A potential misdiagnosis in the COVID-19 pandemic era: a case report of superimposed thrombosis or tumor recurrence

Zoroufian, Arezou; Mohseni-Badalabadi, Reza; Mahalleh, Mehrdad; Ghorashi, Seyyed Mojtaba; Momtahen, Sharam; Omidi, Negar

doi:10.1186/s13019-021-01697-3

Cited by 2 publications

(2 citation statements)

References 9 publications

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“…At the same time, concerns about hypercoagulability in COVID-19 may lead to misdiagnosis of cardiovascular disease in this infection. A case is described in which the patient's symptoms and the results of transesophageal echocardiography were considered as COVID-19-induced thrombosis on the prosthetic valve in a patient with recurrent dedifferentiated liposarcoma of the heart [69].…”

Section: Discussionmentioning

confidence: 99%

High Risk of Heart Tumors after COVID-19

Mitrofanova,

Makarov,

Goncharova

et al. 2023

Life

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An emergence of evidence suggests that severe COVID-19 is associated with an increased risk of developing breast and gastrointestinal cancers. The aim of this research was to assess the risk of heart tumors development in patients who have had COVID-19. Methods: A comparative analysis of 173 heart tumors was conducted between 2016 and 2023. Immunohistochemical examination with antibodies against spike SARS-CoV-2 was performed on 21 heart tumors: 10 myxomas operated before 2020 (the control group), four cardiac myxomas, one proliferating myxoma, three papillary fibroelastomas, two myxofibrosarcomas, one chondrosarcoma resected in 2022–2023. Immunohistochemical analysis with antibodies against CD34 and CD68 was also conducted on the same 11 Post-COVID period heart tumors. Immunofluorescent examination with a cocktail of antibodies against spike SARS-CoV-2/CD34 and spike SARS-CoV-2/CD68 was performed in 2 cases out of 11 (proliferating myxoma and classic myxoma). Results: A 1.5-fold increase in the number of heart tumors by 2023 was observed, with a statistically significant increase in the number of myxomas. There was no correlation with vaccination, and no significant differences were found between patients from 2016–2019 and 2021–2023 in terms of gender, age, and cardiac rhythm dis-orders. Morphological examination revealed the expression of spike SARS-CoV-2 in tumor cells, endothelial cells, and macrophages in 10 out of 11 heart tumors. Conclusion: The detection of SARS-CoV-2 persistence in endothelium and macrophages as well as in tumor cells of benign and malignant cardiac neoplasms, the increase in the number of these tumors, especially cardiac myxomas, after the pandemic by 2023 may indicate a trend toward an increased risk of cardiac neoplasms in COVID-19 patients, which re-quires further research on this issue and a search for new evidence.

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Section: Discussionmentioning

confidence: 99%

High Risk of Heart Tumors after COVID-19

Mitrofanova,

Makarov,

Goncharova

et al. 2023

Life

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“…Afterwards, histopathologic and immunohistochemical investigation of lung nodules con rmed the diagnosis of poorly differentiated neoplasm suggestive of angiosarcoma positive for CD34, CD31, negative staining by PanCK, CAM5. (9)(10)(11)(12); among these is a case of cardiac liposarcoma recurrence with symptoms of dyspnea, palpitation, fever, and sore throat (10). Unfortunately, many cases of cardiac angiosarcoma are not timely diagnosed despite multimodality workups such as echocardiography, chest CT scan, HRCT, and biopsy, due to a broad spectrum of differential diagnoses such as benign tumors, viral, mycobacterial, or rheumatologic diseases being investigated (13).…”

Section: Case Presentationmentioning

confidence: 99%

Primary Cardiac Angiosarcoma With Pulmonary Metastasis in a Young Female: A Case Report and Review of Literature

Kordjazy

Taheri

Parkhideh

et al. 2022

Preprint

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Background: Sarcomas are the most prevalent type of malignant primary cardiac tumor. Clinical presentation differs according to the size and location of the tumor and involvement of other structures. Case presentation: In this article, we present a 38 years old lady as a case of primary cardiac angiosarcoma with a huge challenge in diagnosis and management of the disease. On the 4th of June 2020, she emergently presented to the hospital with the chief complaint of cough and tachypnea, diarrhea, and malaise, and a history of blunt chest trauma three weeks ago. Based on the presentation and transthoracic echocardiography which was compatible with cardiac tamponade, emergent pericardiocentesis was performed. The first imaging showed bilateral pleural effusion, pericardial effusion, and no significant parenchymal lung involvement, which was not compatible with rheumatologic diseases or COVID-19. Based on cardiac CT angiography and evidence of dye entrance to the peri-right atrial area, right atrial free wall rupture was suspected as the cause of the massive pericardial effusion. Following multidisciplinary consensus, she underwent cardiac surgery; in addition to the 3*3 cm right atrium free wall rupture repair, concomitant sampling from the lung nodules, lymph nodes, pericardium, and also the surrounding tissue of the right atrium ruptured defect was performed. Based on immunohistochemistry, the diagnosis was compatible with cardiac angiosarcoma with metastasis to the lung. Due to the advanced stage of the tumor, oncologists advised against chemotherapy or radiotherapy and she went through palliative care. Finally, after a 53-day ICU stay and due to right-sided heart failure, the patient unfortunately died. Conclusion: COVID-19 pandemic has brought diagnostic challenges regarding differentiating SARS-CoV-2 infection from other diagnostic entities. On the other hand, due to the rarity and fatality of primary cardiac angiosarcomas, early diagnosis and possible management seem crucial for prolonged survival. Involving cardiac angiosarcoma in the initial differential diagnosis could warrant timely diagnosis and assessment of various therapies for cure or palliative care.

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A potential misdiagnosis in the COVID-19 pandemic era: a case report of superimposed thrombosis or tumor recurrence

Cited by 2 publications

References 9 publications

High Risk of Heart Tumors after COVID-19

High Risk of Heart Tumors after COVID-19

Primary Cardiac Angiosarcoma With Pulmonary Metastasis in a Young Female: A Case Report and Review of Literature

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