangzhou Institute of Cardiovascular Disease, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China,*Correspondence: Xiaozhen Lin, ; Xiuhong Xu,
| | - Xiuhong Xu
- Department of Acupuncture and Massage Rehabilitation, Integrated Hospital of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China,*Correspondence: Xiaozhen Lin, ; Xiuhong Xu,
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35
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Lloyd J, Gilliat N, Porter G, Pirone F. A case report of an ischaemic stroke, caused by a primary cardiac intimal sarcoma. BMC Cardiovasc Disord 2023; 23:59. [PMID: 36726074 PMCID: PMC9893665 DOI: 10.1186/s12872-023-03090-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 01/24/2023] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Intimal sarcomas are an extremely rare type of primary cardiac malignancy. They most commonly present with symptoms of cardiac dysfunction. We present a case of intimal sarcoma identified without any cardiac signs or symptoms. Cardiac sarcomas historically carry a very poor prognosis. PRESENTATION A 57-year-old man presented with a sudden onset of left limb weakness and disorientation. MRI brain identified an acute ischaemic stroke in the right anterior temporal lobe. Four months later, he presented again with transient left arm weakness. The patient had a normal cardiovascular examination and ECG. All other initial investigations for cryptogenic stroke were non-contributory. The patient did not initially get an echocardiogram. When this investigation was performed, after his second presentation, a large pedunculated mass was present in his left atrium. This was resected and identified histologically as a primary intimal sarcoma of his left atrium. The patient was treated with post-operative radiotherapy but declined chemotherapy. He recovered well post-operatively but subsequently passed away 14 months after diagnosis. CONCLUSIONS It is possible for primary cardiac malignancies to present with only symptoms of systemic emboli. For this reason, echocardiography is a crucial investigation in cases of cryptogenic stroke. Some stroke guidelines do not definitively support routine echocardiography. Primary intimal cardiac sarcoma is a very rare condition with a poor prognosis. The literature is limited to case reports and optimal management is with surgical resection where possible. The role of post operative radiotherapy and chemotherapy is uncertain.
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Affiliation(s)
- Joshua Lloyd
- Te Whatu Ora Health New Zealand - Bay of Plenty, 829 Cameron Road, Tauranga South, Tauranga, 3112, New Zealand.
| | - Navinee Gilliat
- Te Whatu Ora Health New Zealand – Bay of Plenty, 829 Cameron Road, Tauranga South, Tauranga, 3112 New Zealand
| | - Graeme Porter
- Te Whatu Ora Health New Zealand – Bay of Plenty, 829 Cameron Road, Tauranga South, Tauranga, 3112 New Zealand
| | - Francesco Pirone
- Te Whatu Ora Health New Zealand – Waikato, 183 Pembroke Street, Hamilton, 3204 New Zealand
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Rahouma M, Khairallah S, Dabsha A, Baudo M, El-Sayed Ahmed MM, Gambardella I, Lau C, Esmail YM, Mohamed A, Girardi L, Gaudino M, Lorusso R, Mick SL. Geographic variation in malignant cardiac tumors and their outcomes: SEER database analysis. Front Oncol 2023; 13:1071770. [PMID: 36761976 PMCID: PMC9902931 DOI: 10.3389/fonc.2023.1071770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 01/04/2023] [Indexed: 01/26/2023] Open
Abstract
Introduction Primary malignant cardiac tumors (PMCTs) are rare. Geographical distribution has been demonstrated to affect cancer outcomes, making the reduction of geographical inequalities a major priority for cancer control agencies. Geographic survival disparities have not been reported previously for PMCT and the aim of this study is to compare the prevalence and the long-term survival rate with respect to the geographic location of PMCTs using the Surveillance, Epidemiology, and End Results (SEER) research plus data 17 registries between 2000 and 2019. Methods The SEER database was queried to identify geographic variation among PMCTs. We classified the included states into 4 geographical regions (Midwest, Northeast, South and West regions) based on the U.S. Census Bureau-designated regions and divisions. Different demographic and clinical variables were analyzed and compared between the four groups. Kaplan Meier curves and Cox regression were used for survival assessment. Results A total of 563 patients were included in our analysis. The median age was 53 years (inter-quartile range (IQR): 38 - 68 years) and included 26, 90, 101, and 346 patients from the Midwest, Northeast, South, and West regions respectively. Sarcoma represented 65.6% of the cases, followed by hematological tumors (26.2%), while mesothelioma accounted for 2.1%. Treatment analysis showed no significant differences between different regions. Median overall survival was 11, 21, 13, and 11 months for Midwest, Northeast, South and West regions respectively and 5-year overall survival was 22.2%, 25.4%, 14.9%, and 17.6% respectively. On multivariate Cox regression, significant independent predictors of late overall mortality among the entire cohort included age (Hazard Ratio [HR] 1.028), year of diagnosis (HR 0.967), sarcoma (HR 3.36), surgery (HR 0.63) and chemotherapy (HR 0.56). Conclusion Primary malignant cardiac tumors are rare and associated with poor prognosis. Sarcoma is the most common pathological type. Younger age, recent era diagnosis, surgical resection, and chemotherapy were the independent predictors of better survival. While univariate analysis revealed that patients in the South areas had a worse survival trend compared to other areas, geographic disparity in survival was nullified in multivariate analysis.
