1/16. Cardiac rhabdomyosarcoma: diagnosis by MR imaging.We report a case of cardiac rhabdomyosarcoma the initial clinical features of which were pericardial effusion, clinical symptoms of congestive heart failure and probable pulmonary thromboembolism, in which echocardiography constituted the first approach to the diagnosis of cardiac tumor and MRI confirmed it, precisely delimiting the tumoral extension and possible infiltration of pericardiac structures. A brief literature review of this entity is given, the MRI findings obtained in our case are described, and we discuss the advantages and limitations of this technique as compared with other alternatives of image diagnosis.- - - - - - - - - - ranking = 1keywords = thromboembolism (Clic here for more details about this article) |
2/16. Pulmonary tumor embolism from primary cardiac B-cell lymphoma.We report the case of a 54-year-old man with pulmonary embolism during convalescence from "idiopathic" pericarditis. A transthoracic echocardiographic examination indicated a large mass within the right atrium. Subsequently, he died from refractory hypotension. On autopsy, two large whitish nodules were found in the right atrium; there was also nodular epicardial infiltration. Both lungs showed multiple, grossly visible tumor emboli with pulmonary infarction and no evidence of conventional thromboembolism. This is the first report of pulmonary tumor embolism due to large cell B-cell primary cardiac lymphoma. Refractory unexplained pericardial effusion, pulmonary embolism without risk factors for venous thrombosis, and/or the existence of a mass in the right heart should arouse clinical suspicion for this rare malignancy.- - - - - - - - - - ranking = 1keywords = thromboembolism (Clic here for more details about this article) |
3/16. Fragmentation of a right atrial myxoma presenting as a pulmonary embolism.We report here a tricky case of right atrial myxoma with a pulmonary localization mimicking pulmonary thromboembolism. The diagnosis on imaging investigation was delayed because of its atypical appearance. This case report emphasizes the leading role of transthoracic and transesophageal echocardiography in the management of this condition. In autopsy series, the incidence of primary tumors of the heart is evaluated at 0.0017% to 0.19%.(1) Nearly half of them are myxoma.(1, 2) myxoma are more frequently observed in adults and are commonly localized in the left atrium. signs and symptoms are comparable to those arising in other cardiovascular and systemic conditions, including variable cardiac murmur, uneasiness, blackout, systemic embolism, cardiac insufficiency, lasting fever, or sudden death.(3) Rare cases of pulmonary embolism have been described. We report here an atypical case of right atrial myxoma with a pulmonary localization mimicking pulmonary embolus.- - - - - - - - - - ranking = 1keywords = thromboembolism (Clic here for more details about this article) |
4/16. Management of Wilms' tumor with intracardiac extension.We review our experience and the literature in treating 4 patients with Wilms' tumor (WT) with intracardiac extension among 92 patients with this neoplasm. cardiopulmonary bypass with circulatory arrest and profound hypothermia was used. There were 3 boys (3 years, 4 years 5 months, and 15 years) and 1 girl (6 years). The follow-up periods were 8 months, 3 years, 2 years 6 months, and 15 years, respectively. We had no surgical complications and conclude that the preoperative diagnosis is extremely important. These patients must be transferred to institutions where concomitant cardiac procedures can be performed. In treating patients with WT, Doppler ultrasound must be used preoperatively in all cases, not only those in which clinical and radiologic signs of intravascular involvement are found. We propose that preoperative chemotherapy should be used, as it shrinks the thrombus and causes desirable adherence of the thrombus to the venous wall, reducing the probability of thromboembolism during the surgical procedure. We also find this method safer than in our 1st case, where neither cardiac arrest nor hypothermia was used. Our results agree with the literature that intracardiac extension of WT does not worsen its prognosis when a rational surgical approach is used.- - - - - - - - - - ranking = 1keywords = thromboembolism (Clic here for more details about this article) |
5/16. Hepatocellular carcinoma with invasion into right cardiac cavities: report of a case and literature review.Hepatocellular carcinoma is a tumor that rarely invades the inferior vena cava and right heart. We describe the case of a 63-year-old man with jaundice and a history of cryptogenic hepatic cirrhosis with diagnosis of hepatocellular carcinoma. He was referred to the echocardiography laboratory for sudden dyspnea and suggestion of pulmonary thromboembolism. Echocardiographic study reported a mass in the right atrium proceeding from the inferior vena cava.- - - - - - - - - - ranking = 1keywords = thromboembolism (Clic here for more details about this article) |
