scholarly journals Case Report: Thromboembolism and Hemorrhagic Pericardial Effusion—The Janus Face of Primary Pericardial Angiosarcoma

2021 ◽  
Vol 7 ◽  
Author(s):  
Fei F. Chen ◽  
Shu F. Jiang ◽  
Chang Dong ◽  
Ying Che ◽  
Lin Y. Du ◽  
...  
Keyword(s):  
Pericardial Effusion ◽  
Malignant Tumors ◽  
Anticoagulation Therapy ◽  
Pericardial Tamponade ◽  
Clinical Specialist ◽  
Cardiac Angiosarcoma ◽  
Positron Emission ◽  
Clinical Presentations ◽  
Multiple Imaging ◽  
The Right

Background: Primary cardiac angiosarcomas, especially those originating in the pericardium, are extremely rare and aggressive tumors with poor prognosis. These types of malignant tumors have diverse clinical presentations and are often masked by other comorbidities.Case Summary: Our hospital reported a 59-year-old woman who initially presented with pulmonary thromboembolism (PTE) and was subsequently treated with low-molecular-weight heparin. However, she experienced acute pericardial tamponade after anticoagulation therapy, where no obvious mass was primarily identified upon imaging, both in the pericardium or within the heart. Emergency pericardiocentesis and drainage were performed, where a total of 210 mL of bloody effusion was drained. Four months later, she was hospitalized with progressive hemoptysis and dyspnea. A large mixed mass occupying the right pericardium was later identified by coronary computed tomography angiography (CCTA). The mass was consistent with the right atrium, with heterogeneous thickened pericardium and localized moderate pericardial effusion. CCTA and positron emission tomography scans later showed metastases in both lungs and bilateral pleura. Nodules in hilar and mediastinal lymph nodes were also significant. Ultrasound-guided biopsy was performed, and the patient was ultimately diagnosed with an angiosarcoma based on final positive results for both CD31 and CD34 markers. The patient refused chemotherapy and passed away while waiting for her pathology results. The patient survived for 6 months since the first reported episode of PTE.Conclusions: Our case indicates that patients presenting with both embolism and hemorrhage should urgently be channeled to a clinical specialist to confirm any malignant etiology. This would be beneficial to confirm an early diagnosis and lengthen the duration of patient survival. However, the diagnosis of primary cardiac angiosarcoma is still challenging and requires multiple imaging modalities and biopsies in order to assist the accurate diagnosis of disease and achieve effective patient management.

1223 Cholelithiasis and Choledocholithiasis with Migration of Stones into Right Psoas Muscle Cavity

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
J Hunter
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Psoas Muscle ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Imaging Modalities ◽  
Prior History ◽  
Clinical Presentations ◽  
Multiple Imaging ◽  
The Right ◽  
Psoas Major

Abstract Aim To highlight the importance of appropriate imaging modalities for abnormal clinical presentations. Method Xyo woman presented with severe right upper-quadrant pain to the emergency department. Prior history of colicky abdominal pain for 1 year, right-sided nephrectomy and hypertension. She stated that the current epsiode of pain was the worst so far, becoming more persistent, prompting her to call an ambulance. Cholecystitis was suspected, so a Computed Tomography abdomen/pelvis was performed. A dilated, inflamed gallbladder was noted in contact with the right psoas major, with what appeared to be an abscess in the right psoas major. Results A Magnetic Resonance Cholangiopancreatography was performed, which demonstrated that the aforementioned abscess was in fact a large cavity within the psoas major, containing up to 15 gallstones. Cholelithiasis was also seen, with common bile duct dilatation and evidence of a common bile duct stone. An Endoscopic Retrograde Cholangiopancreatography was performed, and X recovered well post-procedure with analgesia and antibiotics. Conclusions Acute cholecystitis/intra-abdominal gallstones may result in abscess/cavity formations and abnormal biliary clinical presentations. It is important therefore to fully investigate abnormal hepatobiliary imaging with multiple imaging modalities to allow for accurate diagnosis and appropriate further management of presentations.

scholarly journals Mesothelioma in two sheep with pericardial effusion and ascites