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Affiliation(s)
- Mohamed Rahouma
- Cardiothoracic Surgery Departments, Weill Cornell Medicine, New York, NY, United States,Surgical Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt,*Correspondence: Mohamed Rahouma, ;
| | - Sherif Khairallah
- Cardiothoracic Surgery Departments, Weill Cornell Medicine, New York, NY, United States,Surgical Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Anas Dabsha
- Cardiothoracic Surgery Departments, Weill Cornell Medicine, New York, NY, United States,Surgical Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Massimo Baudo
- Cardiothoracic Surgery Departments, Weill Cornell Medicine, New York, NY, United States,Cardiac Surgery Department, Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| | - Magdy M. El-Sayed Ahmed
- Cardiothoracic Surgery Department, Mayo Clinic, Jacksonville, FL, United States,Department of Surgery, Zagazig University Faculty of Medicine, Zagazig, Egypt
| | | | - Christopher Lau
- Cardiothoracic Surgery Departments, Weill Cornell Medicine, New York, NY, United States
| | - Yomna M. Esmail
- Cardiothoracic Surgery Departments, Weill Cornell Medicine, New York, NY, United States
| | - Abdelrahman Mohamed
- Surgical Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Leonard Girardi
- Cardiothoracic Surgery Departments, Weill Cornell Medicine, New York, NY, United States
| | - Mario Gaudino
- Cardiothoracic Surgery Departments, Weill Cornell Medicine, New York, NY, United States
| | - Roberto Lorusso
- Department of Cardio-Thoracic Surgery, Maastricht University Medical Centre, Maastricht University, Maastricht, Netherlands,Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, Netherlands
| | - Stephanie L. Mick
- Cardiothoracic Surgery Departments, Weill Cornell Medicine, New York, NY, United States
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Qiang Y, Zeng K, Zhang B, Guan R, Liu Y, Liu Z, Xu H, Zhang X, Ren Y, Deng B, Yang Y. Atypical location of primary cardiac lymphoma in the left heart with atypical clinical presentation: A case report and literature review. Front Surg 2023; 9:1036519. [PMID: 36726943 PMCID: PMC9885797 DOI: 10.3389/fsurg.2022.1036519] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Accepted: 10/24/2022] [Indexed: 01/18/2023] Open
Abstract
Background Primary cardiac lymphoma (PCL) is a rare and aggressive cardiac tumor with very poor prognosis that occurs mostly in the right cardiac cavity. Early diagnosis and treatment may improve its prognosis. In the present report, we describe the diagnosis and treatment of a primary cardiac diffuse large B-cell lymphoma (PC-DLBCL) with atypical location and clinical presentation. Additionally, a literature review was conducted to summarize the current knowledge of the disease. Case Presentation A 71-year-old man visited his local hospital because of syncope, recurrent chest tightness, shortness of breath, palpitations, and profuse sweating for more than 20 days. Chest radiography revealed a mediastinal mass. Cardiac computed tomography (CT) showed multiple enlarged mediastinal lymph nodes. Transthoracic echocardiography (TTE) showed a cardiac mass in the posterior-inferior wall of the left atrium. He was then transferred to our hospital for positron emission tomography-CT (PET-CT) which showed active uptake of fluorodeoxyglucose both in the cardiac mass and in the multiple enlarged mediastinal lymph nodes. Biopsy of the enlarged mediastinal lymph nodes was carried out by using video-assisted thoracic surgery (VATS) technique, and pathological examination confirmed the subtype of PC-DLBCL, Stage IV, NCCN IPI 3. Therefore, the patient received a combination of chemotherapy and immunotherapy with R-CDOP (rituximab, cyclophosphamide, liposome doxorubicin, vincristine, and prednisone). After four courses of treatment in 4 months, the cardiac lymphoma and the enlarged mediastinal lymph nodes achieved complete remission with mild side effects of the chemotherapy. Conclusion Early diagnosis and a precise choice of chemotherapy and immunotherapy based on cardiac imaging and pathological examination may improve the prognosis of PC-DLBCL in an atypical location.
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Affiliation(s)
- Yongjia Qiang
- Department of Cardiovascular Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangdong, China
| | - Kuan Zeng
- Department of Cardiovascular Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangdong, China
| | - Bin Zhang
- Department of Cardiovascular Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangdong, China,Guangdong Provincial Key Laboratory of Epigenetics and Gene Regulation of Malignant Tumors, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangdong, China
| | - Ruicong Guan
- Department of Cardiovascular Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangdong, China,Guangdong Provincial Key Laboratory of Epigenetics and Gene Regulation of Malignant Tumors, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangdong, China
| | - Yuqiang Liu
- Department of Cardiovascular Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangdong, China
| | - Zhuxuan Liu
- Department of Cardiovascular Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangdong, China
| | - Haohua Xu
- Department of Cardiovascular Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangdong, China
| | - Xinyi Zhang
- Department of Cardiovascular Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangdong, China
| | - Yanting Ren
- Department of Pathology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangdong, China
| | - Baoping Deng
- Department of Vascular Surgery, The Fifth Affiliated Hospital, Southern Medical University, Guangdong, China,Correspondence: Yanqi Yang Baoping Deng
| | - Yanqi Yang
- Department of Cardiovascular Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangdong, China,Department of Cardiothoracic Surgery, University Hospital, Linköping University, Linköping, Sweden,Correspondence: Yanqi Yang Baoping Deng
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38
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Guan T, Wei Q, Tang Y, Zhao H, Lu Z, Feng W, Teng Y, Luo Z, Chi K, Ou C, Chen M. Metastatic patterns and prognosis of patients with primary malignant cardiac tumor. Front Cardiovasc Med 2022; 9:1009765. [PMID: 36545022 PMCID: PMC9760733 DOI: 10.3389/fcvm.2022.1009765] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 11/16/2022] [Indexed: 12/07/2022] Open
Abstract
Background Distant metastases are independent negative prognostic factors for patients with primary malignant cardiac tumors (PMCT). This study aims to further investigate metastatic patterns and their prognostic effects in patients with PMCT. Materials and methods This multicenter retrospective study included 218 patients with PMCT diagnosed between 2010 and 2017 from Surveillance, Epidemiology, and End Results (SEER) database. Logistic regression was utilized to identify metastatic risk factors. A Chi-square test was performed to assess the metastatic rate. Kaplan-Meier methods and Cox regression analysis were used to analyze the prognostic effects of metastatic patterns. Results Sarcoma (p = 0.002) and tumor size¿4 cm (p = 0.006) were independent risk factors of distant metastases in patients with PMCT. Single lung metastasis (about 34%) was the most common of all metastatic patterns, and lung metastases occurred more frequently (17.9%) than bone, liver, and brain. Brain metastases had worst overall survival (OS) and cancer-specific survival (CSS) among other metastases, like lung, bone, liver, and brain (OS: HR = 3.20, 95% CI: 1.02-10.00, p = 0.046; CSS: HR = 3.53, 95% CI: 1.09-11.47, p = 0.036). Conclusion Patients with PMCT who had sarcoma or a tumor larger than 4 cm had a higher risk of distant metastases. Lung was the most common metastatic site, and brain metastases had worst survival among others, such as lung, bone, liver, and brain. The results of this study provide insight for early detection, diagnosis, and treatment of distant metastases associated with PMCT.
