Malignant Fibrous Histiocytoma of the Heart Presenting as Hemoptysis

DiNardo-Ekery, Dorothy; Lau, K Y; Spicer, Melvin J.; Ascherl, M V

doi:10.1378/chest.93.5.1099

Cited by 4 publications

(1 citation statement)

References 13 publications

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“…Conduction disturbances, left ventricular decompensation, and embolic sequalae may also be observed. A rare case of cardiac malignant fibrous histiocytoma presenting with hemoptysis has been reported [63]. Over a third developed distant mets in the AFIP series [2].…”

Section: Selected Primary Malignant Cardiac Tumorsmentioning

confidence: 99%

Primary malignant cardiac tumors: Update 1992

Thomas

Johnson

Stoddard

et al. 1992

Med. Pediatr. Oncol.

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CLINICAL SUMMARYA 37-year-old male initially complained of polyarthralgias, fever and shortness of breath in February of 1986. Physical examination was unremarkable and routine laboratory analysis was unrevealing. The ANA and rheumatoid factor were negative. The sedimentation rate was 62 (elevated), and the C-reactive protein was 7.2 (elevated). The patient was initially thought to have adult onset Still's disease or familial Mediterranean fever. He was started on aspirin and later switched to oral steroids with marginal resolution of symptoms.With the persistence of symptoms, the patient was admitted to a hospital in April. The arthralgias and dyspnea worsened. Past medical and surgical histories were unremarkable. The family, social, and work history were all noncontributory. Physical examination was remarkable for a temperature of 99.6"F, hyperdynamic precordium, with the first heart sound maximally heard at the apex and the second heart sound maximally heard at the base. There was a 3/6 crescendo murmur heard at the apex which radiated toward the axilla, compatible with mitral valve regurgitation. Approximately 0.12 seconds after the second heart sound, a plop, followed by a soft diastolic rumble, was audible. Musculoskeletal exam failed to reveal clubbing, cyanosis, edema or joint swelling. Chest radiographs were remarkable for bilateral small pleural effusions as well as bilateral interstitial infiltrates at the bases. Computed tomography of the chest revealed an interstitial pattern in the lungs. A gallium scan noted diffuse bilateral lung parenchymal uptake.A 2-D echocardiogram revealed a 3.0 X 3.0 cm distal left atrial mass which was attached to the posterior atrial wall above the posterior mitral leaflet. It appeared to prolapse into the valve orifice during diastole.It was felt that the patient had an atrial myxoma, and a thoracotomy was undertaken on April 15, 1986. The atrial mass was identified and resected. The lesion had a pedunculated stalk arising approximately 4.0 mm above the posterior leaflet of the mitral valve annulus. The 0 1992 Wiley-Liss, Inc.

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Section: Selected Primary Malignant Cardiac Tumorsmentioning

confidence: 99%

Primary malignant cardiac tumors: Update 1992

Thomas

Johnson

Stoddard

et al. 1992

Med. Pediatr. Oncol.

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et al. 2002

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This report describes the case of a 16-year-old boy who underwent surgical treatment of a cardiac malignant fibrous histiocytoma (MFH). He was admitted to our hospital for exertional dyspnea. An ultracardiogram (UCG) revealed a tumor about 10cm in diameter, in the left atrium. Extirpation of the left atrial tumor, including the part extending into the pulmonary veins, was performed under cardiopulmonary bypass. Histological examination confirmed a diagnosis of MFH. No adjuvant chemotherapy or radiotherapy was given. While there has been no evidence of local recurrence or metastasis in the 9 months since his operation, strict follow-up is being done by UCG and computed tomography. A few reviews of this entity have been reported; however, they have confused autopsy cases with surgical cases. Therefore, we reviewed only the surgical cases of this type of cardiac tumor documented in the literature. According to our review of the literature, this patient is the youngest among the 42 cases of surgically treated cardiac MFH reported to date.

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