Tumor of the heart in a young woman; a rare manifestation of Wegener granulomatosis

Singh, Remmi S.; Rosen, Seymour

doi:10.1016/j.humpath.2011.04.020

Cited by 5 publications

(5 citation statements)

References 7 publications

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“…These conditions may involve multiple organ systems including the heart, and all components of the heart may be affected, including the valves, coronary arteries, conduction system, myocardium, endocardium or pericardium [21]. Furthermore, there have been several prior reports of IP developing in patients with disorders such as Wegener’s granulomatosis [7, 8], sarcoidosis [9, 10], Behcet’s disease [11, 12], and rheumatoid arthritis [13-15]. These IPs may arise in the presence of a known systemic inflammatory disease or may be an isolated finding, and are likely pathologically distinct from IMT.…”

Section: Discussionmentioning

confidence: 99%

“…These IPs may arise in the presence of a known systemic inflammatory disease or may be an isolated finding, and are likely pathologically distinct from IMT. Indeed, pathological examination of cardiac IP in patients with a known systemic inflammatory disease has been found to be histologically consistent with their systemic process [7-15].…”

Section: Discussionmentioning

confidence: 99%

“…While recommendations for surgical excision depend on presumed etiology and presence of symptoms or obstructive physiology, some tumors such as hemangiomas [3] and inflammatory myofibroblastic tumors (IMT) [4-6] have been known to regress either spontaneously or after treatment with steroids. There are several prior reports of cardiac masses associated with systemic disorders such as Wegner’s granulomatosis [7, 8], sarcoidosis [9, 10], Behcet’s disease [11, 12] and rheumatoid arthritis [13-15]; however, owing to the rarity of these masses, there is currently no consensus regarding management. We present three cases of patients with cardiac masses occurring in association with systemic inflammatory disease whose lesions significantly diminished with conservative therapy, review the English language literature regarding such an approach, and suggest an algorithm for management of these types of masses.…”

Section: Introductionmentioning

confidence: 99%

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Management of Inflammatory Cardiac Masses

Karnik

Awtry

2018

Cardiol Res

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Systemic rheumatologic and inflammatory disorders can affect almost any organ system, including the heart. The cardiac valves, conduction system, myocardium, endocardium, pericardium, and coronary arteries may be affected. Intracardiac masses may develop as part of the disease process or a consequence of their therapy, such as methotrexate-associated nodulosis. Optimal therapy in these cases is not known, since many patients are asymptomatic and the potential benefit of surgical excision must be weighed against its associated morbidity and mortality. Importantly, these inflammatory masses must be differentiated from thrombus, infection, and primary and metastatic tumors. We present three cases of inflammatory cardiac masses associated with rheumatoid arthritis and Wegener’s granulomatosis, which were successfully treated conservatively, and propose a management algorithm. The benefits of such an approach must be individualized and weighed against the risks of systemic embolization, stroke and obstruction.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Management of Inflammatory Cardiac Masses

Karnik

Awtry

2018

Cardiol Res

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“…These findings are reported in few cases on papillary muscles, left or right ventricular cavity or valves and only two of them have been associated with VT [5][6]. Treatment with cyclophosphamide and corticosteroids is described that improve the cardiac symptomatology [7].…”

Section: Review Of the Literaturementioning

confidence: 99%

Unusual Heart Involvement of Wegener's Granulomatosis and Literature Review

Cambronero-Cortinas¹,

Corbí-Pascual²,

Gallego-Sanchez³

et al. 2016

ICFJ

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<p>A female patient, 60 years of age, was presented to our hospital with chest pain and monomorphic ventricular tachycardia (VT). She was transferred to the Coronary Care Unit and amiodarone perfusion restored basal rhythm in atrial fibrillation. She has not sign of heart failure. A transtoracic echocardiogram (TTE) was performed and an one mitral mass was found at atrioventricular junction with displacement of the posterior mitral leaflet A transesophageal echocardiogram (TEE) demonstrated a mass at atrioventricular junction level with severe mitral regurgitation. Cardiac Magnetic Resonance (CMR) confirmed the mass and anterolateral papillary muscle was thickening and hypertrophied with hyperenhancement consistent with fibrosis. Moreover, T2-weighted imaging demonstrated hyperintense mass with respect to the surrounding myocardium in relation of inflammatory mass. She had saddle nose by destruction of the septum, bilateral hearing loss, sinusitis and scleritis and renal involvement as well. This patient was diagnosed of Wegener's Granulomatosis (WG) and she was treated with methylprednisolone during 3 days, continued with prednisolone and cyclophosphamide. An 8 days later echocardiogram did not find the mass. However, the patient developed symptomatology of heart failure and in the context of severe mitral regurgitation, mitral valve replacement was decided in multi-disciplinary Cardiology-Cardiothoracic meeting.</p>

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“…Aortic insufficiency is the most common valvular manifestation, followed by mitral regurgitation and aortic stenosis. Endocardial masses also have been described, mimicking primary infectious endocarditis (59,64).…”

Section: Granulomatosis With Polyangiitis and Microscopicmentioning

confidence: 99%

CT and MR Imaging of Cardiothoracic Vasculitis

Broncano¹,

Vargas²,

Bhalla³

et al. 2018

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The term vasculitis includes a variable group of entities in which the common characteristic is inflammation of the walls of blood vessels occurring at some time during the course of the disease. The vasculitides can be divided into primary and secondary vasculitides, depending on the etiology and according to the size of the vessel affected. Both primary vasculitis and secondary vasculitis are associated with cardiac morbidity that is often subclinical. Cardiac involvement is associated with prognostic implications and higher rates of related mortality. Vasculitis of cardiac structures and the assessment of disease extent are important for appropriate management and selection of treatment. Although echocardiography, radionuclide imaging, and catheter-directed coronary angiography remain the cornerstones of cardiac imaging, cardiac computed tomography and magnetic resonance imaging can offer a 360° assessment of cardiac anatomy, function, and complications secondary to vasculitis. Postoperative complications, which are more frequent in patients with active disease, can also be depicted with those imaging modalities. A multidisciplinary approach is important to yield an appropriate estimate of the disease activity and extent and, therefore, to enable better treatment selection and monitoring. Online supplemental material is available for this article. RSNA, 2018.

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Tumor of the heart in a young woman; a rare manifestation of Wegener granulomatosis

Cited by 5 publications

References 7 publications

Management of Inflammatory Cardiac Masses

Management of Inflammatory Cardiac Masses

Unusual Heart Involvement of Wegener's Granulomatosis and Literature Review

CT and MR Imaging of Cardiothoracic Vasculitis

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