• Journal of Chest Surgery
• /
• v.54 no.6
• /
• pp.532-534
• /
• 2021

This study examined a rarely seen benign heart tumor that was found incidentally on a chest X-ray. Radiological images were taken of a 42-year-old patient with no symptoms of a heart condition, showing a thick-walled left lung cavity that appeared after prior inflammation and concomitant enlargement of the cardiac shadow. A large subepicardial lipoma in combination with a chronic abscess on the left lung was revealed on chest computed tomography. The treatment consisted of simultaneous surgical removal of both the lung and heart lesions using video-assisted thoracoscopic surgery.

• Journal of Chest Surgery
• /
• v.43 no.4
• /
• pp.375-380
• /
• 2010

Background: Primary cardiac tumors are extremely rare. The most common type are benign myxomas, and these are almost completely curable with early surgery. Malignant tumors, however, such as sarcomas, are difficult to remove surgically, and their prognosis is known to be poor. In this study, data on patients who had undergone surgical treatment of cardiac tumor in the authors' hospital were collected and analyzed. Material and Method: The subjects included 28 patients who had undergone surgical treatment of cardiac tumor from August 1993 to December 2008. Their medical records were reviewed and retrospectively analyzed. Result: The patients were aged from 20 to 76 years (mean age: $54.2{\pm}15.6$), and 11 were male (39%) and 17 female (61%). Fifteen of them (54%) underwent emergency surgery to improve heart failure symptoms. The most common preoperative symptom was dyspnea (15 cases, 54%). Preoperative echocardiography was performed on all the patients. The average size of the tumor as measured during the operation was $7.0{\pm}6.9cm$ (the average length of the long axis was 2∼40 cm), and the sites of tumor attachment were the interatrial septum (18 cases, 64%), the left atrium (9 cases, 32%), the mitral valve annulus (2 cases, 7%), and the left ventricle (2 cases, 7%). The operation was performed with an incision through both atria in all the patients, and a complete excision was made in 25 cases (89%). According to the biopsy results, there were 4 cases of sarcoma (14%), 1 case of lipoma (4%), and 23 cases of myxoma (82%). The three cases in which the tumors were not completely excised were sarcomas. No operative deaths occurred after the operations. Outpatient follow-up was possible for 24 cases (86%), with a mean follow-up period of $46.8{\pm}42.7$ months. Late death occurred in 3 of the 24 patients; each of these patients had sarcomas. Of these patients, the first had undergone two repeat surgeries, the second had metastatic sites removed, and the last had only chemotherapy. The average recurrence time was $12.7{\pm}10.8$ months, and the average metastasis time was $20.5{\pm}16.8$ months. Conclusion: Most cardiac tumors are benign myxomas. In principle, they should be surgically treated because they can create risks such as embolism, and can be radically treated when surgically removed. In most cases, however, malignant sarcomas are already considerably advanced with severe infiltration into the neighboring tissues at the time of diagnosis. The surgical removal of malignant sarcomas is known to be difficult because of the advanced stage and degree of infiltration. We suggest that excision of the removable portion of the tumor sites to alleviate symptoms such as heart failure can improve quality of life.

• Journal of Chest Surgery
• /
• v.34 no.11
• /
• pp.861-864
• /
• 2001

tumors. We report a primary cardiac myxosarcoma in a 40-year-old female patient who was admitted to the hospital because of exertional dyspnea and palpitation. The patient underwent emergency operation immediately after the intracardiac (left atrium) tumor was discovered by an echocardiography. Palliative tumor removal was done and final Pathologic diagnosis was primary cardiac myxosarcoma. She was discharged without complications.

• Journal of Chest Surgery
• /
• v.43 no.2
• /
• pp.176-179
• /
• 2010

Cardiac papillary fibroelastomas are the second most common primary tumor of the heart and they most commonly affect the left cardiac valves. However, occurrence of this tumor on the right side of the heart has been rarely reported, with only a few cases having been documented on the pulmonary valve. We present here a rare case of a papillary fibroelastoma that occurred on the pulmonary valve and this was successfully managed by replacing the pulmonary valve in a patient with congestive heart failure.

• Journal of Chest Surgery
• /
• v.25 no.12
• /
• pp.1550-1555
• /
• 1992

From June 1989 to July 1992, we used centrifugal Biomedicus pump[CBP] in 20 patients In 9 cases, CBP was used as ventricular assistance after heart surgery for those who could not be weaned off bypass even with intra-aortic balloon counter-pulsation and with maximal inotropic support In 8 patients, CBP was used as partial left heart bypass during repair of aortic aneurysms or congenital aortic anomalies. And in 3 patients, CBP was used as vena caval bypass during resection of renal cell carcinoma with tumor extension into the inferior vena cava. In 2 of 9 patients with ventricular assistance, they were weaned off the device successfully after 16 hours and 7 days respectively. But the patients died of intracranial hemorrhage and sepsis, 7 and 29 days after weaning from cardiac support, respectively. In all the patients who underwent aortic of vena caval surgery using CBP as shunt, there were no complications such as postoperative bleeding necessitating reoperation, renal failure or neurologic sequelae. In conclusion, the centrifugal type of ventricular assistance may be potentially life saving treatment modality in patients with severe postoperative low cardiac output syndrome. The CBP can be safely employed for resection of renal cell carcinoma with vena caval tumor extension and for repair of aortic aneurysms.

