11/59. Inferior vena cava--right atrial tumor thrombus in malignant pelvic bone tumors in children.Two patients with IVC and right atrial tumor thrombus associated with malignant bone tumors are described. Other tumors such as Wilms', renal cell CA, testicular adrenal and hepatic neoplasms have also been reported to invade the IVC. Ultrasound, CT and MRI are helpful in evaluating the presence of vascular thrombosis as well as its longitudinal extent, and intracardiac involvement.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
12/59. Electric dissociation within left atrial appendage diagnosed by Doppler echocardiography.We describe a patient who presented with a transient ischemic event in whom transesophageal echocardiography showed presence of an accessory lobe within the left atrial appendage that was in atrial fibrillation by pulsed wave Doppler when the left and right atrial appendages, pulmonary vein, and right atria were in sinus rhythm.- - - - - - - - - - ranking = 8471.0379340263keywords = appendage (Clic here for more details about this article) |
13/59. Large atrial appendage thrombus in the presence of severe mitral regurgitation: contradictory hemodynamics or expected findings.A case of a large left atrial appendage thrombus in the presence of severe mitral regurgitation is presented. The use of transesophageal echocardiography in this setting was not only useful but also crucial despite the low anticipated diagnostic yield given the expected altered left atrial flow dynamics from the turbulent regurgitant lesion. However, additional confounding factors could have acted as potential mechanisms to enhance thrombosis in this setting and consequently are discussed.- - - - - - - - - - ranking = 7059.1982783552keywords = appendage (Clic here for more details about this article) |
14/59. Calcified right ventricular mass and pulmonary embolism in a previously healthy young woman.A 20-year-old woman with a recent episode of pulmonary embolism was found by echocardiographic examination to have a calcified apical right ventricular intracavitary mass. She had a history of cigarette smoking and had been taking oral contraceptive pills. At age 17 years, she had sustained substantial blunt chest injury during a motor vehicle accident. The intracardiac mass was resected and represented an old calcified mural thrombus. It is postulated that its development was related to cardiac trauma. These intracavitary masses have been referred to as cardiac calcified amorphous tumors and generally represent old organized and focally calcified mural thrombus. They should be distinguished from calcified benign or malignant neoplasms of the heart.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
15/59. Three unusual myxomas originating from the left atrial appendage: a case report.Most left atrial appendage masses have been reported to be thrombus, particularly in the presence of atrial fibrillation. The presence of any mass other than thrombus is extremely rare in the left atrial appendage. This report presents the rare case of a 70-year-old woman presenting with paroxysmal atrial fibrillation and syncope who was given the diagnosis of having 3 myxomas originating from the left atrial appendage. The diagnosis was established by the help of transesophageal echocardiography and confirmed by histologic examination after operation. The advantage of transesophageal echocardiography in this case and for patients with atrial fibrillation is emphasized.- - - - - - - - - - ranking = 9882.8775896973keywords = appendage (Clic here for more details about this article) |
16/59. A microscopic adenocarcinoma of the stomach with pulmonary tumor thrombotic microangiopathy in a 17-year-old male.Pulmonary tumor thrombotic microangiopathy (PTTM), characterized by widespread fibrocellular intimal proliferation of the small pulmonary arteries and arterioles in patients with metastatic carcinomas, has been reported in only few cases. In childhood, gastrointestinal tumors represent less than 5% of pediatric neoplasms, and carcinomas within this subgroup have been very rarely described, in particular those arising in the stomach. We report on a case of a microscopic gastric signet-ring cell carcinoma identified by serial step sections through the entire stomach at autopsy. The patient was a 17-year-old high school student with severe dyspnea and marked pulmonary hypertension due to PTTM. Although the combination of PTTM with gastric cancer is very rare in childhood, it should be considered in the differential diagnosis of primary pulmonary hypertension and progressive respiratory failure, as indicated by a review of previously reported cases.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
