State of the art paper Sarcomas of the heart as a difficult interdisciplinary problem

Ostrowski, Stanisław; Marcinkiewicz, Anna; Kośmider, Anna; Jaszewski, Ryszard

doi:10.5114/aoms.2014.40741

Cited by 29 publications

(30 citation statements)

References 104 publications

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“…Although, statin administration has been associated with a reduction of POD in critically ill patients [49,50], conflict results have been observed after cardiac surgery [1,2,16,51]. The multifactorial and complex pathogenesis of POD may explain this discrepancy [51][52][53][54][55][56][57][58]. Therefore, no definitive conclusions on the protective effects of statins on POD can be determined in the cardiac surgery setting.…”

Section: Discussionmentioning

confidence: 76%

Effects of statins on delirium following cardiac surgery – evidence from literature

Mariscalco¹,

Mariani²,

Biancari³

et al. 2015

Psychiatr Pol

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SummaryDelirium is a common complication after cardiac surgery, being associated with significant mortality and morbidity. The pathogenesis of postoperative delirium (POD) is complex and multifactorial, involving an interaction of multiple predisposing and precipitating factors. There are several hypotheses regarding the underlying mechanisms of POD, and the most recent emerging one involves neuroinflammation, which is exacerbated by the cardiopulmonary bypass-induced systemic inflammatory response. Experimental and clinical studies have recently documented improved perioperative central neural protection exerted by statins because of their anti-inflammatory, immunomodulatory, and antithrombotic properties. The present review will focused on the possible protective effect exerted by preoperative statin administration on delirium following cardiac surgery.

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Section: Discussionmentioning

confidence: 76%

Effects of statins on delirium following cardiac surgery – evidence from literature

Mariscalco¹,

Mariani²,

Biancari³

et al. 2015

Psychiatr Pol

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“…Early Cardiac sarcomas are often asymptomatic and produce nonspecific symptoms and mimic other pathologies. The poor prognosis of cardiac sarcomas is related to their tendency to infiltrate myocardium locally and or distant metastasis in the course of disease [3]. There are different presenting symptoms according to the location of the tumor and large vessel involvement: cardiac valvular or pump dysfunction, pericardial effusion or tamponade, arrhythmias, embolism to brain, lung, or retina, and symptoms such as dyspnea, chest pain, and syncope [4].…”

Section: Discussionmentioning

confidence: 99%

“…Even with radical resections such as bench surgery and transplantation, although the local recurrence may be reduced to some extent, distant metastasis would be yet anticipated. Adjuvant therapies such as radiotherapy or chemotherapy have not been well evaluated in preventing local recurrences or distant metastasis [3,4].…”

Section: Discussionmentioning

confidence: 99%

Small intestine and ovarian metastasis in a patient with a history of cardiac fibrosacoma

Esfehani

Mahmoodzadeh

Omranipour

2015

Journal of the Egyptian National Cancer Institute

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Metastatic tumors involving the small bowel are much more common than primary neoplasms. The most common metastases to the small intestine are those arising from other intra-abdominal organs. Metastases from extra-abdominal tumors are rare but may be found in patients with adenocarcinoma of the breast and carcinoma of the lung. Cutaneous melanoma is the most common extra-abdominal source involving the small intestine, with involvement of the small intestine noted in more than half of the patients dying from malignant melanoma [1]. While intestinal metastasis from sarcoma has been described, this is an extremely rare occurrence especially from a rare malignant sarcoma of cardiac origin. The dismal prognosis of cardiac sarcomas results from extensive local invasion at presentation or distant metastasis. Metastasis to the small bowel may cause obstruction, bleeding, or intussusception in which the diagnosis may be delayed because of rarity of the condition and mild and vague abdominal symptoms at early presentation. In this report, a 35 year old woman a known case of cardiac fibrosarcoma was admitted to the emergency ward with abdominal pain and distention, bloody diarrhea, and recurrent nausea and vomiting. Jejuno-jejunal invagination was diagnosed at laparotomy along with tumoral involvement of the left ovary. Histopathological study showed that there was a fibrosarcoma compatible with the earlier diagnosis of primary cardiac tumor. We have described some aspects of diagnosis and treatment of this rare cause of intestinal intussusception.

