Oncotic (Myxomatous) Aneurysms: A Review of Management

AbstractAtrial myxomas are the most common primary cardiac tumors and may manifest with neurological symptoms in ∼ 30% of cases. Cerebral ischemia, aneurysmal formation, and extravascular metastases are mechanisms that lead to these neurological manifestations. Perilesional changes on computed tomography (CT) and magnetic resonance imaging (MRI) may help in the diagnosis of myxomatous aneurysms, which are usually located in the distal middle cerebral artery (MCA) and in the posterior cerebral artery (PCA) circulation territories. Careful resection of the cardiac lesion is essential for preventing embolism. However, treatment of myxomatous aneurysms is controversial due to the limited understanding of the natural history of this condition. Treatment may include clinical observation in asymptomatic patients, surgical resection, endovascular approaches, adjuvant chemotherapy, and low-dose radiation therapy. We present one case of a female patient with myxomatous aneurysm secondary to an atrial myxoma who presented with neurological symptoms and another case of a female patient who developed neurological symptoms after initial surgical treatment of the primary lesion. Lesion growth rate, topography, morphology, and the patient's clinical condition must be considered when choosing a therapeutical method. Further clinical studies are needed to achieve a better understanding and treatment of this disease.

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Unusual presentation during childhood of left ventricular myxoma

Cardiology in the Young ◽

10.1017/s1047951100004777 ◽

1998 ◽

Vol 8 (1) ◽

pp. 126-127 ◽

Cited By ~ 5

Author(s):

A. Kapoor ◽

S. Radhakrishnan ◽

N. Sinha

Keyword(s):

Left Ventricle ◽

Left Atrium ◽

Febrile Illness ◽

Left Ventricular ◽

Unusual Presentation ◽

Cardiac Tumors ◽

History Of ◽

Primary Cardiac Tumors

AbstractAmongst all primary cardiac tumors, myxomas are the commonest, and their commonest site of origin is the left atrium. Myxomas originating in the left ventricle are rare. When seen, they usually present with a history of systemic embolisation and/or syncopal episodes, with constitutional symptoms being absent. We report here a child with left ventricular myxoma who presented with a prolonged febrile illness.

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Coincident craniopharyngioma and unruptured aneurysm at the right M1- M2 segment of the middle cerebral artery. Case report 1

JBNC - JORNAL BRASILEIRO DE NEUROCIRURGIA ◽

10.22290/jbnc.v29i01.1719 ◽

2019 ◽

Vol 29 (01) ◽

pp. 35-39

Author(s):

Williams Escalante ◽

Denis Isao Ueoka ◽

Eduardo Andre Goulart de Alcântara ◽

Anderson Rodrigo de Sousa ◽

Paulo Henrique Pires de Aguiar ◽

...

Keyword(s):

Middle Cerebral Artery ◽

Cerebral Artery ◽

Unruptured Aneurysm ◽

Vascular Lesions ◽

Resonance Imaging ◽

Surgical Time ◽

Appropriate Treatment ◽

History Of ◽

Magnetic Resonance Imaging Mri ◽

The Right

We report a case of coincident craniopharyngioma with an unruptured aneurysm at the right M1- M2 segment of the middle cerebral artery; and discuss the surgical approach to two different pathologies treated at same surgical time, as well as current theories to explain the coincidence or association between tumor and vascular lesions at the sellar and suprasellar regions. The patient was a 59-year-old woman; with a history of visual impairment and headache. Both lesions were identified by magnetic resonance imaging (MRI) and cerebral angiography, and were treated surgically. We suggest individualized treatment for each case, choosing the best neurosurgical approach to achieve an appropriate treatment of both pathologies in the same operative session.

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Cardiac lymphoma with early response to chemotherapy: A case report and review of the literature

Journal of Nuclear Cardiology ◽

10.1007/s12350-021-02570-5 ◽

2021 ◽

Author(s):

Andrea Bonelli ◽

Sara Paris ◽

Stefano Bisegna ◽

Giuseppe Milesi ◽

Emanuele Gavazzi ◽

...

Keyword(s):

Imaging Techniques ◽

Early Response ◽

Cardiac Tumors ◽

Cardiac Lymphoma ◽

Asymptomatic Patients ◽

Response To Chemotherapy ◽

Great Vessels ◽

History Of ◽

Good Improvement ◽

Specific Symptoms

AbstractCardiac tumors are rare and benign masses account for the most part of the diagnosis. When malignant cancer is detected, primary or secondary cardiac lymphoma are quite frequent. Cardiac lymphoma may present as an intra or peri-cardiac mass or, rarely, it may diffusely infiltrate the myocardium. Although often asymptomatic, patients can have non-specific symptoms. Acute presentations with cardiogenic shock, unstable angina, or acute myocardial infarction are also described. Modern imaging techniques can help the clinicians not only in the diagnostic phase but also during administration of chemotherapy. A multidisciplinary counseling and serial multi-parametric assessment (echocardiography, cardiac troponin) seem to be the most effective approach to prevent possible fatal complications (i.e., cardiac rupture). Currently, only chemo- and radiotherapy are available options for treatment, but the prognosis remains poor. This is a case of secondary cardiac lymphoma presenting as a mediastinal mass with large infiltration of the heart and the great vessels with a good improvement after only one cycle of chemotherapy. It demonstrates the importance of an early diagnosis to modify the natural history of the disease.

