Cardiac tumors are rare.However,cardiac metastases can occur in up to 10%of patients with cancer.Among cardiac neoplasms,metastases are much more common than primary cardiac tumors.[1]Metastatic cardiac neoplasms most...Cardiac tumors are rare.However,cardiac metastases can occur in up to 10%of patients with cancer.Among cardiac neoplasms,metastases are much more common than primary cardiac tumors.[1]Metastatic cardiac neoplasms most frequently metastasize from the respiratory system.展开更多
Cardiac myxomas are common primary neoplasms of the heart.They are biologically benign but“functionally malignant”because of the potential for embolization.They arise most commonly from the left atrium,but no chambe...Cardiac myxomas are common primary neoplasms of the heart.They are biologically benign but“functionally malignant”because of the potential for embolization.They arise most commonly from the left atrium,but no chambers of the heart are immune.They may be sporadic in the majority but also familial as a part of the Carney complex.Two morphological forms exist:polypoid and papillary.Polypoid myxomas often present with obstructive features,while the papillary forms are more prone to embolization.Histogenesis is still controversial;the current view centres around origin from the primitive pluripotent mesenchymal cells.They may be of giant proportion,be calcified or get infected.Clinical presentation typically involves the triad of intracardiac obstruction,embolic events and constitutional symptoms.Precordial examination findings may simulate those of mitral or tricuspid stenosis.The presence of tumour plop and change of the physical findings with changing position may help differentiation between the two.Echocardiography is the investigation of choice.Echogenic polypoid or papillary mobile mass within the atrial cavity remaining attached to the interatrial septum through a stalk are the tell-tale echocardiographic features.Cardiac magnetic resonance and computed tomographic scanning may have incremental diagnostic value.Histopathological examination reveals abundant loose myxoid stroma with scattered round,polygonal or stellate cells with dense irregular nuclei.Genetic testing may detect mutations in the PRKAR1A gene in the familial form of cardiac myxoma,i.e.the Carney complex.Surgical excision is the mainstay of treatment with low operative mortality,excellent postoperative survival and low recurrence rate.The current trend favours minimal-access surgery with or without robotic assistance.Physicians should have appropriate preparedness to make a timely diagnosis and enthusiastic treatment to avoid potentially fatal complications.展开更多
The heart is an unusual site of metastasis from any malignancy.We report a case of cardiac metastasis from colorectal cancer.A 70-year-old woman was referred with a presumptive diagnosis of sigmoid colon cancer with c...The heart is an unusual site of metastasis from any malignancy.We report a case of cardiac metastasis from colorectal cancer.A 70-year-old woman was referred with a presumptive diagnosis of sigmoid colon cancer with cardiac myxoma.Two-dimensional echocardiography showed a 4 cm × 4.5 cm mobile mass on the lateral right atrial wall,and computed tomography revealed a low attenuated lobulating mass in the right atrium.The patient underwent anterior resection for sigmoid colon cancer(T4N2).Thereafter,she experienced progressive shortness of breath.Therefore,a cardiac operation was performed 2 wk after the colorectal operation.Histological examination revealed adenocarcinoma,which was identical to the primary lesion.Although two-dimensional echocardiography has become the diagnostic test of choice for detecting cardiac tumors,in patients with colorectal cancer showing a cardiac mass,further diagnostic evaluation such as a magnetic resonance imaging might be necessary.展开更多
Papillary fibroelastoma(PFE)is a primary,histologically benign endocardial neoplasm.Though PFE has long been reported as the second most common primary cardiac neoplasm,it has since pulled ahead of cardiac myxomas,lar...Papillary fibroelastoma(PFE)is a primary,histologically benign endocardial neoplasm.Though PFE has long been reported as the second most common primary cardiac neoplasm,it has since pulled ahead of cardiac myxomas,largely due to evolving cardiac imaging modalities.While PFEs are benign histologically,they have the potential for devastating clinical consequences,transient ischemic attack,stroke,myocardial infarction,syncope,pulmonary,and peripheral embolism.Despite increased detection rate,there remains uncertainty regarding etiology,exact prevalence,and clinical management of PFEs.This paucity of information is reflected by the lack of official guidelines on this matter.In this article,we aim to summarize the current state of understanding regarding PFE and discuss areas of ongoing controversy.展开更多