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Section: Ewing Sarcoma In the Right Ventriclementioning

confidence: 99%

“…1 Metastases to the heart are 20 to 40 times more prevalent than are primary cardiac malignancies. 1 The estimated incidence of metastasis to the heart is 10% to 15.4%; lung tumors, lymphomas, and carcinomas of the breast are the typical metastatic sources. 2,3 Ewing sarcoma is the second most frequent primary malignant bone tumor (after osteosarcoma) but accounts for only a small proportion of cardiac metastases.…”

Section: Ewing Sarcoma In the Right Ventriclementioning

confidence: 99%

Ewing Sarcoma in the Right Ventricle

Petrović

Zhao

Thangam

et al. 2016

Texas Heart Institute Journal

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Ewing sarcoma is the second most prevalent malignant primary bone tumor but constitutes only a small proportion of cardiac metastases. We present a case of asymptomatic Ewing sarcoma metastatic to the right ventricle.A 1 Approximately 25% of primary cardiac tumors are malignant.1 Metastases to the heart are 20 to 40 times more prevalent than are primary cardiac malignancies.1 The estimated incidence of metastasis to the heart is 10% to 15.4%; lung tumors, lymphomas, and carcinomas of the breast are the typical metastatic sources. 2,3Ewing sarcoma is the second most frequent primary malignant bone tumor (after osteosarcoma) but accounts for only a small proportion of cardiac metastases. 4-6 Its metastatic incidence in the right ventricle (RV) is not precisely known. We present the case of a patient who had asymptomatic Ewing sarcoma metastatic to the RV. Case ReportIn December 2013, a 36-year-old asymptomatic man presented for evaluation of a mass in his RV. Three years earlier, because of translocation-negative Ewing sarcoma, he had undergone below-the-knee amputation of the left leg and consequent chemotherapy. Two years later, he was found to have a lung metastasis. Genetic analysis of the resected lung tissue identified mechanistic target of rapamycin (mTOR) E1799K, Ewing sarcoma breakpoint region 1 (EWSR1) gene fusion with nuclear factor of activated Tcell cytoplasmic 2 gene (NFATc2), and topoisomerase 1 (TOP1) amplification lesions. These were consistent with Ewing sarcoma and prompted further chemotherapy.Three months after the lung resection, magnetic resonance images (MRI) of the lungs revealed a 3.5 × 2.6-cm enhancing mass in the RV (Fig. 1), and the patient presented at our institution for possible resection of the mass. He was exceptionally physically fit and had no history of cardiac diseases. Results of positron emission tomography (PET) confirmed the presence of a metabolically active tumor (Fig. 2). The patient underwent cardiac evaluation and was cleared for surgery.An intraoperative transesophageal echocardiogram showed a preserved left ventricular (LV) ejection fraction. Other than a pedunculated mass attached to the RV, there were no structural abnormalities of the heart.Under direct vision, with a normothermic beating heart, the tumor was resected with negative margins and no residual mass. Right atrial biopsies were also performed (with 2-mm negative margins on a frozen section). The total cardiopulmonary bypass time was 22 min. Postoperative transthoracic echocardiograms (TTEs) showed normal LV and RV size and function.The morphology and immunohistochemical stains of the resected mass were consistent with a metastatic Ewing sarcoma tumor deposit. It was composed of highly malignant cells with moderate nuclear pleomorphism, a high nuclear-to-cytoplasmic ratio, frequent mitoses (16 per 10 high-power fields), and clear-to-finely vacuolated

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State of the art paper Sarcomas of the heart as a difficult interdisciplinary problem

Cited by 29 publications

References 104 publications

Effects of statins on delirium following cardiac surgery – evidence from literature

Effects of statins on delirium following cardiac surgery – evidence from literature

Small intestine and ovarian metastasis in a patient with a history of cardiac fibrosacoma

Ewing Sarcoma in the Right Ventricle

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