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Affiliation(s)
- Tianwang Guan
- Department of Cardiology, Laboratory of Heart Center, Zhujiang Hospital, Southern Medical University, Guangzhou, China,Guangdong Provincial Biomedical Engineering Technology Research Center for Cardiovascular Disease, Sino-Japanese Cooperation Platform for Translational Research in Heart Failure, Guangzhou, China
| | - Qingqian Wei
- Department of Clinical Medicine, Clinical Medical School, Guangzhou Medical University, Guangzhou, China
| | - Yongshi Tang
- Department of Clinical Medicine, Clinical Medical School, Guangzhou Medical University, Guangzhou, China
| | - Hongjun Zhao
- Department of Clinical Medicine, Clinical Medical School, Guangzhou Medical University, Guangzhou, China
| | - Zhenxing Lu
- Department of Cardiology, Laboratory of Heart Center, Zhujiang Hospital, Southern Medical University, Guangzhou, China,Guangdong Provincial Biomedical Engineering Technology Research Center for Cardiovascular Disease, Sino-Japanese Cooperation Platform for Translational Research in Heart Failure, Guangzhou, China
| | - Weijing Feng
- State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Lab of Shock and Microcirculation, Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yintong Teng
- Department of Cardiology, Laboratory of Heart Center, Zhujiang Hospital, Southern Medical University, Guangzhou, China,Guangdong Provincial Biomedical Engineering Technology Research Center for Cardiovascular Disease, Sino-Japanese Cooperation Platform for Translational Research in Heart Failure, Guangzhou, China
| | - Zehao Luo
- Department of Clinical Medicine, Clinical Medical School, Guangzhou Medical University, Guangzhou, China
| | - Kaiyi Chi
- Department of Clinical Medicine, Clinical Medical School, Guangzhou Medical University, Guangzhou, China
| | - Caiwen Ou
- Department of Cardiology, Laboratory of Heart Center, Zhujiang Hospital, Southern Medical University, Guangzhou, China,Dongguan Hospital of Southern Medical University, Southern Medical University, Dongguan, China,*Correspondence: Caiwen Ou,
| | - Minsheng Chen
- Department of Cardiology, Laboratory of Heart Center, Zhujiang Hospital, Southern Medical University, Guangzhou, China,Guangdong Provincial Biomedical Engineering Technology Research Center for Cardiovascular Disease, Sino-Japanese Cooperation Platform for Translational Research in Heart Failure, Guangzhou, China,Minsheng Chen,
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Offin M, De Silva DL, Sauter JL, Egger JV, Yorke E, Adusumilli PS, Rimner A, Rusch VW, Zauderer MG. Multimodality Therapy in Patients With Primary Pericardial Mesothelioma. J Thorac Oncol 2022; 17:1428-1432. [PMID: 36075530 PMCID: PMC9691618 DOI: 10.1016/j.jtho.2022.08.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 07/21/2022] [Accepted: 08/26/2022] [Indexed: 10/14/2022]
Abstract
INTRODUCTION Primary pericardial mesothelioma (PPM) has no accepted standard-of-care treatment options with management and outcomes often extrapolated from diffuse pleural mesothelioma. Disease-specific research is needed to better define PPM. We report our institutional experience with PPM highlighting the potential role for multimodality therapy. METHODS Patients with PPM diagnosed by a multidisciplinary team of medical oncologists, thoracic surgeons, thoracic pathologists, and radiologists between January 2011 and January 2022 were followed to February 2022. Clinicopathologic features and treatment outcomes were annotated. Overall survival (OS) was defined from the date of pathologic diagnosis. RESULTS The median age at diagnosis of the 12 patients identified with having PPM was 51 (range: 21-71) years old. Most patients were of female sex (n = 8; 67%), 75% of the samples were epithelioid (n = 9), and 25% were nonepithelioid (two sarcomatoid and one biphasic). Most cases (92%, 11 of 12) had expression of at least two mesothelial markers on immunohistochemistry. The median OS of the cohort was 25.9 months. Five patients had an OS greater than 12 months; four of whom received pericardial radiation. Three of the patients who received radiation did so as part of a trimodality approach (surgical resection, adjuvant chemotherapy, and radiation); the OS for patients who received trimodality therapy was 70.3 months versus 8.2 months for those who did not. CONCLUSIONS PPM represents a distinct disease with no universally accepted treatment options. Our findings suggest that trimodality therapy may improve outcomes in selected patients with PPM.
