An unusual cause of ventricular tachycardia

Abstract

Inflammatory pseudotumour (IP) of the heart is an extremely uncommon and potentially fatal lesion which presents a challenging diagnosis even for the experienced pathologist, cardiologist and cardiac surgeon. This spindle cell tumour is known to be present in virtually every anatomical region but, in adults, has only previously been found in the heart at postmortem. We report the case of a 27-year-old man who presented with ventricular tachyarrhythmias and a right ventricular mass which was subsequently shown to be an IP.

Inflammatory pseudotumor (inflammatory myofibroblastic tumor) of the mitral valve of the heart

“…Cardiac IPT/IMT is rare, and only isolated cases have been reported: 39 cases have been reported in the English language literature, and 37 are listed in Table 2 (the two unlisted cases lacked precise data) 3,6,10–33 . The patients ranged in age from 5 weeks to 72 years, with a predilection for females.…”

Cardiac Inflammatory Myofibroblastic Tumor

“…The majority of tumors are firm in consistency, with a few showing mucoid and, rarely, friable areas. Areas of cystic degeneration, Eilers et al 557 20 18 yrs M Constitutional, other IVS, RV, RVOT 3.5 IMT SR 14 21 11 mo M Cardiac RVOT, IVS, PV 2.5 IMT SR 15 22 22 yrs M Constitutional, GI IVS 8.6 IP SR 16 23 49 yrs M Cardiac, respiratory LA, MV, Pveins U IMT SR 17 24 62 yrs F Respiratory, cardiac AV, MV U IP SR 18 25 3 mo F Constitutional, cardiac LV 5.4 IMT T 19 14 5 wks M Respiratory RA 6 IMT U 20 14 2 yrs F Neurologic LV, MV 4 IMT SR 21 14 5 yrs F Neurologic LV, MV 3 IMT U 22 14 10 yrs M Cardiac RVOT 1.5 IMT U 23 14 12 yrs M Neurologic RV 6 IMT U 24 14 17 yrs F Cardiac RV, TV 5 IMT U 25 14 19 yrs F Constitutional LV 3.2 IMT SR 26 14 21 yrs F Constitutional, respiratory IVS, PV, RVOT 4 IMT SR 27 26 69 yrs F Constitutional, respiratory AV, IVS, MV 3 IMT SR 28 27 7 yrs F Cardiac TV, RVOT, PA, PV 5 IMT SR 29 28 54 yrs F A/I AV, AVS, CA, MV, TV 4.8 IP S 30 29 48 yrs F Constitutional AR, AV, PA, RVOT U IMT A, S 31 30 2 mo M Neurologic, cardiac, respiratory RV, RA, TV 2 IMT SR 32 31 2 mo F Cardiac RA 2.5 IMT SR 33 32, 33 35 yrs M Constitutional, respiratory IAS, CS, RA, RV, TV 5 PFT SR 34 34 27 yrs M Cardiac, constitutional, respiratory IVS, RV, LV, P 2.5 IP IB 35 35 13 41 13 wks M U RV 2.5 IMT SR 43 41 1 yrs M U RV 2 IMT SR 44 42 62 yrs M Syncope IAS, RA, AV 5 IP SR 45 43 3 mo F Respiratory IVS U IMT SR 46 44 5 mo F Cardiac IVS, RVOT, PV, PA 3 IMT SR 47 45 4 mo M A/I RA 5 IP SR 48 46 15 yrs M Cardiac, sudden death CA (also spleen by autopsy) U IPT N/A 49 46 5 mo F Respiratory RA, SVC, AVG 2.5 IPT SR 50 47 1 yrs 48 17 yrs M Constitutional, other IAS, IVS, RA, RV, TV U IPT SR 54 …”

“…The various synonyms were taken into account, identifying 57 cases of IMT. Table 1 summarizes all 57 cases, 6 –52 including the case at our institution. This represents the most comprehensive review of cardiac IMTs published to date.…”

Inflammatory Myofibroblastic Tumor of the Aortic Valves Causing Sudden Cardiac Death: A Case Report and Review of the Literature

“…It may occur throughout the body and at any age, but the majority of the cases have been reported in the abdominal or pelvic cavity of children and young adults [1–3]. Inflammatory myofibroblastic tumor of the heart is rare, with fewer than 60 cases being reported in the literature under various designations, including IMT, plasma cell granuloma, inflammatory pseudotumor, and inflammatory fibrosarcoma [1,4–47]. It typically presents as an endocardium-based polypoid mass and may arise in the atrium, ventricle, and/or cardiac valve.…”