Tumors of the cardiac conduction system(CCS) have rarely been reported. The CCS from 198 cardiac-related deaths(Group Ⅰ) ,and 838 deaths from non-cardiovascular diseases or trauma(Group Ⅱ) ,were studied. Sampling wa...Tumors of the cardiac conduction system(CCS) have rarely been reported. The CCS from 198 cardiac-related deaths(Group Ⅰ) ,and 838 deaths from non-cardiovascular diseases or trauma(Group Ⅱ) ,were studied. Sampling was done of the sinoatrial node(SAN) and atrio-ventricular node(AVN) along their long axis of each node as a single block and the His bundle(HB) perpendicular to its long axis in 2-4 blocks. Five-micron serial sections were made;tissue slices were taken intermittently,every 20th from the SAN,every 10th from the AVN,and every 30th from the HB and bundle branches(BB) ,by continuous slices three times. Tumors in the CCS were found in 12 cases(1.155 %) ,where 10(0.965%) were primary tumors,and 2(0.193%) were metastatic tumors. The primary tumors included 4 fibromata compressing the HB(0.386 %) ,4 hemangiomata(0.386%) ,1 AVN tumor(0.097 %) ,and 1 rhabdomyoma(0.097 %) . In 8 of the 10 cases,the tumors were located in the AVN or HB. The metastatic tumors originated from lymphocytic leukemia and malignant lymphoma(histiocytic type) in lung,and were all found in the SAN. Of the 12 cases,2 were from the group Ⅰ. Tumors in the CCS are the smallest tumors in different parts of the body,which can cause sudden death.展开更多
Primary cardiac hemangioendothelioma is extremely rare.1-3 Up to now less than twenty cases have been reported in English literature, the data about this kind of cardiac tumors are scanty. In this report, a case of a ...Primary cardiac hemangioendothelioma is extremely rare.1-3 Up to now less than twenty cases have been reported in English literature, the data about this kind of cardiac tumors are scanty. In this report, a case of a huge hemangio-endothelioma that arose from the right atrium and was successfully resected is presented.展开更多
Primary cardiac neoplasms are exceedingly rare with a reported prevalence of 0.001% to 0.03% in autopsy series. Sarcomas that most frequently encountered are angiosarcoma, undifferentiated sarcoma, osteosarcoma and le...Primary cardiac neoplasms are exceedingly rare with a reported prevalence of 0.001% to 0.03% in autopsy series. Sarcomas that most frequently encountered are angiosarcoma, undifferentiated sarcoma, osteosarcoma and leiomyosarcoma, being the second most common primary cardiac neoplasm in all age groups.展开更多
背景与目的目前肺癌已经成为老年肿瘤患者中最常见的恶性肿瘤类型之一,而手术仍是其首选治疗手段,在老年肺癌患者术后并发症中,心律失常的发生率最高。本研究旨在分析70岁以上高龄肺癌患者术后早期心律失常的危险因素。方法回顾性分析1...背景与目的目前肺癌已经成为老年肿瘤患者中最常见的恶性肿瘤类型之一,而手术仍是其首选治疗手段,在老年肺癌患者术后并发症中,心律失常的发生率最高。本研究旨在分析70岁以上高龄肺癌患者术后早期心律失常的危险因素。方法回顾性分析1997年7月-2008年5月在解放军总医院胸外科行原发性肺癌切除术的352例高龄患者中术后出现心律失常者的危险因素。单因素分析应用χ2检验,多因素分析应用Logistic回归进行统计。结果 352例高龄肺癌患者中,术后发生心律失常者71例,发生率为20.2%。经多因素分析发现,患者的年龄、合并心血管疾病史、术前心电图异常、一秒用力呼气容积(forced expiratory volume in one second,FEV1)、心脏射血分数(ejec-tion fraction,EF)、手术方式的选择、手术时间与术后心律失常相关,且均为危险因素。结论应注意预防高龄肺癌患者术后心律失常的发生。展开更多
文摘Cardiac tumors are rare.However,cardiac metastases can occur in up to 10%of patients with cancer.Among cardiac neoplasms,metastases are much more common than primary cardiac tumors.[1]Metastatic cardiac neoplasms most frequently metastasize from the respiratory system.
文摘Cardiac myxomas are common primary neoplasms of the heart.They are biologically benign but“functionally malignant”because of the potential for embolization.They arise most commonly from the left atrium,but no chambers of the heart are immune.They may be sporadic in the majority but also familial as a part of the Carney complex.Two morphological forms exist:polypoid and papillary.Polypoid myxomas often present with obstructive features,while the papillary forms are more prone to embolization.Histogenesis is still controversial;the current view centres around origin from the primitive pluripotent mesenchymal cells.They may be of giant proportion,be calcified or get infected.Clinical presentation typically involves the triad of intracardiac obstruction,embolic events and constitutional symptoms.Precordial examination findings may simulate those of mitral or tricuspid stenosis.The presence of tumour plop and change of the physical findings with changing position may help differentiation between the two.Echocardiography is the investigation of choice.Echogenic polypoid or papillary mobile mass within the atrial cavity remaining attached to the interatrial septum through a stalk are the tell-tale echocardiographic features.Cardiac magnetic resonance and computed tomographic scanning may have incremental diagnostic value.Histopathological examination reveals abundant loose myxoid stroma with scattered round,polygonal or stellate cells with dense irregular nuclei.Genetic testing may detect mutations in the PRKAR1A gene in the familial form of cardiac myxoma,i.e.the Carney complex.Surgical excision is the mainstay of treatment with low operative mortality,excellent postoperative survival and low recurrence rate.The current trend favours minimal-access surgery with or without robotic assistance.Physicians should have appropriate preparedness to make a timely diagnosis and enthusiastic treatment to avoid potentially fatal complications.