2020 ◽  
Vol 8 (1) ◽  
pp. e001031
Author(s):  
Nicola Fletcher ◽  
Camilla Brena ◽  
Amanda Carson ◽  
Mark Wessels ◽  
Tobias Floyd
Keyword(s):  
Differential Diagnosis ◽  
Pericardial Effusion ◽  
Domestic Animals ◽  
Diagnostic Pathology ◽  
First Case ◽  
Clinical Presentations ◽  
Rare Tumours ◽  
Microscopic Features ◽  
History Of ◽  
The Right

Mesotheliomas are rare tumours in domestic animals. These tumours have a range of clinical presentations, and a range of gross and microscopic features can be present. We report mesotheliomas in two sheep submitted to Animal and Plant Health Agency’s diagnostic pathology service with diverse clinical presentations. The first case was a 2-year-old ewe with a history of sudden death that had a nodular mass in the wall of the right auricle and marked pericardial effusion and ascites. The second case was a 3-year-old ewe with a history of recumbency which had a papillary mass in the peritoneal cavity and marked ascites. A diagnosis of mesothelioma in both cases was confirmed by immunohistochemistry for cytokeratin and vimentin. These cases highlight the diverse presenting signs that can be present with mesothelioma, and this tumour should be considered as a differential diagnosis in sheep with peritoneal, pericardial or pleural effusion at gross postmortem.

Cardiac Angiosarcoma: A Case with Bilateral Pleural and Pericardial Effusion

2014 ◽  
Vol 16 (6) ◽  
pp. 353 ◽  
Author(s):  
Mehmet Oc ◽  
Bora Farsak ◽  
Oguzhan Arun ◽  
Bahar Oc ◽  
Murat Simsek ◽  
...  
Keyword(s):  
Pericardial Effusion ◽  
Poor Prognosis ◽  
Malignant Tumors ◽  
Tumor Resection ◽  
Right Atrial ◽  
Short Survival ◽  
Cardiac Angiosarcoma

Cardiac sarcomas are rare malignant tumors. Angiosarcoma is the most common cardiac sarcoma and is present in up to 33% of cases. Angiosarcomas have a poor prognosis, with a short survival expectancy. We report a case of a right atrial angiosarcoma treated by partial tumor resection followed by chemotherapy.

scholarly journals Benefits and Limitations of Multimodality Imaging in the Diagnosis of a Primary Cardiac Lymphoma

2014 ◽  
Vol 41 (6) ◽  
pp. 657-659 ◽  
Author(s):  
Prabhjot Singh Nijjar ◽  
Sofia Carolina Masri ◽  
Ashenafi Tamene ◽  
Helina Kassahun ◽  
Kenneth Liao ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Malignant Tumors ◽  
Emission Tomography ◽  
Cardiac Tumors ◽  
Imaging Methods ◽  
Positron Emission ◽  
Multiple Imaging ◽  
Primary Cardiac Tumors

Primary cardiac tumors are far rarer than tumors metastatic to the heart. Angiosarcoma is the primary cardiac neoplasm most frequently detected; lymphomas constitute only 1% of primary cardiac tumors. We present the case of a 55-year-old woman with a recently diagnosed intracardiac mass who was referred to our institution for consideration of urgent orthotopic heart transplantation. Initial images suggested an angiosarcoma; however, a biopsy specimen of the mass was diagnostic for diffuse large B-cell lymphoma. The patient underwent chemotherapy rather than surgery, and she was asymptomatic 34 months later. We use our patient's case to discuss the benefits and limitations of multiple imaging methods in the evaluation of cardiac masses. Certain features revealed by computed tomography, cardiac magnetic resonance, and positron emission tomography can suggest a diagnosis of angiosarcoma rather than lymphoma. Cardiac magnetic resonance and positron emission tomography enable reliable distinction between benign and malignant tumors; however, the characteristics of different malignant tumors can overlap. Despite the great usefulness of multiple imaging methods for timely diagnosis, defining the extent of spread and the hemodynamic impact, and monitoring responses to treatment, we think that biopsy analysis is still warranted in order to obtain a correct histologic diagnosis in cases of suspected malignant cardiac tumors.

