Primary cardiac tumors: early and late results of surgical treatment in 91 patients

Centofanti, Paolo; Rosa, Elio Di; Deorsola, Luca; Dato, Guglielmo Mario Actis; Patanè, Francesco; Torre, Michele La; Barbato, Luciano; Verzini, Alessandro; Fortunato, G.; Summa, Michele di

doi:10.1016/s0003-4975(99)00700-6

Cited by 296 publications

(245 citation statements)

References 32 publications

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“…In early reports, some authors demonstrated a frequency of 30-40% of embolization in their reports (20,25,26). Recent reports of the sign of embolism associated with cardiac tumors showed a downward trend with the frequency of 20-25% (6,(27)(28)(29), and in this retrospective study we reported the frequency of 21.5%.…”

supporting

confidence: 52%

Surgical treatment of cardiac tumors: a 5-year experience from a single cardiac center

Liang

Shen

et al. 2016

J. Thorac. Dis.

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Background: Cardiac tumors are rare but manifested with various clinical presentations and often cause unexpected symptoms or sudden death. The objective is to review the clinical presentation, histopathological spectrum, mortality and follow-up data of patients with cardiac tumors following surgery treatment over a period of 5 years. Methods:We retrospectively collected the medical records of all patients diagnosed of cardiac tumors in the period between January 2008 and December 2013 at the cardiac center of our university. Clinical histories, perioperative data, surgical findings, efficacy and follow-up data were reviewed in our study.Patients were divided into two groups according to site distribution of the tumors in the heart.Results: A total of 131 patients underwent surgical treatment of cardiac tumors were enrolled in this study, with a mean age of 51.39±16.37. The result of analysis showed that 79.47% (n=104) of the primary intracardiac tumors were benign, while primary malignant neoplasms accounted for 16.03% (n=21) of all patients, with the remainder (n=6, 4.6%) metastatic tumors transferred from other organs. Among all patients there were 2 in-hospital deaths and the survival rate in all patients at 1-year, 3-year and 5-year follow up was 83.20%, 78.62% and 66.41% respectively. Both patients with tumors in the left and right heart had similar basic characteristics except sex gender (P=0.002), BSA (P=0.045) and weight (P=0.033). Compared with patients with tumors in the right heart, patients with tumors in the left heart had significant higher CPB time (P<0.001), cross clamp time (P<0.001) and time of mechanical ventilation (P<0.001), and they also had longer ICU stay (P<0.001) but not total hospital stay (P=0.434).Conclusions: Surgical resection represents an effective protocol in treating cardiac tumors. Data in our study of cardiac tumors on frequency and allocation were consistent with previous reports which may provide useful clinical evidence on shared data, and data revealed that patients with malignant cardiac tumors had significant lower survival both in hospital and long-term follow-up.

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supporting

confidence: 52%

Surgical treatment of cardiac tumors: a 5-year experience from a single cardiac center

Liang

Shen

et al. 2016

J. Thorac. Dis.

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“…Early diagnosis of malignant primary cardiac tumours is critical, as these lesions tend to respond poorly to chemotherapy and adjuvant therapies. [5][6][7] Complete surgical excision tends to be the best curative measure. 5,8 Unfortunately, malignant primary cardiac tumours have high mortality rates, as advanced disease is present at diagnosis in most cases.…”

Section: Discussionmentioning

confidence: 99%

“…5,8 Unfortunately, malignant primary cardiac tumours have high mortality rates, as advanced disease is present at diagnosis in most cases. [5][6][7][8] The anesthetic considerations for patients with large cardiac tumours relate to risks associated with mediastinal masses and risks unique to cardiac tumours. As with anterior mediastinal masses, large cardiac tumours create significant mass effect on vital cardiovascular and respiratory structures, increasing the risk of cardiorespiratory compromise with the induction of anesthesia.…”

Section: Discussionmentioning

confidence: 99%

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Case report: Giant cardiac malignancy in a nine-year-old female