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Affiliation(s)
- Michael Offin
- Thoracic Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Medicine, Weill Cornell Medical College, New York, New York.
| | - Dilanka L De Silva
- Thoracic Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Jennifer L Sauter
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Jacklynn V Egger
- Thoracic Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Ellen Yorke
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Prasad S Adusumilli
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Andreas Rimner
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Valerie W Rusch
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Marjorie G Zauderer
- Thoracic Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Medicine, Weill Cornell Medical College, New York, New York
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40
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Multimodality Imaging of Benign Primary Cardiac Tumor. Diagnostics (Basel) 2022; 12:diagnostics12102543. [PMID: 36292232 PMCID: PMC9601182 DOI: 10.3390/diagnostics12102543] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/04/2022] [Accepted: 10/18/2022] [Indexed: 11/17/2022] Open
Abstract
Primary cardiac tumors (PCTs) are rare, with benign PCTs being relatively common in approximately 75% of all PCTs. Benign PCTs are usually asymptomatic, and they are found incidentally by imaging. Even if patients present with symptoms, they are usually nonspecific. Before the application of imaging modalities to the heart, our understanding of these tumors is limited to case reports and autopsy studies. The advent and improvement of various imaging technologies have enabled the non-invasive evaluation of benign PCTs. Although echocardiography is the most commonly used imaging examination, it is not the best method to describe the histological characteristics of tumors. At present, cardiac magnetic resonance (CMR) and cardiac computed tomography (CCT) are often used to assess benign PCTs providing detailed information on anatomical and tissue features. In fact, each imaging modality has its own advantages and disadvantages, multimodality imaging uses two or more imaging types to provide valuable complementary information. With the widespread use of multimodality imaging, these techniques play an indispensable role in the management of patients with benign PCTs by providing useful diagnostic and prognostic information to guide treatment. This article reviews the multimodality imaging characterizations of common benign PCTs.
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41
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Borg B, Borg N, Pisani D, Schembri KJ, Magri CJ. Monophasic synovial sarcoma: a rare cause of a primary cardiac malignancy. Br J Hosp Med (Lond) 2022; 83:1-3. [DOI: 10.12968/hmed.2022.0240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Bernard Borg
- Department of Medicine, Mater Dei Hospital, Msida, Malta
| | - Norbert Borg
- University of Malta Medical School, Msida, Malta
| | - David Pisani
- Department of Pathology, Mater Dei Hospital, Msida, Malta
| | - Kevin J Schembri
- Department of Cardiothoracic Surgery, Mater Dei Hospital, Msida, Malta
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Aloysius MM, Shrivastava S, Rojulpote C, Naseer R, Hanif H, Babic M, Gentilezza K, Boruah PK, Pancholy S. Racial and ethnic characteristics and cancer-specific survival in Primary Malignant Cardiac Tumors. Front Cardiovasc Med 2022; 9:961160. [PMID: 36093161 PMCID: PMC9453391 DOI: 10.3389/fcvm.2022.961160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 08/09/2022] [Indexed: 12/03/2022] Open
Abstract
Background There is limited insight into the epidemiological characteristics and effect of race and ethnicity on Primary Malignant Cardiac Tumors (PMCTs). Objectives Comparison of clinical characteristics and cancer-specific survival outcomes of major races in the United States from the Surveillance, Epidemiology and End-Result (SEER) registry. Methods ICD-O-3 codes were used to identify PMCTs for the years 1975 to 2015. Three major races were identified—“White”, “Black”, and “Asian/Pacific Islander”. Cancer-specific survival outcomes were compared using Kaplan-Meier analysis across and amongst races, based on tumor histology. A subgroup analysis of cancer-specific survival was performed between “Hispanics” and “non-Hispanics.” Results Seven hundred and twenty patients were identified−47% females and 79% White, mean age at diagnosis (47 ± 20 years). Black patients were significantly younger (39 ± 18 years) and presented more commonly with angiosarcomas (53%). Non-angiogenic sarcomas and lymphomas were the most common tumors in the White (38%) and Asian/Pacific Islander (34%) cohorts. For a median follow-up period of 50 (IQR3-86) months, cancer-specific survival (mean ± SD, in months) was worse in Blacks (9 ± 3) as compared to Whites (15 ± 1) and Asian/Pacific Islander (14 ± 1) (p-value; Black vs. White <0.001; Black vs. Asian/Pacific Islanders = 0.017, White vs. Asian/Pacific Islanders = 0.3). Subgroup analysis with 116 (16%) Hispanics (40% females; mean age of 40 ± 20 years) showed a longer mean cancer-specific survival of 16.9 ± 2.4 months as compared to 13.6 ± 1.1 months in non-Hispanics (p = 0.011). Conclusion Black and non-Hispanic patients have poorer cancer-specific survival in PMCTs.