scholarly journals Cardiac Angiosarcoma

2011 ◽  
Vol 2011 ◽  
pp. 1-3
Author(s):  
Monique Esteves Cardoso ◽  
Leonardo Secchin Canale ◽  
Rosana Grandelle Ramos ◽  
Edson da Silva Salvador Junior ◽  
Stephan Lachtermacher
Keyword(s):  
Adjuvant Therapy ◽  
Right Atrium ◽  
Malignant Tumors ◽  
Tumor Resection ◽  
Cardiac Tumors ◽  
Primary Tumors ◽  
Cardiac Angiosarcoma ◽  
Cardiac Metastases ◽  
The Right ◽  
Primary Cardiac Tumors

Despite cardiac metastases are found in about 20% of cancer deaths, the presence of primary cardiac tumors is rare. Most primary tumors are benign, and malignant tumors comprise about 15%. We report a 21-year-old man with fever, dyspnea, and hemoptysis that was diagnosed with angiosarcoma of the right atrium and pulmonary metastasis. Patient was submitted to surgical tumor resection without adjuvant therapy and died four months after diagnosis.

scholarly journals Angiosarcoma of the Right Atrium with Extension to SVC and IVC Presenting with Complete Heart Block and Significant Pericardial Effusion

2016 ◽  
Vol 2016 ◽  
pp. 1-3
Author(s):  
Hossein Vakili ◽  
Isa Khaheshi ◽  
Mehdi Memaryan ◽  
Shooka Esmaeeli
Keyword(s):  
Pericardial Effusion ◽  
Right Atrium ◽  
Heart Block ◽  
Complete Heart Block ◽  
Histological Subtype ◽  
Preliminary Diagnosis ◽  
Cardiac Neoplasms ◽  
Cardiac Angiosarcoma ◽  
Healthy Man ◽  
The Right

Primary cardiac neoplasms are particularly unusual. Angiosarcoma is the most frequently seen histological subtype and is described by its infiltrating and damaging nature. Inappropriately, primary cardiac angiosarcoma is often missed as a preliminary diagnosis because of its scarcity. We present a 29-year-old previously healthy man with complete heart block and pericardial effusion who was finally diagnosed with angiosarcoma of the right atrium with extension to SVC and IVC.

scholarly journals Cardiac Angiosarcoma:A case report and review of the literature

2021 ◽  
Author(s):  
Limin Luo ◽  
Weipeng Zhao ◽  
Kun Liu
Keyword(s):  
Case Report ◽  
Malignant Tumors ◽  
Right Atrial ◽  
Cardiac Tumors ◽  
Review Of The Literature ◽  
Primary Tumors ◽  
Cardiac Angiosarcoma ◽  
Right Atrial Appendage ◽  
The Right ◽  
Primary Cardiac Tumors

Primary cardiac tumors are extremely rare.Most primary tumors are benign,and malignant tumors comprise about 15%1.Angiosarcoma is the most common type of primary cardiac malignant tumors.Compared with the left atrium or ventricle,the tumor prefer to occur in the right atrium or ventricle,especially the right atrium.In this case report,we present the case of a 32-year-old female with cardiac angiosarcoma primary to the right atrial appendage(RAA).

Pericardial disease

2020 ◽  
pp. 3501-3508
Author(s):  
Michael Henein
Keyword(s):  
Traumatic Injury ◽  
Pericardial Tamponade ◽  
Haemodynamic Instability ◽  
Shortness Of Breath ◽  
Acute Pericarditis ◽  
Pericardial Disease ◽  
Clinical Presentations ◽  
Wide Range ◽  
Ventricular Puncture ◽  
The Right

The most common clinical presentations of pericardial disease are pericarditis, effusion, tamponade, and constriction. With acute pericarditis, the most common proven causes are viral infection or as a complication of myocardial infarction, but a wide range of other conditions including autoimmune rheumatic disorders and tuberculosis need to be considered. With pericardial effusion, acute rapid collection is usually caused by traumatic injury, iatrogenic ventricular puncture, or aortic dissection. Presentation is with pericardial tamponade, which is a condition of haemodynamic instability caused by chamber compression because increased intrapericardial pressure is greater than the filling pressure of the right and left ventricles. Presentation is typically with shortness of breath or circulatory collapse. With pericardial constriction, a stiff pericardium loses its stretching ability to accommodate normal changes in intracardiac pressures. Most patients present with leg or abdominal swelling and dyspnoea.