文摘The heart is an unusual site of metastasis from any malignancy.We report a case of cardiac metastasis from colorectal cancer.A 70-year-old woman was referred with a presumptive diagnosis of sigmoid colon cancer with cardiac myxoma.Two-dimensional echocardiography showed a 4 cm × 4.5 cm mobile mass on the lateral right atrial wall,and computed tomography revealed a low attenuated lobulating mass in the right atrium.The patient underwent anterior resection for sigmoid colon cancer(T4N2).Thereafter,she experienced progressive shortness of breath.Therefore,a cardiac operation was performed 2 wk after the colorectal operation.Histological examination revealed adenocarcinoma,which was identical to the primary lesion.Although two-dimensional echocardiography has become the diagnostic test of choice for detecting cardiac tumors,in patients with colorectal cancer showing a cardiac mass,further diagnostic evaluation such as a magnetic resonance imaging might be necessary.
文摘Papillary fibroelastoma(PFE)is a primary,histologically benign endocardial neoplasm.Though PFE has long been reported as the second most common primary cardiac neoplasm,it has since pulled ahead of cardiac myxomas,largely due to evolving cardiac imaging modalities.While PFEs are benign histologically,they have the potential for devastating clinical consequences,transient ischemic attack,stroke,myocardial infarction,syncope,pulmonary,and peripheral embolism.Despite increased detection rate,there remains uncertainty regarding etiology,exact prevalence,and clinical management of PFEs.This paucity of information is reflected by the lack of official guidelines on this matter.In this article,we aim to summarize the current state of understanding regarding PFE and discuss areas of ongoing controversy.
文摘Tumors of the cardiac conduction system(CCS) have rarely been reported. The CCS from 198 cardiac-related deaths(Group Ⅰ) ,and 838 deaths from non-cardiovascular diseases or trauma(Group Ⅱ) ,were studied. Sampling was done of the sinoatrial node(SAN) and atrio-ventricular node(AVN) along their long axis of each node as a single block and the His bundle(HB) perpendicular to its long axis in 2-4 blocks. Five-micron serial sections were made;tissue slices were taken intermittently,every 20th from the SAN,every 10th from the AVN,and every 30th from the HB and bundle branches(BB) ,by continuous slices three times. Tumors in the CCS were found in 12 cases(1.155 %) ,where 10(0.965%) were primary tumors,and 2(0.193%) were metastatic tumors. The primary tumors included 4 fibromata compressing the HB(0.386 %) ,4 hemangiomata(0.386%) ,1 AVN tumor(0.097 %) ,and 1 rhabdomyoma(0.097 %) . In 8 of the 10 cases,the tumors were located in the AVN or HB. The metastatic tumors originated from lymphocytic leukemia and malignant lymphoma(histiocytic type) in lung,and were all found in the SAN. Of the 12 cases,2 were from the group Ⅰ. Tumors in the CCS are the smallest tumors in different parts of the body,which can cause sudden death.
文摘Primary cardiac hemangioendothelioma is extremely rare.1-3 Up to now less than twenty cases have been reported in English literature, the data about this kind of cardiac tumors are scanty. In this report, a case of a huge hemangio-endothelioma that arose from the right atrium and was successfully resected is presented.
文摘Primary cardiac neoplasms are exceedingly rare with a reported prevalence of 0.001% to 0.03% in autopsy series. Sarcomas that most frequently encountered are angiosarcoma, undifferentiated sarcoma, osteosarcoma and leiomyosarcoma, being the second most common primary cardiac neoplasm in all age groups.
文摘背景与目的目前肺癌已经成为老年肿瘤患者中最常见的恶性肿瘤类型之一,而手术仍是其首选治疗手段,在老年肺癌患者术后并发症中,心律失常的发生率最高。本研究旨在分析70岁以上高龄肺癌患者术后早期心律失常的危险因素。方法回顾性分析1997年7月-2008年5月在解放军总医院胸外科行原发性肺癌切除术的352例高龄患者中术后出现心律失常者的危险因素。单因素分析应用χ2检验,多因素分析应用Logistic回归进行统计。结果 352例高龄肺癌患者中,术后发生心律失常者71例,发生率为20.2%。经多因素分析发现,患者的年龄、合并心血管疾病史、术前心电图异常、一秒用力呼气容积(forced expiratory volume in one second,FEV1)、心脏射血分数(ejec-tion fraction,EF)、手术方式的选择、手术时间与术后心律失常相关,且均为危险因素。结论应注意预防高龄肺癌患者术后心律失常的发生。