17/59. asphyxia by tracheobronchial thrombus.asphyxia secondary to airway obstruction has numerous underlying causes, both acute and chronic. Causes of chronic airway obstruction, such as neoplasms and tracheal scarring, are often clinically apparent well prior to asphyxia. Causes of acute airway obstruction may not be as obvious to clinicians or investigators. These include infections, anaphylactic reactions, status asthmaticus, inhalational injuries, and aspirations, which may result in acute obstruction and sudden death.We report the deaths of 2 individuals, a 43-year-old female and a 78-year-old female, both with adenocarcinoma. The 43-year-old was hospitalized with a stage III, poorly differentiated infiltrating ductal carcinoma of the breast metastatic to the lymph nodes. She was intubated to treat poor respiratory function and acidosis. A bronchoalveolar lavage was consistent with alveolar hemorrhage; no organisms were identified. Blood and "clot" were in her endotracheal tube, so the endotracheal tube was replaced. She became comatose and life support was withdrawn. At autopsy, a large red-gray thrombus obstructed the trachea and extended into the right bronchus. Microscopically, the entire clot was composed of fibrin, red blood cells, and some mucus. Findings of acute respiratory distress syndrome with hyaline membranes were identified. The cause of death was listed as acute respiratory distress syndrome with tracheobronchial thrombus. Experiencing a decline in mental status, the 78-year-old had metastatic adenocarcinoma of unknown primary. She developed sudden respiratory distress and an airway obstruction was discovered. After failure to relieve the obstruction, she decompensated and died. At autopsy, a large, red-gray thrombus obstructed the distal trachea and both bronchi. Microscopically, the thrombus was composed of fibrin, platelets, and red blood cells. The cause of death was asphyxia secondary to airway obstruction by thrombus. We present these 2 unusual cases of asphyxia and review of the literature focusing on asphyxia and the etiology of airway thrombi.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
18/59. An inverted left atrial appendage mimicking an intraatrial thrombus after a ross operation.Inverted left atrial appendage (ILAA) is a rare manifestation. The case is reported of a patient with a history of factor v Leiden who underwent a Ross operation. An intra-atrial mass was discovered one month postoperatively and suspected to be a thrombus. Despite six months' anticoagulant treatment, the intra-atrial mass persisted. Ultimately, the patient was reoperated on due to hemostatic risks factors, and an ILAA was found. The diagnosis of ILAA remains a major challenge. Despite widespread use of postoperative echocardiography, the few reported cases confirm ILAA to be a rare phenomenon. The finding at post-cardiotomy echocardiography of a left atrial mass associated with an absence of the left appendage is highly suggestive of a diagnosis of ILAA. As the incidence of complications remains to be defined, treatment remains controversial, but embolic risk factors such as hemostatic disease or atrial fibrillation invariably lead to surgery. In an asymptomatic patient without thromboembolic risks factors, a conservative approach should be considered, because of the risk of reoperation.- - - - - - - - - - ranking = 8471.0379340263keywords = appendage (Clic here for more details about this article) |
19/59. Robotic-assisted left atrial ligation for stroke reduction in chronic atrial fibrillation: a case report.patients with atrial fibrillation are at significant risk for sustaining a thromboembolic stroke. More than 90% of thromboemboli form in the left atrial appendage. ligation of the left atrial appendage to reduce the risk of stroke is often performed in connection with other cardiac surgical procedures. As a stand-alone procedure, however, left atrial ligation has generally been deemed too invasive and has gained little support as an alternative therapeutic option. We report a case of port-access robotic-assisted left atrial ligation as a stand-alone procedure in a patient with chronic atrial fibrillation in whom anticoagulation was a contraindication. To our knowledge, this is the first reported case of stand-alone robotic-assisted left atrial ligation in the literature.- - - - - - - - - - ranking = 2823.6793113421keywords = appendage (Clic here for more details about this article) |
20/59. Multifocal penile epithelioid hemangioendothelioma masquerading as superficial penile vein thrombosis.A 42-year-old man presented with a progressively painful mass of the penile shaft that clinically resembled superficial penile vein thrombosis. The patient's symptoms were refractory to conservative therapy, and surgical excision revealed multifocal penile epithelioid hemangioendothelioma. He had no evidence of metastatic disease and was well 1 year after excision. vascular neoplasms should be included in the differential diagnosis of painful penile masses and penile thrombophlebitis. To our knowledge, this is only the second reported case of multifocal penile epithelioid hemangioendothelioma.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
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