11/282. Loculated pericardial effusion due to congestive heart failure: an unusual case of vanishing tumor--a case report.Loculation of a pleural effusion within an interlobar fissure as a result of congestive heart failure is a well-known entity. It has been termed "vanishing" or "phantom" tumor because its roentgenographic appearance simulates a pulmonary tumor and resolves with treatment of the congestive heart failure. The authors describe an 89-year-old man with a loculated pericardial effusion on the left cardiac border on chest roentgenogram. This was initially thought to represent an occult metastatic malignancy; however, its etiology became obvious when it disappeared with therapy of heart failure. Loculated pericardial effusion should be included in the differential diagnosis of roentgenographic densities in the chest when seen on the left cardiac border.- - - - - - - - - - ranking = 1keywords = chest (Clic here for more details about this article) |
12/282. Epithelioid and spindle-celled leiomyosarcoma of the heart. Report of 2 cases and review of the literature.BACKGROUND: Primary cardiac leiomyosarcomas are rare. Isolated reported cases and small series generally describe spindle-celled, high-grade tumors with poor short-term survival; however, the pathologic features of many of these tumors are incompletely documented. The authors report in detail the clinicopathologic features of 2 relatively low-grade epithelioid and spindle-celled primary cardiac leiomyosarcomas. methods: Cases 1 and 2 were studied using standard histochemical and immunohistochemical techniques, and case 1 was examined by electron microscopy. The literature was reviewed with regard to primary cardiac leiomyosarcomas. RESULTS: Both tumors showed epithelioid and spindle-celled areas. The tumor in case 1 was low grade, and the tumor in case 2 was predominately low grade with a high-grade focus. A review of 28 reported cases revealed a wide age range (mean, 43 years), equal male-to-female ratio, and a predilection for the left atrium (48%). Follow-up of reported cases with fewer than 5 mitoses per 10 high-power fields showed a mean survival of 22 months compared with a 9-month mean survival for all others. CONCLUSIONS: Short-term follow-up of reported cases of high-grade cardiac leiomyosarcoma suggests a poor prognosis. Long-term follow-up in our case 2, along with follow-up of reported cases that were histologically similar to our cases, suggests that cardiac leiomyosarcomas with low-grade features or mixed low- and high-grade features also have a poor overall long-term survival, with a high rate of local recurrence and systemic spread.- - - - - - - - - - ranking = 0.014864983853674keywords = area (Clic here for more details about this article) |
13/282. Treatment of life-threatening huge atrial myxoma: report of two cases.We herein report two patients with left atrial myxoma who needed an emergency operation. Case 1 was a 48-year-old woman who was injured in a traffic accident and underwent an operation for a right leg fracture. Just after the operation she developed cardiac and respiratory arrest with complaints of chest pain. She was successfully resuscitated and diagnosed to have a left atrial myxoma by echocardiography. Emergency surgery was performed and a giant left atrial myxoma was thus removed from the atrial septum. Case 2 was a 54-year-old housewife who was transferred to our department under the diagnosis of a left atrial myxoma by echocardiography. She complained of dyspnea and chest discomfort. By angiography, the tumor was seen to be partially incarcerated at the diastolic phase. A huge myxoma was removed from the atrial septum which was secured by a patch closure. Cardiac echocardiography can help rule out left atrial myxoma if it is highly suspected. As early surgical mortality is low and the long-term results are good, we strongly believe that patients with cardiac myxoma should be operated on as early as possible, once a diagnosis is made.- - - - - - - - - - ranking = 9.6399835271665keywords = chest pain, chest, pain (Clic here for more details about this article) |
14/282. Papillary fibroelastoma of the mitral valve 12 years after mitral valve commissurotomy.A 63 year-old woman who had had mitral valve commissurotomy 12 years earlier was seen because of rheumatic mitral stenosis and left brachial paresis due to cerebral embolism. On clinical evaluation, a diastolic rumble was heard over the mitral area, and the echocardiogram revealed a mass attached to the mitral subvalvular apparatus. The patient was operated on, and both the surgical and histologic findings depicted papillary fibroelastoma. This tumor may occur as an isolated lesion or be associated with mitral valve stenosis or other cardiac abnormalities, and it is an important source of emboli. Early echocardiographic diagnosis, followed by surgical excision, may avoid serious complications such as stroke, myocardial infarction, and sudden death.- - - - - - - - - - ranking = 0.014864983853674keywords = area (Clic here for more details about this article) |
15/282. Giant primary cardiac liposarcoma vascularized via the circumflex coronary artery.A 51-year-old patient presented with a history of chest pain and progressive dyspnea. CT scan demonstrated a lipomatous mass encircling the heart and compressing the left lung. After median sternotomy, an intrapericardial tumor of 3200 g with a vascular pedicle arising from the circumflex coronary artery was resected. A histologic diagnosis of a well-differentiated liposarcoma was made. The patient is alive and well 2 years postoperatively. This tumor with its unusual vascularization is the largest of the few primary cardiac liposarcomas that have been reported.- - - - - - - - - - ranking = 9.1399835271665keywords = chest pain, chest, pain (Clic here for more details about this article) |
