Cases reported "Heart Neoplasms"

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1/509. Intrapericardial yolk sac tumor associated with acute myocarditis.

    An occult intrapericardial yolk sac tumor occurred in a 3-year-old girl with a fatal outcome. At autopsy, a 5.5-cm mass surrounded the base of the heart and compressed the left atrium posteriorly. Histologically, the tumor was a pure yolk sac tumor. Postmortem chemical analyses of the blood revealed an alpha-fetoprotein level greater than 7000 microg/L. Acute myocarditis of both ventricles was also found.
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2/509. Left ventricular rhabdomyoma. A case report.

    BACKGROUND: Cardiac tumours in infancy are rare, with a predominant incidence of rhabdomyoma. Diagnosis can best be obtained by pre-cordial and transoesophageal echocardiography. Because of the tendency for spontaneous regression conservative therapy is generally recommended. A rare indication for surgical treatment is described. methods: Experimental design: case report. Setting: Pediatric cardiology and cardiac surgery in a university hospital. Patient: a case of a rhabdomyoma of the left ventricle is described which was attached to the left ventricular outflow tract and the left coronary cusp of the aortic valve, causing outflow obstruction of the left ventricle. Intervention: the tumour was removed surgically using cardiopulmonary bypass. Measure: achievement of relief of left ventricular outflow obstruction. RESULTS: Immediate and complete relief of the left ventricular outflow tract was achieved with preservation of the aortic valve. The patient recovered well. CONCLUSIONS: Cardiac rhabdomyomas can usually be treated conservatively. Surgical therapy can be successfully applied when rhabdomyoma results in hemodynamic problems or arrhythmias.
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3/509. Recurrent myxoma of the left ventricle. Case report and review of the literature.

    A 29-year-old female was found to have a left ventricular mass while in the 14th week of gestation. Seven years earlier she had undergone removal of a left ventricular myxoma. At re-operation, after elective interruption of pregnancy, a recurrent left ventricular myxoma was successfully excised. According to a review of the literature recurrence of an isolated, localized left ventricular myxoma has not been previously reported.
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4/509. Localized pericarditis with calcifications mimicking a pericardial tumor.

    A 62-year-old man was admitted with increasing palpitations. radiography of the chest demonstrated a calcified mass. magnetic resonance imaging revealed compression of the right ventricle by a tumor. At the time of cardiac catheterization, the coronary arteries were found not to supply blood flow of the mass, and no dip-and-plateau pattern was seen in the right ventricular pressure measurements. At the time of surgery, the mass was found to be a focal calcified thickening of the pericardium containing only pus. The thickening resembled an oval pericardial tumor. Microbiologic examination of the pus revealed propionibacterium acnes.
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5/509. Late diastolic tumor "plop" in an asymptomatic case of right atrial myxoma.

    Myxomas of the right atrium are rare tumors of the heart. They have been almost always described as symptomatic tumors. auscultation and phonocardiography have been revealed tumor "plop" (P) as an early diastolic phenomenon, but the late "plop" has not be described. The aim of the case report is to present late diastolic tumor "plop" in an asymptomatic case of right atrial myxoma. A thirty year old man without any subjective symptoms was admitted to the clinic because of a murmur found during a routine examination when applying for a new job. Two dimensional echocardiography showed slightly enlarged right atrium with a myxoma in it. M-mode echocardiogram taken from parasternal short axis plane revealed a wide cluster of echoes in the right atrium moving into the right ventricle inflow tract in diastole. Simultaneous phonocardiogram showed splitting of the first sound (0.06 sec.). The tumor "plop" occurred in late diastole, 0.22 seconds after the second sound (S2) and coincided with maximum tumor protrusion into the right ventricle. After successful operation of the tumor without catheterisation, echophonocardiographic finding has become quite normal.
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6/509. Right intraventricular metastasis of squamous cell carcinoma of the uterine cervix: an autopsy case and literature review.

    An autopsy case of squamous cell carcinoma of the uterine cervix, which developed cardiac intracavitary metastasis in a 28-year-old Filipina, is reported. At autopsy, the right ventricle contained a soft, red-purple, cauliflower-like mass. Histologically, this mass was made up of sheets of malignant squamous cells similar to the primary uterine foci. The metastases were extensive and associated with multiple organ involvement. Although this case was stage Ib at operation, vascular invasion at the primary site was characteristic, and the intracavitary tumor of the right ventricle developed without myocardial involvement. The carcinoma of the primary site extended along the inferior vena cava and settled as an intracardiac obstructive mass. A literature review (including the present case) disclosed only 14 uterine cervical carcinomas with right intracavitary metastasis. The mean age of these patients was 46 years of age (range, 28-77 years). The clinical stage was Ib in two cases, IIa in one case, IIb in six cases, and IIIb in two cases. The prognosis of these cases was poor; 13 of the patients died at an average of 19.1 months after diagnosis.
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7/509. tuberous sclerosis with intracardiac rhabdomyoma in a fetus with trisomy 21: case report and review of literature.

    A large cardiac rhabdomyoma protruding into the left ventricle was diagnosed in a fetus at 21 2 weeks of gestation by grey-scale echocardiography. Obstruction to left ventricular outflow was ruled out by colour and spectral Doppler echocardiography. No other abnormalities were noted and karyotyping by cordocentesis revealed trisomy 21 (47,XY, 21). Post-mortem examination after termination of pregnancy confirmed the prenatal diagnosis of cardiac rhabdomyoma and in addition revealed fetal tuberous sclerosis. Demonstration of cardiac rhabdomyoma by prenatal ultrasound should raise suspicion of the presence of fetal tuberous sclerosis. Despite the incidental association with aneuploidy, fetal karyotyping is suggested for optimal counselling of parents.
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8/509. Left ventricular hemangioma.

    Cardiac hemangiomas are rare, primary benign cardiac tumors. The authors report their experience of diagnosis and treatment of an hemangioma localized into the left ventricle. The tumor could be successfully resected and there is no recurrence at 1 year follow-up.
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9/509. Serial MRI of cerebral infarcts before and after removal of an atrial myxoma.

    We describe a cerebral infarct caused by atrial myxoma. A 30-year-old woman with an atrial myxoma presented with a right hemisensory deficit. MRI carried out before and after removal of the myxoma, showed multiple small bilateral white-matter infarcts which increased in number up to the surgery. A lesion in the left thalamus, which enlarged and showed contrast enhancement 4 months before surgery, resembled an old cerebral infarct by the time the myxoma was removed. The number of lesions stopped increasing after surgery. We suggest that atrial myxomas should be removed even in asymptomatic patients, to prevent cerebral infarcts due to embolism of tumour or thrombus.
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10/509. Pseudoaneurysm of the left ventricular free wall caused by tumor.

    Ventricular pseudoaneurysms occur as complications of myocardial infarction, cardiac operations, trauma, and infective endocarditis. The process involves rupture of the ventricular wall where a structural weakness exists and containment of the blood by the pericardium. Although various malignancies may invade the heart, a pseudoaneurysm of the left ventricle caused by tumor has not been reported.
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