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Refractory Ascites as the Only Presenting Symptom of Chronic Calcified Constrictive Pericarditis: A Diagnostic Challenge

The Heart Surgery Forum ◽

10.1532/hsf98.2013251 ◽

2014 ◽

Vol 17 (1) ◽

pp. 42

Author(s):

Shi-Min Yuan

Keyword(s):

Computed Tomography ◽

Liver Cirrhosis ◽

Female Patient ◽

Constrictive Pericarditis ◽

Delayed Diagnosis ◽

Young Female ◽

Refractory Ascites ◽

Diagnostic Challenge ◽

Massive Ascites ◽

History Of

Extracardiac manifestations of constrictive pericarditis, such as massive ascites and liver cirrhosis, often cover the true situation and lead to a delayed diagnosis. A young female patient was referred to this hospital due to a 4-year history of refractory ascites as the only presenting symptom. A diagnosis of chronic calcified constrictive pericarditis was eventually established based on echocardiography, ultrasonography, and computed tomography. Cardiac catheterization was not performed. Pericardiectomy led to relief of her ascites. Refractory ascites warrants thorough investigation for constrictive pericarditis.

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Magnetic Resonance Imaging of Pseudo-impingement of Rotator Cuff with Strength Training

10.25259/ijmsr_21_2019 ◽

2019 ◽

Vol 1 ◽

pp. 2-6

Author(s):

Asad Naqvi ◽

Timothy Ariyanayagam ◽

Mir Akber Ali ◽

Akhila Rachakonda ◽

Hema N. Choudur

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Rotator Cuff ◽

Strength Training ◽

Radiology Department ◽

Resonance Imaging ◽

Subacromial Space ◽

History Of ◽

Magnetic Resonance Imaging Mri ◽

Training Exercises

Objective: The objective of this study was to outline a novel unique concept of secondary impingement of the muscles, myotendons, and tendons of the rotator cuff from hypertrophy as a result of strength training exercises. Methods: In this retrospective observational study, 58 patients were referred for an magnetic resonance imaging (MRI) by the orthopedic surgeon to the radiology department over a period of 1½ years. All patients gave a history of strength training exercises and presented with clinical features of rotator cuff impingement. Results: We identified features of hypertrophy of rotator cuff muscles, myotendons, and tendons in 12 of these 58 patients. This was the only abnormality on MRI. The hypertrophy of rotator cuff muscles and tendon bulk completely filling the subacromial space to the point of overfilling and resulting in secondary compressive features. Conclusion: Rotator cuff impingement is a common phenomenon that can occur with various inlet and outlet pathological conditions. However, rotator cuff impingement may also result from muscle and tendon hypertrophy from strength training regimens. Hypertrophy of the rotator cuff can result in overfilling of the subacromial space, leading to secondary impingement, which we have termed as “pseudo-impingement.”

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Computed Tomography and Magnetic Resonance Imaging-aided Diagnosis of Primary Essential Cutis Verticis Gyrata: A Case Report with 5-year Follow-up and Review of the Literature

Current Medical Imaging Formerly Current Medical Imaging Reviews ◽

10.2174/1573405614666181005113448 ◽

2019 ◽

Vol 15 (9) ◽

pp. 906-910

Author(s):

Hongzhang Zhu ◽

Shi-Ting Feng ◽

Xingqi Zhang ◽

Zunfu Ke ◽

Ruixi Zeng ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Three Dimensional ◽

Stable Condition ◽

Resonance Imaging ◽

Mri Findings ◽

Cutis Verticis Gyrata ◽

Essential Form ◽

History Of ◽

Magnetic Resonance Imaging Mri

Background: Cutis Verticis Gyrata (CVG) is a rare skin disease caused by overgrowth of the scalp, presenting as cerebriform folds and wrinkles. CVG can be classified into two forms: primary (essential and non-essential) and secondary. The primary non-essential form is often associated with neurological and ophthalmological abnormalities, while the primary essential form occurs without associated comorbidities. Discussion: We report on a rare case of primary essential CVG with a 4-year history of normal-colored scalp skin mass in the parietal-occipital region without symptom in a 34-year-old male patient, retrospectively summarizing his pathological and Computer Tomography (CT) and magnetic resonance imaging (MRI) findings. The major clinical observations on the CT and MR sectional images include a thickened dermis and excessive growth of the scalp, forming the characteristic scalp folds. With the help of CT and MRI Three-dimensional (3D) reconstruction techniques, the characteristic skin changes could be displayed intuitively, providing more evidence for a diagnosis of CVG. At the 5-year followup, there were no obvious changes in the lesion. Conclusion: Based on our observations, we propose that not all patients with primary essential CVG need surgical intervention, and continuous clinical observation should be an appropriate therapy for those in stable condition.