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Affiliation(s)
- Mark M. Aloysius
- Department of Internal Medicine, The Wright Center for Graduate Medical Education, Scranton, PA, United States
| | - Sanskriti Shrivastava
- Department of Internal Medicine, The Wright Center for Graduate Medical Education, Scranton, PA, United States
- *Correspondence: Sanskriti Shrivastava ;
| | - Chaitanya Rojulpote
- Department of Internal Medicine, The Wright Center for Graduate Medical Education, Scranton, PA, United States
| | - Raza Naseer
- Department of Internal Medicine, The Wright Center for Graduate Medical Education, Scranton, PA, United States
| | - Hamza Hanif
- Department of Internal Medicine, The Wright Center for Graduate Medical Education, Scranton, PA, United States
| | - Milos Babic
- Department of Internal Medicine, The Wright Center for Graduate Medical Education, Scranton, PA, United States
| | - Kenneth Gentilezza
- Department of Physical Medicine and Rehabilitation, The Wright Center for Graduate Medical Education, Scranton, PA, United States
| | - Pranjal K. Boruah
- Department of Cardiovascular Diseases, The Wright Center for Graduate Medical Education, Scranton, PA, United States
| | - Samir Pancholy
- Department of Cardiovascular Diseases, The Wright Center for Graduate Medical Education, Scranton, PA, United States
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Gaisendrees C, Gerfer S, Schröder C, Schlachtenberger G, Walter S, Ivanov B, Eghbalzadeh K, Lühr M, Djordjevic I, Rahmanian P, Mader N, Kuhn-Régnier F, Wahlers T. Benign and malignant cardiac masses: long-term outcomes after surgical resection. Expert Rev Anticancer Ther 2022; 22:1153-1158. [PMID: 35997214 DOI: 10.1080/14737140.2022.2116006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Cardiac tumors represent a rare and heterogenous pathologic entity, with a cumulative incidence of up to 0.02%. This study aimed to investigate one of the largest patient cohorts published for clinical presentation and long-term outcomes after surgical resection. RESEARCH DESIGN Between 2009 and 2021, 183 consecutive patients underwent surgery for tumor excision in our center. Preoperative baseline characteristics, intraoperative data, and long-term survival were analyzed. The diagnosis was confirmed postoperatively by histology and Immunohistochemical investigations. Kaplan-Meier curves assessed survival, and the Cox, proportional hazards model, was used to identify prognostic factors for overall survival. RESULTS This series included 183 consecutive patients; most (n=169, 92.3%) were diagnosed with benign cardiac masses. The mean age of patients was 60 ± 16 years, and 48% (n=88) were females. The largest group of tumors is represented by myxoma (n = 98; 54%). The most common malignant tumor was sarcomas (n = 5; 2.7%). The mean hospital stay was 11 ± 6.5 days, and all-cause mortality after ten years was 14%. CONCLUSION Surgery represents the gold standard in treating primary cardiac tumors; in benign tumors, it is highly effective and curative, whereas, in malignant tumors, it remains associated with more prolonged survival.
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Affiliation(s)
- Christopher Gaisendrees
- University Hospital Cologne, Heart Centre, Department of Cardiothoracic Surgery, Cologne, Germany
| | - Stephen Gerfer
- University Hospital Cologne, Heart Centre, Department of Cardiothoracic Surgery, Cologne, Germany
| | - Charlotte Schröder
- University Hospital Cologne, Heart Centre, Department of Cardiothoracic Surgery, Cologne, Germany
| | - Georg Schlachtenberger
- University Hospital Cologne, Heart Centre, Department of Cardiothoracic Surgery, Cologne, Germany
| | - Sebastian Walter
- University Hospital Cologne, Department of Orthopaedics, Cologne, Germany
| | - Borko Ivanov
- University Hospital Cologne, Heart Centre, Department of Cardiothoracic Surgery, Cologne, Germany
| | - Kaveh Eghbalzadeh
- University Hospital Cologne, Heart Centre, Department of Cardiothoracic Surgery, Cologne, Germany
| | - Maximilian Lühr
- University Hospital Cologne, Heart Centre, Department of Cardiothoracic Surgery, Cologne, Germany
| | - Ilija Djordjevic
- University Hospital Cologne, Heart Centre, Department of Cardiothoracic Surgery, Cologne, Germany
| | - Parwis Rahmanian
- University Hospital Cologne, Heart Centre, Department of Cardiothoracic Surgery, Cologne, Germany
| | - Navid Mader
- University Hospital Cologne, Heart Centre, Department of Cardiothoracic Surgery, Cologne, Germany
| | - Ferdinand Kuhn-Régnier
- University Hospital Cologne, Heart Centre, Department of Cardiothoracic Surgery, Cologne, Germany
| | - Thorsten Wahlers
- University Hospital Cologne, Heart Centre, Department of Cardiothoracic Surgery, Cologne, Germany
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Outcomes of Octogenarians with Primary Malignant Cardiac Tumors: National Cancer Database Analysis. J Clin Med 2022; 11:jcm11164899. [PMID: 36013139 PMCID: PMC9410046 DOI: 10.3390/jcm11164899] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 08/09/2022] [Accepted: 08/17/2022] [Indexed: 11/16/2022] Open
Abstract
Data concerning age-related populations affected with primary malignant cardiac tumors (PMCTs) are still scarce. The aim of the current study was to analyze mortality differences amongst different age groups of patients with PMCTs, as reported by the National Cancer Database (NCDB). The NCDB was retrospectively reviewed for PMCTs from 2004 to 2017. The primary outcome was late mortality differences amongst different age categories (octogenarian, septuagenarian, younger age), while secondary outcomes included differences in treatment patterns and perioperative (30-day) mortality. A total of 736 patients were included, including 72 (9.8%) septuagenarians and 44 (5.98%) octogenarians. Angiosarcoma was the most prevalent PMCT. Surgery was performed in 432 (58.7%) patients (60.3%, 55.6%, and 40.9% in younger age, septuagenarian, and octogenarian, respectively, p = 0.04), with a corresponding 30-day mortality of 9.0% (7.0, 15.0, and 38.9% respectively, p < 0.001) and a median overall survival of 15.7 months (18.1, 8.7, and 4.5 months respectively). Using multivariable Cox regression, independent predictors of late mortality included octogenarian, governmental insurance, CDCC grade II/III, earlier year of diagnosis, angiosarcoma, stage III/IV, and absence of surgery/chemotherapy. With increasing age, patients presented a more significant comorbidity burden compared to younger ones and were treated more conservatively. Early and late survival outcomes progressively declined with advanced age.