16/282. A survivor of near sudden death caused by giant left atrial myxoma.Sudden hemodynamic collapse occurred in a 20-year-old man after an Emergency Department visit with a complaint of dizziness and chest discomfort. A left atrial myxoma was demonstrated by echocardiography. resuscitation procedures followed by surgical repair resulted in an excellent outcome. Although sudden death is a serious manifestation of cardiac myxoma, reports of survivors of near sudden death caused by this tumor have been rare.- - - - - - - - - - ranking = 0.5keywords = chest (Clic here for more details about this article) |
17/282. Primary pericardial mesothelioma presenting as constrictive pericarditis.Primary pericardial mesothelioma is a rare tumour, often discovered late in a patient's clinical course or at autopsy. Antemortem diagnosis is usually made at the time of surgery. A patient who presented with what appeared to be viral pericarditis in October 1997 is reported. Recurrent symptoms prompted re-evaluation with echocardiography, chest computed tomography, magnetic resonance imaging, cardiac catheterization and a diagnosis of constrictive pericarditis. Associated hepatic dysfunction was found to be secondary to congestion. After operative pericardiotomy and histological examination, primary pericardial mesothelioma was diagnosed. The lesion was surgically debulked.- - - - - - - - - - ranking = 0.5keywords = chest (Clic here for more details about this article) |
18/282. Primary intimal sarcoma of pulmonary valve and trunk with osteogenic sarcomatous elements. Report of a case considered to be pulmonary embolus.A 49-year-old woman had a six-week history of increasing shortness of breath and fatigue. X-ray films and pulmonary scans showed multiple areas of emboli, especially in the right lung. Treatment with heparin was unsuccessful, and although a repeat scan showed only slight changes, the patient's condition deteriorated. Acute pulmonary edema and ventricular tachycardia preceded her death. autopsy revealed a primary intimal sarcoma with osteogenic elements arising in the posterior leaflet of the pulmonary valve and obstructing the main pulmonary artery and its right branch.- - - - - - - - - - ranking = 0.014864983853674keywords = area (Clic here for more details about this article) |
19/282. A case of primary cardiac B cell lymphoma associated with ventricular tachycardia, successfully treated with systemic chemotherapy and radiotherapy: a long-term survival case.We experienced a long-term survival case of primary cardiac lymphoma (PCL) demonstrating ventricular tachycardia (VT) as an initial sign, which was related to localized myocardial damage by lymphoma cells. A 70-year-old woman with sustained VT was admitted to the Kofu Municipal Hospital. VT ceased with the administration of disopyramide intravenously. The origin of the VT was the free wall of the right ventricular outflow tract (RVOT) as observed by electrocardiography on admission. A solitary mass in the free wall of the RVOT was found by echocardiography, chest computed tomographic scanning and magnetic resonance imaging. There was no evidence of extracardiac involvement. The patient was histologically diagnosed as PCL by endomyocardial biopsy. Chemotherapy started immediately after the diagnosis and the mass showed a marked reduction in size. After 8 cycles of chemotherapy, radiotherapy was performed. Pericardial thickness in the free wall of the RVOT developed without severe side effects. Complete remission has been maintained for 30 months after the initial diagnosis, and no recurrence and arrhythmias have been detected during the follow-up period. It was demonstrated that rapid diagnosis and chemotherapy followed by radiotherapy for PCL achieved better survival.- - - - - - - - - - ranking = 0.5keywords = chest (Clic here for more details about this article) |
20/282. Primary cardiac sarcoma: two case reports.Two case reports of primary cardiac sarcoma, which is uncommon, are presented. The first case, a 38-year-old male, complained of chest tightness. Chest roentgenograms showed enlargement of the cardiac shadow and left pleural effusion. Transthoracic echocardiography and chest magnetic resonance imaging showed a tumor in the right atrium, and pericardial effusion. The tumor involved the right atrial wall and interatrial septum, and was partially resected. Pathohistological examination revealed angiosarcoma. He died 1 month later. The second case, a 19-year-old male complained of dyspnea and orthopnea. Chest roentgenograms showed pulmonary congestion. Transthoracic echocardiography showed a large mobile mass in the left atrium. An emergency operation was performed and the tumor was totally resected. Pathohistological examination demonstrated leiomyosarcoma. The postoperative course was uneventful, but the tumor rapidly recurred. Second and third operations were performed at intervals of 2 months. After the third operation, he was treated with radiotherapy. Local recurrence was not found but multiple distant metastases were found 2 months after completion of radiation therapy.- - - - - - - - - - ranking = 1keywords = chest (Clic here for more details about this article) |
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