6/16. Surgical treatment for primary cardiac leiomyosarcoma causing right ventricular outflow obstruction.A 55-year-old man was admitted to another hospital because of dry cough and dyspnea that rapidly worsened before admission. Chest computed tomography revealed a low-density mass that nearly obstructed the main pulmonary arterial trunk. Pulmonary thromboembolism was suspected and treated with catheter-directed thrombolysis therapy. Despite optimal thrombolysis and anticoagulant therapy, his symptoms persisted. He was referred for further examination and possible surgery for presumed pulmonary thromboembolism. The mass appeared more likely to be a tumor than a thrombus on careful analysis of the magnetic resonance imaging. At surgery, the anterior wall of the main pulmonary arterial trunk, the pulmonary valve, annulus, and the right ventricular outflow tract were all invaded by what was found to be a tumor and were resected under conventional cardiopulmonary bypass. The resected area was reconstructed with a 25-mm-diameter bioprosthetic valve and Xenomedica patch. Final pathological diagnosis was primary cardiac leiomyosarcoma involving the pulmonary valve. Postoperative course was uneventful, and he was discharged 11 days after surgery without adjuvant therapy because he refused it. Ten months later, the patient was well, but a chest X-ray revealed some coin lesions in the bilateral lung fields that were thought to be metastatic tumor.- - - - - - - - - - ranking = 2keywords = thromboembolism (Clic here for more details about this article) |
7/16. Right ventricular cardiac myxoma. Diagnostic usefulness of cardiac magnetic resonance imaging.BACKGROUND: Cardiac myxomas are the most common type of cardiac tumors. About 75-85% of cardiac myxomas originate in the left atrium, 15-20% in the right atrium. Most myxomas arise from the interatrial septum adjacent to the fossa ovalis. Only 3-4% are found in the left and right ventricle each. Although myxomas are histologically benign, they may be fatal because of their strategic position. CASE STUDY: The authors report on a 24-year-old patient with stabbing thoracic pain and dyspnea due to pulmonary thromboembolism that was caused by an atypically localized myxoma at the right ventricular apex originating from the interventricular septum. The diagnosis was based on cardiac magnetic resonance (CMR) imaging. Superior to echocardiography, CMR could strengthen the diagnostic accuracy by additional information on tissue characterization using different imaging sequences. Typically for cardiac myxomas, contrast enhancement was moderate and delayed enhancement was found in the outer circumferential tumor margins only. CONCLUSION: High spatial resolution and multiplane imaging combined with different acquisition patterns of CMR achieve a global view of the heart that seems to be useful for diagnosing cardiac tumorous masses.- - - - - - - - - - ranking = 1keywords = thromboembolism (Clic here for more details about this article) |
8/16. Asymptomatic cardiac papillary fibroelastoma: diagnostic assessment and therapy.Papillary fibroelastoma is a rare benign cardiac tumor with elevated risk for embolization. This report describes the case of a 65-year-old man, admitted for the occasional finding of a round, pedunculate mass adherent to the chordae of the anterior mitral valve leaflet, mimicking an endocarditic mass. Appropriate diagnostic evaluations lead to the suspect of a papillary fibroelastoma. Because of the elevated risk of thromboembolism, surgery was emergently performed with complete removal of the mass and preservation of the integrity of the mitral valve. Histologic evaluation confirmed the diagnosis. Papillary fibroelastoma should be always considered in the differential diagnosis of intracardiac masses.- - - - - - - - - - ranking = 1keywords = thromboembolism (Clic here for more details about this article) |
9/16. Primary cardiac leiomyosarcomas.Two patients with primary cardiac leiomyosarcoma, one of the rarest malignant tumors of the heart, are described. The first patient had a tumor of the pulmonary trunk and was admitted with symptoms suggestive of pulmonary thromboembolism. The second had a tumor of the left atrium and had signs and symptoms of mitral valve obstruction and regurgitation. The 2 patients were operated on and later underwent adjuvant chemotherapy. Both died more than 22 months after operation, having required multiple hospital admissions for treatment of complications related to the pathology or the treatment of the primary cardiac leiomyosarcoma. Nonetheless, aggressive surgical excision followed by chemotherapy appears to have improved survival in these patients with primary cardiac leiomyosarcoma, as they are among the longest survivors reported.- - - - - - - - - - ranking = 1keywords = thromboembolism (Clic here for more details about this article) |
10/16. aortic valve tumor: an unusual cause of coronary obstruction during cardiac catheterization.Coronary artery obstruction during cardiac catheterization is a rare but serious complication that has been reported to occur in 0.15 to 0.5% of cases. The most common causes of intraprocedural coronary occlusion include thromboembolism, air embolism, and coronary dissection. This report describes the angiographic findings of a patient who developed chest pain with electrocardiographic evidence of myocardial ischemia due to obstruction of the right coronary artery by an aortic valve tumor.- - - - - - - - - - ranking = 1keywords = thromboembolism (Clic here for more details about this article) |
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