Malignant schwannoma of the heart

Abstract

Summary:Primary cardiac tumor is an extremely rare disease entity. Only three cases of primary malignant cardiac schwannoma, the subject of this report, have been recorded in Japan. Recently, we encountered a case of malignant schwannoma in which retention of pericardial effusion was the first clinical finding. This case was a 30-year-old female, who had dyspnea at work, general fatigue, and fever. Striking cardiac expansion was seen, with a cardiothoracic ratio (CTR) d 6 9 % on chest x-ray. Twodimensional echocardiograms showed a large volume of pericardial effusion between the side wall of the left ventricle and the epicardium, and the presence of a parenchymatous tumor. An increase in tumor size was detected on chest computer tomography (CT) scan. Using a pump oxygenator, median stemotomy was performed to reach the epicardium. A pale yellow, soft tumor was Seen in the left atrium near the left ventricle. Histologically, the patient was diagnosed as having a malignant schwannoma. We have reported a case of primary malignant schwannoma which was surmised to have arisen from the boundary between the atrium and the ventricle.

A Rare Cause of Acute Heart Failure: Malignant Schwannoma of the Pericardium

“…Neurogenic cardiac tumors are extremely rare, and they are almost always benign and primary, although they may sometimes present as malignant, [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] multiple malignant, 11,13 and metastatic tumors.…”

“…4 However, it can be found in the left atrium, protruding from the left atrium into the left ventricle during diastole, 6 or near the left ventricle. 8 Symptoms are related to its location; in fact, extrinsic compression and pericardial effusion (often hemorrhagic) may occur when it is located in the atrial wall or in the pericardial sac, or it may lead to valvular obstruction when it is inside the atrial chamber. When the hepatic veins or the vena cava are obstructed, signs of cardiac failure may appear.…”

“…The most common symptoms are chest pain, dyspnea, arrhythmias, conductive disorders, and syncope, and these are frequently associated with pericardial effusion. 8,13 It is revealed by echocardiography, but CT scan and magnetic resonance imaging can better define the location, extent, and involvement of other structures. In this case, the 3 noninvasive modalities simply detected the mass, but they did not make a tissue diagnosis.…”

Primary Schwannoma of the Right Atrium: Successful Surgical Resection

“…Primary neurogenic tumors of the heart originating in the nerve sheath are extremely uncommon, and to date, 10 cases of neurilemomas, or schwannomas, have been reported. [1][2][3][4][5][6][7][8] We report the case of a patient with a right atrial tumor who underwent a successful resection; histological examination revealed a benign primary schwannoma of the heart.…”

“…Symptoms also depend on the size, the rate of growth, and how promptly they are detected and removed. The most common clinical findings are chest pain, dyspnea, orthopnea, distal edema, syncope, arrhythmias, and conductive disorders, and these symptoms are frequently associated to pericardial effusion 1,5 and acute atrial fibrillation. 6 Nevertheless, cardiac schwannomas can have a benign and asymptomatic presentation, such as in the patient reported here, as well as in other previously reported cases, 8 where early identification and consequently smaller tumor size or location favored a lack of symptoms.…”