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Awad AK, Elgenidy A, Afifi AM, Sá MP, Ramlawi B. Specific causes of death among patients with cardiac sarcoma in the United States-An analysis of The Surveillance, Epidemiology, and End Results (SEER) Program. J Card Surg 2022; 37:3961-3963. [PMID: 35979675 DOI: 10.1111/jocs.16857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 08/11/2022] [Indexed: 12/01/2022]
Abstract
Representing 10%-25% of the primary cardiac neoplasms, primary malignant cardiac tumors (PMCT) have a poor prognosis, yet with rare incidence. Constituting more than 50% of the PMCT, cardiac sarcoma has increased not only in incidence over the past five decades but also in severity. Patients with PMCTs, especially sarcomas, have the worst prognosis when compared with other cardiac or extracardiac tumors. This retrospective study was performed using SEER*stat software, latest version 8.3.9.2(5) by accessing seer 18 registries plus data (excl AK) Nov 2020 Sub (2000-2018) for standard mortality ratio (SMR). A total of 235 patients were identified of whom 49.4% were females. Most of our patients were Stage 4 (n = 81) and distant in location (n = 92). The most common treatment method was tumor-directed surgery (n = 164), chemotherapy (n = 146), and radiotherapy (n = 55). Furthermore, other associated cancers with cardiac sarcoma were rare, with ten cases with lung and bronchus cancer (SMR: 37.95, 95% confidence interval [CI]: 18.2, 69.8), four with bone and joints (SMR: 1726.05, 95% CI: 470.2, 4419.3). During a 5-year follow-up, 235 patients died primarily due to cardiac sarcoma (n = 182, 77.4%), other cancers (n = 34, 14.4%), and other noncancerous causes (n = 19, 8%), while the noncancerous causes were attributed mainly to cardiovascular diseases (n = 4, 21%, SMR: 4.95, 95% CI: 1.35, 12.67), septicemia (n = 2, 10.5%, SMR: 41.23, 95% CI: 4.99, 148.95).
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Affiliation(s)
- Ahmed K Awad
- Faculty of Medicine, Ain-Shams University, Cairo, Egypt
| | | | - Ahmed M Afifi
- Department of Gastroenterology, Hepatology and Nutrition Diseases, MD Anderson Cancer Center, Houston, Texas, USA
| | - Michel P Sá
- Department of Cardiothoracic Surgery, Lankenau Heart Institute, Lankenau Medical Center, Main Line Health, Wynnewood, Pennsylvania, USA.,Department of Cardiothoracic Surgery Research, Lankenau Institute for Medical Research, Wynnewood, Pennsylvania, USA
| | - Basel Ramlawi
- Department of Cardiothoracic Surgery, Lankenau Heart Institute, Lankenau Medical Center, Main Line Health, Wynnewood, Pennsylvania, USA.,Department of Cardiothoracic Surgery Research, Lankenau Institute for Medical Research, Wynnewood, Pennsylvania, USA
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Sankarasubramanian S, Prabhakar P, Narasimhan MK. Genetic insights into cardiac tumors: a comprehensive review. MEDICAL ONCOLOGY (NORTHWOOD, LONDON, ENGLAND) 2022; 39:164. [PMID: 35972566 DOI: 10.1007/s12032-022-01761-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 05/31/2022] [Indexed: 11/24/2022]
Abstract
Cardiac neoplasms are rare, however, also a curable form of the disease once detected early. In recent years the viscus tumors have gained their highlights, due to the advancement in techniques like echocardiography both 2D and 3D, MRI, etc. These cardiac tumors are divided based on their benign and malignant nature and also as well as primary and secondary cardiac tumors. Largely the primary cardiac tumors are often than secondary cardiac tumors. The secondary tumor happens anywhere in the body involving the heart. The most common malignant tumors are sarcoma, some are angiosarcomas, fibromas, rhabdosarcoma, and leiomyosarcoma. The primary sarcoma affects both men and women at an equal rate with non-specific symptoms. These conditions led to high demand in genomic testing that helps in spot the mutation that leads to the particular type of cardiac neoplasm and it additionally helps to screen the mutated sequence and stop it from being inherited. Recent studies on cardiac tumors have revealed many genes that are involved in tumorigenesis and technologies have enabled the right screening of the tumor location within the heart and their histopathological studies were also studied. This review principally focuses on the understanding of the various forms of cardiac tumors, genetic variants involved and their influence, genetic testing, and different diagnostic approaches in cardiac tumors.
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Affiliation(s)
- Sivaramasundaram Sankarasubramanian
- Department of Genetic Engineering, School of Bioengineering, College of Engineering and Technology, SRM Institute of Science and Technology, SRM Nagar, Kattankulathur, Chennai, Tamil Nadu, 603203, India
| | - Prathiksha Prabhakar
- Department of Genetic Engineering, School of Bioengineering, College of Engineering and Technology, SRM Institute of Science and Technology, SRM Nagar, Kattankulathur, Chennai, Tamil Nadu, 603203, India
| | - Manoj Kumar Narasimhan
- Department of Genetic Engineering, School of Bioengineering, College of Engineering and Technology, SRM Institute of Science and Technology, SRM Nagar, Kattankulathur, Chennai, Tamil Nadu, 603203, India.