The Diagnostic Value of Pericardial Fluid and Pericardial Biopsy: Single Center Experiences

2016 ◽  
Vol 19 (1) ◽  
pp. 023 ◽  
Author(s):  
Mehmet Yildirim ◽  
Recep Ustaalioglu ◽  
Murat Erkan ◽  
Bala Basak Oven Ustaalioglu ◽  
Hatice Demirbag ◽  
...  
Keyword(s):  
Pericardial Effusion ◽  
Thoracoscopic Surgery ◽  
Pericardial Tamponade ◽  
Pericardial Fluid ◽  
Pathological Examination ◽  
Common Disease ◽  
Pericardial Window ◽  
Surgical Interventions ◽  
History Of ◽  
Recurrent Pericardial Effusion

<strong>Background:</strong> Patients with recurrent pericardial effusion and pericardial tamponade are usually treated in thoracic surgery clinics by VATS (video-assisted thoracoscopic surgery) or open pericardial window operation. The diagnostic importance of pathological evaluation of the pericardial fluid and tissue in the same patients has been reported in few studies. We reviewed pathological examination of the pericardial tissue and fluid specimens and the effect on the clinical treatment in our clinic, and compared the results with the literature. <br /><strong>Methods:</strong> We retrospectively analyzed 174 patients who underwent pericardial window operation due to pericardial tamponade or recurrent pericardial effusion. For all patients both the results of the pericardial fluid and pericardial biopsy specimen were evaluated. Clinicopathological factors were analyzed by using descriptive analysis. <br /><strong>Results:</strong> Median age was 61 (range, 20-94 years). The most common benign diagnosis was chronic inflammation (94 patients) by pericardial biopsy. History of malignancy was present in 28 patients (16.1%) and the most common disease was lung cancer (14 patients). A total of 24 patients (13.8%) could be diagnosed as having malignancy by pericardial fluid or pericardial biopsy examination. The malignancy was recognized for 12 patients who had a history of cancer; 9 of 12 with pericardial biopsy, 7 diagnosed by pericardial fluid. Twelve of 156 patients were recognized as having underlying malignancy by pericardial biopsy (n = 9) or fluid examination (n = 10), without known malignancy previously. <br /><strong>Conclusion:</strong> Recurrent pericardial effusion/pericardial tamponade are entities frequently diagnosed, and surgical interventions may be needed either for diagnosis and/or treatment, but specific etiology can rarely be obtained in spite of pathological examination of either pericardial tissue or fluid. For increasing the probability of a specific diagnosis both the pericardial fluid and the pericardial tissues have to be sent for pathologic examination.

scholarly journals Primary Gastrointestinal Stromal Tumor of the Liver with Cystic Changes

2019 ◽  
Vol 13 (1) ◽  
pp. 58-65
Author(s):  
Takashi Tashiro ◽  
Fumihiro Uwamori ◽  
Yukiomi Nakade ◽  
Tadahisa Inoue ◽  
Yuji Kobayashi ◽  
...  
Keyword(s):  
Liver Tumors ◽  
Past History ◽  
Brain Infarction ◽  
Arterial Phase ◽  
First Case ◽  
Positron Emission ◽  
Cystic Changes ◽  
Multiple Bone Metastases ◽  
The Right ◽  
Cells Of Cajal

Gastrointestinal stromal tumors (GISTs) are known to originate specifically from the intestinal cells of Cajal located in the gastrointestinal mesenchyme. GISTs developing outside of the digestive tract have barely been reported. We encountered a first case of large primary GISTs in the liver with cystic changes. A 63-year-old man with a past history of brain infarction visited our hospital. The computed tomography (CT) revealed a 6-cm and a 10-cm mass in the right and the caudal lobe of the liver, respectively. These tumors have marginal enhancement in the arterial phase; however, they presented as hypodense in the internal tumor sites. Both liver tumors had cystic changes. Gastrointestinal examinations using endoscopy revealed no other gastrointestinal tumors, and [18F]-fluoro-2-deoxy-D-glucose positron emission tomography/CT revealed multiple bone metastases in addition to the liver tumors. The liver tumor specimens were composed of spindle cells, and the immunohistochemical staining for c-Kit and for DOG1, as discovered on GIST, was positive. The patient was diagnosed with primary hepatic GIST with cystic changes.

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