• Journal of Chest Surgery
• /
• v.39 no.11 s.268
• /
• pp.858-860
• /
• 2006

Papillary fibroelastoma is the second most common benign cardiac tumor, usually involving the cardiac valve. Papillary fibroelastoma attached at the right coronary cusp of the aortic valve was found in a 51-year-old woman, who was presented with chest pain and dyspnea. During the operation, the tumor mass was excised without causing damage on the aortic valve leaflet.

• Investigative Magnetic Resonance Imaging
• /
• v.15 no.2
• /
• pp.165-169
• /
• 2011

Cardiac myxoma is the most common benign tumor of the heart. However, low incidence of recurrence and metastasis has been reported. A 49-year-old female patient was admitted in the hospital due to sudden onset of left side weakness. Magnetic resonance imaging (MRI) of brain showed multifocal areas of diffusion restriction on diffusion weighted images. Echocardiography was performed to evaluate the cause of embolic brain infarction and cardiac myxoma was found in the left atrium. The patient underwent complete excision of the mass. One year later, the patient was readmitted with symptoms of dysarthria. Brain MRI showed newly developed multiple hemorrhagic metastatic lesions. The patient underwent radiotherapy of the metastatic lesions. Although rare, cardiac myxoma can cause delayed metastasis. We report a rare case of delayed multiple cerebral metastases from the completely resected cardiac myxoma.

• Journal of Chest Surgery
• /
• v.29 no.3
• /
• pp.311-314
• /
• 1996

Eighteen patients (13 female and ave male) aged from 15 to 62 years (mean age 42.6 years) underwent excision of cardiac myxoma(17 left atrial, one right atrial) between 1985 and 1994 at Pusan National University hospital. All patients complained of exertional dyspnea and most had a few additional symtoms including palpitation, chest pain, syncope, general weakness, weight loss, fever, cough and epigastric disconyort. The diagnosis was made by echocardiography alone in left atrial myxomas but a myxoma in right atrium was diagnosed incidentally during mitral valve replacement for rheumatic valvular heart disease. The tumor attachment sites were fossa ovalis in 13, other interatrial septum in 4, mitral valve annulus in one and free wall of left atrium in two cases. The tumor was excised successfully via right atriotomy in 8 and biatriotomy in 10 cases. There was no hospital nor late death, and no recurrent case during the follow up period. Curative surgical excision of cardiac myxoma can be performed with low morbidity and very low r currence rate.

• Asian Pacific Journal of Cancer Prevention
• /
• v.13 no.1
• /
• pp.247-250
• /
• 2012

Objective: To determine whether CDX2 and villin protein expression are associated with intestinal metaplasia (IM) in gastric cardiac mucosa and to explore the relationship with evolution of gastric cardiac adenocarcinoma (GCA). Methods: We studied 143 gastric cardiac biopsy or resection specimens from Henan province China, including 25 cardiac gastritis specimens with IM, 65 dysplasia specimens with IM and 35 gastric cardiac adenocarcinoma specimens and stained them for CDX2 and villin by the immunohistochemical SP method. 15 normal gastric cardiac biopsy specimens were also collected as control. Results: (1) Normal gastric mucosa presented no CDX2 and villin expression. The positive rates of CDX2 protein in cardiac gastritis with IM, dysplasia with IM, and carcinoma tissues were 84.0% (21/25), 66.7% (32/48) and 36.4% (20/55), respectively. While the positive rates of villin protein in cardiac gastritis with IM, dysplasia with IM, and carcinoma tissues were 76.0% (19/25), 70.8% (34/48) and 45.5% (25/55), respectively. There were significant differences among the three groups for both CDX2 and villin (P<0.01). Spearman's rank correlation coefficient(rho) showed a close correlation between the two proteins (r=0.843, P<0.01) and both were positively related with tumor differentiation (both P<0.05), but not associated with age, sex, invasion and metastasis of lymph node (P>0.05). Conclusion: Our results suggest that ectopic expression of CDX2 and villin may be involved in early-stage IM and tumorigenesis in gastric cardia and the expression of villin may be regulated by CDX2.

• Journal of Chest Surgery
• /
• v.20 no.3
• /
• pp.570-573
• /
• 1987

A surgical operation on a patient with infected left atrial myxoma is presented. The patient was a 50-year-old woman who was admitted to the Kyung Hee Medical Center Hospital on March 7 1987 with complaints of high fever, cough and dyspnea that occurred a few days prior to admission. She, who no definite history of the previous cardiac-related problems was obtained from, had visited a dentist to have her eight teeth pulled out a few months prior to this admission. A preoperative 2-D echocardiogram revealed a left atrial tumor, strongly suggesting myxoma and two blood cultures drawn prior to surgery yielded streptococcus viridans. Under the preoperative impression of an infected left atrial myxoma, the tumor was removed through a biatrial approach after establishing CPB and cold cardioplegic. Pathologic examination of the tumor demonstrated a typical myxoma with bacterial colonies within. Postoperative course was uneventful and she was completely well at discharge from the hospital. To our best knowledge, this report is the first surgical experience of infected left atrial myxoma in the Korean literature.