Scott

Troshynski

Clarke

et al. 2012

Can J Anesth/J Can Anesth

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Purpose To describe the management of a giant cardiac malignancy initially diagnosed as an anterior mediastinal mass. Clinical features A nine-year-old female with right facial swelling and chronic cough was diagnosed with a large right mediastinal mass. Intermittent ventricular and supraventricular arrhythmias were noted on admission electrocardiograms. Empiric corticosteroid and radiation therapy did not reduce the size of the tumour, and initial tissue biopsies were non-diagnostic. Due to worsening tamponade physiology and persistent arrhythmias, the patient was scheduled for tumour debulking with potential resection. Prior to surgery, a multidisciplinary team was assembled to delineate team member responsibilities and treatment algorithms. The procedure was performed under general anesthesia with spontaneous ventilation preserved during endotracheal intubation and invasive line placement. The team was prepared to provide extracorporeal mechanical support if needed. The child required inotropic and vasoactive medications after transitioning to positive pressure ventilation, but her hemodynamics improved with sternotomy. The lesion was identified as a malignant cardiac clear-cell tumour that was unresectable. Her sternum was left open, as attempted closure led to the re-creation of tamponade physiology. She underwent delayed sternal closure days later. After months of chemotherapy that resulted in significant tumour involution, she underwent successful surgical resection. Conclusion Giant primary cardiac tumours may present similarly to large anterior mediastinal masses. The care of patients with these lesions requires an understanding of the risks associated with mediastinal masses as well as those unique to cardiac tumours. A multidisciplinary approach is critical to providing safe and effective care throughout this process. RésuméObjectif De´crire la prise en charge d'une tumeur cardiaque ge´ante initialement diagnostique´e comme e´tant une masse me´diastinale ante´rieure. Caractéristiques cliniques Un diagnostic de volumineuse masse me´diastinale droite a e´te´fait chez une fillette aˆge´e de neuf ans, pre´sentant une enflure de la partie droite du visage

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“…Diagnostic methods most commonly used include transthoracic echocardiography (TTE), transesophageal echocardiography (TEE), magnetic resonance imaging (MRI) and computed tomography (CT). The ideal treatment for primary heart tumors is surgical removal but in inoperable cases heart transplantation may have to be considered [4][5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Cardiac lymphangioma

Biskupski¹,

Waligórski²,

Mokrzycki³

et al. 2013

kitp

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StreszczenieLymphangioma to bardzo rzadki, pierwotny nowotwór serca. Rozpoznawany jest zwykle przypadkowo w badaniach autopsyjnych. Do tej pory wydano zaledwie kilkanaście publikacji dotyczących tego nowotworu. W pięciu przypadkach rozpoznano go przypadkowo, w pozostałych dawał objawy kliniczne. Wynikały one z ucisku na struktury serca lub z zaburzonego przepływu krwi przez serce. Najczęściej były to objawy niewydolności krążenia i zaburzenia rytmu serca. W diagnostyce najbardziej przydatne jest badanie echokardiograficzne przezklatkowe i przezprzełykowe (TTE, TEE), które obrazuje guz wraz z efektem hemodynamicznym. Ostateczne rozpoznanie ustalane jest zwykle na podstawie badania histopatologicznego preparatu po jego operacyjnym usunięciu. Leczeniem z wyboru jest chirurgiczne wycięcie guza. W pracy przedstawiono przypadek lymphangioma, który był zlokalizowany w świetle prawego przedsionka i powodował znaczne utrudnienie napły-wu krwi do prawej komory, co było przyczyną niewydolności krążenia. Omówiono także wszystkie znane opisy przypadków tego nowotworu, które dotyczyły serca. Słowa kluczowe: guz serca, echokardiografia, operacja. Kardiochirurgia i Torakochirurgia Polska 2013; 10 (3) 283 CASE REPORT AbstractLymphangioma is a very rare primary tumor of the heart. It is usually incidentally found during autopsies and there have only been a handful of documented cases of this tumor in the heart. In 5 cases, it was discovered accidentally and the remaining cases gave clinical symptoms. Major symptoms of heart lymphangiomas include compression of surrounding mediastinal structures and/or inadequate blood flow through the heart. Specifically the cardiac disturbances lead to rhythm and circulatory failure. The most useful diagnostic tests for this heart tumor include echocardiography, which shows not only the tumor but also its hemodynamic effects. The following article presents the accidental finding of a lymphangioma, localized in the right atrium. It caused considerable difficulty for the blood flow into the right heart chamber, which then led to circulatory failure. In addition we will also discuss all known cases of cardiac lymphangiomas.

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Primary cardiac tumors: early and late results of surgical treatment in 91 patients

Cited by 296 publications

References 32 publications

Surgical treatment of cardiac tumors: a 5-year experience from a single cardiac center

Surgical treatment of cardiac tumors: a 5-year experience from a single cardiac center

Case report: Giant cardiac malignancy in a nine-year-old female

Cardiac lymphangioma

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