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Intracardiac EUS-B-Guided FNA for Diagnosing Cardiac Tumors

Respiration ◽

10.1159/000516504 ◽

2021 ◽

pp. 1-5

Author(s):

Haizea Alvarez Martinez ◽

Jolanda C. Kuijvenhoven ◽

Jouke T. Annema

Keyword(s):

Left Atrium ◽

Heart Surgery ◽

Open Heart Surgery ◽

Needle Aspiration ◽

Invasive Technique ◽

Cardiac Tumors ◽

Surgical Interventions ◽

Tumor Diagnostics ◽

Specific Tumor ◽

Primary Cardiac Tumors

Primary cardiac tumors are extremely rare. Obtaining a tissue diagnosis is difficult and commonly requires open-heart surgery with associated morbidity. Esophageal endoscopic ultrasound (EUS) and EUS with the EBUS scope (EUS-B) provide real-time sampling of centrally located lung tumors and mediastinal lymph nodes. They also provide an excellent view of the left atrium, since it is located adjacent to the esophagus. To date, left atrium tumor diagnostics by endosonography is poorly explored. We describe 2 exceptional diagnostic cases of left atrium tumors in which cardiac surgery was hazardous due to the clinical condition or previous surgical interventions. During EUS-B-guided fine-needle aspiration (FNA), the left atrial masses were successfully and safely sampled, revealing a Burkitt lymphoma and a synovial sarcoma. FNA including cell block analysis enabled specific tumor diagnosis and molecular subtyping. Our findings suggest that in selected cases, linear endosonography qualifies as a minimally invasive technique for intracardiac tumor diagnostics.

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Characteristics, management, and outcomes among admissions for primary cardiac tumors: Results from the National Inpatient Sample

Journal of Cardiac Surgery ◽

10.1111/jocs.15862 ◽

2021 ◽

Author(s):

Joseph N. Heaton ◽

Nehal Dhaduk ◽

Alexis K. Okoh ◽

Khoi P. Dang‐Ho ◽

Rajiv Tayal ◽

...

Keyword(s):

Cardiac Tumors ◽

National Inpatient Sample ◽

Primary Cardiac Tumors

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Imaging in alpha-1 antitrypsin deficiency: a window into the disease

Therapeutic Advances in Chronic Disease ◽

10.1177/20406223211024523 ◽

2021 ◽

Vol 12_suppl ◽

pp. 204062232110245

Author(s):

Yuh-Chin Tony Huang ◽

Marion Wencker ◽

Bastiaan Driehuys

Keyword(s):

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Essential Information ◽

Plain Chest Radiograph ◽

Antitrypsin Deficiency ◽

Alpha 1 Antitrypsin Deficiency ◽

History Of ◽

Detailed Assessment ◽

Alpha 1 Antitrypsin ◽

Magnetic Resonance Imaging Mri

Imaging modalities such as plain chest radiograph and computed tomography (CT) are important tools in the assessment of patients with chronic obstructive pulmonary disease (COPD) of any etiology. These methods facilitate differential diagnoses and the assessment of individual lung pathologies, such as the presence of emphysema, bullae, or fibrosis. However, as emphysema is the core pathological consequence in the lungs of patients with alpha-1 antitrypsin deficiency (AATD), and because AATD is associated with the development of other lung pathologies such as bronchiectasis, there is a greater need for patients with AATD than those with non-AATD-related COPD to undergo more detailed assessment using CT. In the field of AATD, CT provides essential information regarding the presence, distribution, and morphology of emphysema. In addition, it offers the option to quantify the extent of emphysema. These data have implications for treatment decisions such as initiation of alpha-1 antitrypsin (AAT) therapy, or suitability for surgical or endoscopic interventions for reducing lung volume. Furthermore, CT has provided vital insight regarding the natural history of emphysema progression in AATD, and CT densitometry has underpinned research into the efficacy of AAT therapy. Moving forward, hyperpolarized xenon gas (129Xe) lung magnetic resonance imaging (MRI) is emerging as a promising complement to CT by adding comprehensive measures of regional lung function. It also avoids the main disadvantage of CT: the associated radiation. This chapter provides an overview of technological aspects of imaging in AATD, as well as its role in the management of patients and clinical research. In addition, perspectives on the future potential role of lung MRI in AATD are outlined.

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