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Xie Y, Hong ZL, Zhao YC, Chen S, Lin YC, Wu SS. Percutaneous ultrasound-guided core needle biopsy for the diagnosis of cardiac tumors: Optimizing the treatment strategy for patients with intermural and pericardial cardiac tumors. Front Oncol 2022; 12:931081. [PMID: 35992842 PMCID: PMC9389083 DOI: 10.3389/fonc.2022.931081] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 07/06/2022] [Indexed: 01/08/2023] Open
Abstract
Objective The aims of this study are to investigate the clinical value and practical safety of ultrasound-guided percutaneous core needle biopsy on diagnosing cardiac tumor and to discuss the treatment strategy for cardiac intermural and pericardial tumors. Methods The clinical data were retrospectively collected for patients with intermural and pericardial cardiac tumors. The patients were divided into groups of surgical resection, surgical resection after obtaining pathological tissue by PUS-CNB, and/or radiotherapy according to the treatment modality. Ultrasound-guided aspiration biopsy was divided into cardiac tumor biopsy and extracardiac lesion biopsy according to patient conditions. The surgical time was recorded, and the safety and clinical application value of PUS-CNB for the diagnosis of cardiac tumors were evaluated in terms of complications and satisfaction with pathological sampling. Results A total of 18 patient cases were collected, and PUS-CNB of cardiac tumors was performed in 8 cases, with sampling times averaging 15.6 ± 3.0 min. Four cases of cardiac tumors combined with extracardiac tumors were biopsied, with puncture times averaging 13.0 ± 2.9 min. All 12 biopsied patients had no postoperative complications. Except for 1 failed biopsy, the biopsies were successful and the pathological results were consistent with the clinical diagnosis with a satisfaction rate of 91.7%. Except for two cases of surgical resection, the rest were considered for conservative treatment. Surgical resection and/or biopsy were performed in six cases, and two cases were aggravated after surgery. The final pathology of all 17 cardiac tumors was malignant. Conclusion PUS-CNB is safe and effective, providing a simple and undemanding method for accurate diagnosis of cardiac intermural and pericardial tumors while avoiding unnecessary open-heart surgery.
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Affiliation(s)
- Ying Xie
- Department of Hematology, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Zhi-liang Hong
- Department of Ultrasonography, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Yan-chun Zhao
- Department of Ultrasonography, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Sheng Chen
- Department of Ultrasonography, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Yu-cheng Lin
- Department of Ultrasonography, Affiliated Fuzhou First Hospital of Fujian Medical University, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Song-song Wu
- Department of Ultrasonography, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
- *Correspondence: Song-song Wu,
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Epidemiology and survival of patients with malignant carotid body tumors in the SEER database. J Vasc Surg 2022; 76:973-978.e1. [PMID: 35697309 DOI: 10.1016/j.jvs.2022.04.039] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 04/03/2022] [Accepted: 04/11/2022] [Indexed: 12/17/2022]
Abstract
OBJECTIVE The objective of this study was to investigate population-based epidemiology, survival outcomes, and prognostic factors of malignant carotid body tumors (CBTs). METHODS Patients with malignant CBTs who were diagnosed between 1975 and 2018 were screened from nine registries of the Surveillance, Epidemiology, and End Results (SEER) database. Cases that were coded as "carotid body tumor, malignant" or malignant tumors with the primary site recorded as "carotid body" were screened for inclusion in the study. The incidence of malignant CBT was calculated with SEER∗Stat software. Survival outcomes were analyzed using the Kaplan-Meier method and log-rank tests. RESULTS A total of 72 patients with malignant CBT were screened for inclusion in the study, including 41 females (56.9%) and 31 males (43.1%). Based on the SEER program data, the incidence of malignant CBT was found to fluctuate between 0 to 0.02 cases per 100,000 people per year, with a slow but noticeable uptick after 1990. The most commonly affected populations included women and patients between the ages of 35 and 44, which accounted for 59.9% and 27.8% of patients in the study, respectively. During a median follow-up of 82 months, four patients were lost to follow-up, and 28 deaths were identified. Of those, 20 were considered disease-specific deaths. Further analysis found that the 5-year and 10-year overall survival rates were 78.9% and 67.8%, respectively, whereas the 5-year and 10-year disease-specific survival rates were 84.5% and 75.2%, respectively. The Kaplan-Meier method and log-rank tests indicated that age <50 years, sex, race, tumor number, and surgical treatment were unrelated to both overall survival and disease-specific survival. CONCLUSIONS A retrospective review of the SEER database found that the incidence of malignant CBT was extremely rare and prone to fluctuation, but that it slowly trended upward over time. Malignant CBT was found to more likely affect females, and it could be diagnosed at any age. The overall prognosis for malignant CBT appeared to be good, with acceptable 5-year and 10-year survival rates. Due to a number of factors complicating malignant CBT surgery, surgical treatment should be considered with caution.
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Gaisendrees C, Gerfer S, Schlachtenberger G, Walter SG, Ivanov B, Merkle-Storms J, Mihaylova M, Sabashnikov A, Djordjevic I, Rahmanian P, Mader N, Kuhn-Régnier F, Wahlers T. Cardiac tumors-sex-related characteristics and outcomes after surgical resection. J Surg Oncol 2022; 126:823-829. [PMID: 35665932 DOI: 10.1002/jso.26971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 05/18/2022] [Accepted: 05/22/2022] [Indexed: 11/08/2022]
Abstract
OBJECTIVES Cardiac tumors represent a rare and heterogeneous pathological entity, with a cumulative incidence of up to 0.02%. Gender was previously reported to influence outcomes after tumor surgery. This study aimed to investigate for gender-related differences in outcomes after cardiac surgery. METHODS Between 2009 and 2021, 95 male and 88 female patients underwent surgery for tumor extirpation in our center. Preoperative baseline characteristics, intraoperative data, and long-term survival were analyzed. The diagnosis was confirmed postoperatively by (immune-)histopathological analysis. RESULTS There were no significant differences in baseline characteristics and survival. Myxoma was the most common tumor type overall and was more diagnosed in women (n = 36 vs. n = 62, p ≤ 0.001). Sarcoma was the most common malignant tumor type (n = 5). Tumor location at the atrial septum was more likely in women (n = 26 vs. n = 16, p = 0.041), whereas ventricular localization was more common in male patients (n = 20 vs. n = 7, p = 0.001). Minimally invasive tumor extirpation was significantly more often performed in women, and in-hospital stay was shorter in female patients. CONCLUSION The localization and dignity of cardiac tumors differ between genders, not affecting survival. Surgical tumor extirpation remains the gold standard of treatment for cardiac tumors in both genders as it is highly effective and associated with good long-term survivorship.
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Affiliation(s)
- Christopher Gaisendrees
- Department of Cardiothoracic Surgery, University Hospital Cologne, Heart Centre, Cologne, Germany
| | - Stephen Gerfer
- Department of Cardiothoracic Surgery, University Hospital Cologne, Heart Centre, Cologne, Germany
| | - Georg Schlachtenberger
- Department of Cardiothoracic Surgery, University Hospital Cologne, Heart Centre, Cologne, Germany
| | - Sebastian G Walter
- Department of Orthopaedic Surgery and Traumatology, University Hospital Cologne, Cologne, Germany
| | - Borko Ivanov
- Department of Cardiothoracic Surgery, University Hospital Cologne, Heart Centre, Cologne, Germany
| | - Julia Merkle-Storms
- Department of Cardiothoracic Surgery, University Hospital Cologne, Heart Centre, Cologne, Germany
| | - Mariya Mihaylova
- Department of Cardiothoracic Surgery, University Hospital Cologne, Heart Centre, Cologne, Germany
| | - Anton Sabashnikov
- Department of Cardiothoracic Surgery, University Hospital Cologne, Heart Centre, Cologne, Germany
| | - Ilija Djordjevic
- Department of Cardiothoracic Surgery, University Hospital Cologne, Heart Centre, Cologne, Germany
| | - Parwis Rahmanian
- Department of Cardiothoracic Surgery, University Hospital Cologne, Heart Centre, Cologne, Germany
| | - Navid Mader
- Department of Cardiothoracic Surgery, University Hospital Cologne, Heart Centre, Cologne, Germany
| | - Ferdinand Kuhn-Régnier
- Department of Cardiothoracic Surgery, University Hospital Cologne, Heart Centre, Cologne, Germany
| | - Thorsten Wahlers
- Department of Cardiothoracic Surgery, University Hospital Cologne, Heart Centre, Cologne, Germany
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Newell P, Zogg CK, Kusner J, Hirji S, Kerolos M, Kaneko T. National outcomes following benign cardiac tumor resection: A critical sex-based disparity. J Card Surg 2022; 37:2653-2660. [PMID: 35662249 DOI: 10.1111/jocs.16654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 04/28/2022] [Accepted: 05/04/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Treatment of benign primary cardiac tumors involves surgical resection, but reported outcomes from multi-institutional or national databases are scarce. This study examines contemporary national outcomes following surgical resection of benign primary atrial and ventricular tumors. METHODS The 2016-2018 Nationwide Readmissions Database was queried for all patients ≥18 years with a primary diagnosis of benign neoplasm of the heart who underwent resection of the atria, ventricles, or atrial/ventricular septum. Primary outcomes were 30-day mortality, readmission, and composite morbidity (defined as stroke, permanent pacemaker implantation, bleeding complication, or acute kidney injury). Multivariable analysis was used to identify independent predictors of worse outcomes. RESULTS A weighted total of 2557 patients met inclusion criteria. Mean age was 61 years, 67.9% were female, and patients had relatively low comorbidity burdens (mean Charlson Comorbidity Index 1.39). The majority of patients underwent excision of the left atrium (71.5%), followed by the intra-atrial septum (26.6%), right atrium (2.9%). There was no difference in 30-day mortality (2.1% vs. 1.3%, p = .550), 30-day readmission (7.0% vs. 9.1%, p = .222), or 30-day composite morbidity (56.8% vs. 53.8%, p = .369) between females and males, respectively. However, on multivariable analysis, female sex was independently associated with increased risk of 30-day mortality (adjusted odds ratio = 2.65, p = .028). Tumor location (atria, ventricles, septum) was not predictive of mortality. CONCLUSION Benign atrial and ventricular tumors are uncommon, but disproportionately impact female patients, with female sex being an independent predictor of 30-day mortality. Root-cause analysis is necessary to determine the ultimate cause of this disparity.
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Affiliation(s)
- Paige Newell
- Division of Cardiac Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.,Center for Surgery and Public Health, Boston, Massachusetts, USA
| | - Cheryl K Zogg
- Center for Surgery and Public Health, Boston, Massachusetts, USA.,Yale School of Medicine, New Haven, Connecticut, USA
| | - Jonathan Kusner
- Division of Cardiac Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.,Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
| | - Sameer Hirji
- Division of Cardiac Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Mariam Kerolos
- Division of Cardiac Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Tsuyoshi Kaneko
- Division of Cardiac Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
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