Clinical characteristics and surgical treatment of cardiac tumors in 28 patients_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LI Bin , LIU Ai'jun , SI Rui , YANG Ming ,  SU Junwu

Department of Pediatric Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, P.R.China;

Corresponding author：

SU Junwu, Email: azsujunwu@126.com

Keywords：

Primary benign cardiac tumor; secondary cardiac tumor; surgery

DOI：

10.7507/1007-4848.202006064

Video：

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Objective To analyze the clinical characteristics and surgical treatment results of cardiac tumors.Methods Clinical data of 28 patients with cardiac tumors, who underwent cardiac surgery in our hospital from 2013 to 2019 were retrospectively reviewed. There were 12 males and 16 females. The median age was 11.5 years, ranging 1 month to 69 years; and the median weight was 39.0 (4.8-100.0) kg. All patients underwent tumor resection under cardiopulmonary bypass with general anesthesia, and postoperative pathological analysis was performed.Results There were 27 patients with primary cardiac tumors and 1 patient with secondary cardiac tumor. Among the primary cardiac tumors, there were 16 myxomas, 5 rhabdomyomas, 3 inflammatory myofibroblastomas, 2 fibroids and 2 hemangiomas. The secondary cardiac tumor was chondrosarcoma. A total of 28 cardiac tumors occurred in 29 locations, including 14 in the left atrium, 3 in the right atrium, 1 in the left ventricle, 7 in the right ventricle, 2 in the mitral and 2 in the tricuspid. Cerebral embolism occurred in 6 patients, peripheral vascular embolism in 3 patients, and syncope in 3 patients. There was no death during the perioperative period and in the long term follow-up. Complete resection was performed in 25 patients and partial resection was performed in 3 patients. During the follow-up, 2 patients with myxoma received reoperation for recurrence. Among the 3 patients with partial resection, residual tumor tissue disappeared in 2 patients, and in the other patient, there was no change in the size of the residual tumor tissue during the follow-up compared to that at discharge.Conclusion Cardiac surgery is an effective method for patients with primary benign cardiac tumors. However, whether the cardiac tumor tissue can be completely removed depends on the anatomical location of the tumor during the operation. If there are systemic embolism events and syncope, the possibility of cardiac tumors should be considered.

Citation： LI Bin, LIU Ai'jun, SI Rui, YANG Ming, SU Junwu. Clinical characteristics and surgical treatment of cardiac tumors in 28 patients. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2021, 28(2): 208-213. doi: 10.7507/1007-4848.202006064 Copy

1.	Yanagawa B, Mazine A, Chan EY, et al. Surgery for tumors of the heart. Semin Thorac Cardiovasc Surg, 2018, 30(4): 385-397.
2.	Butany J, Nair V, Naseemuddin A, et al. Cardiac tumours: diagnosis and management. Lancet Oncol, 2005, 6(4): 219-228.
3.	Goldberg AD, Blankstein R, Padera RF. Tumors metastatic to the heart. Circulation, 2013, 128(16): 1790-1794.
4.	Bahnson HT, Newman EV. Diagnosis and surgical removal of intracavitary myxoma of the right atrium. Bull Johns Hopkins Hosp, 1953, 93(3): 150-163.
5.	Chitwood WR Jr. Clarence Crafoord and the first successful resection of a cardiac myxoma. Ann Thorac Surg, 1992, 54(5): 997-998.
6.	Strecker T, Rösch J, Weyand M, et al. Primary and metastatic cardiac tumors: imaging characteristics, surgical treatment, and histopathological spectrum: a 10-year-experience at a German heart center. Cardiovasc Pathol, 2012, 21(5): 436-443.
7.	Wang JG, Wang B, Hu Y, et al. Clinicopathologic features and outcomes of primary cardiac tumors: a 16-year-experience with 212 patients at a Chinese medical center. Cardiovasc Pathol, 2018, 33: 45-54.
8.	Lau C, Leonard JR, Schwann AN, et al. A 20-year experience with resection of primary cardiac tumors and metastatic tumors of the heart. Ann Thorac Surg, 2019, 107(4): 1126-1131.
9.	Yuan SM. Fetal primary cardiac tumors during perinatal period. Pediatr Neonatol, 2017, 58(3): 205-210.
10.	Bonavia L, Jackson J, Pui-Yee Law J, et al. Brainstem stroke caused by left atrial cardiac papillary fibroelastoma: an increasingly recognized rare cause of stroke. Cardiovasc Pathol, 2019, 40: 65-67.
11.	Wang Q, Yang F, Zhu F, et al. A case report of left atrial myxoma-induced acute myocardial infarction and successive stroke. Medicine (Baltimore), 2018, 97(51): e13451.
12.	Szerszyńska A, Nowak R, Łaskawski G, et al. Recurrent pneumonia and pulmonary embolism in a young patient as a presentation of right ventricular myxoma. Kardiol Pol, 2019, 77(1): 63.
13.	Akgun T, Gulsen K, Cinier G, et al. Electrocardiographic characteristics of metastatic cardiac tumors presenting with ST-segment elevation. J Electrocardiol, 2019, 59: 93-99.
14.	Koźma M, Stokłosa P, Kuśmierczyk M, et al. Cardiac papillary fibroelastoma mimicking infective endocarditis. Kardiol Pol, 2019, 77(1): 61.
15.	de Almeida LA, Hueb JC, de Moraes Silva MA, et al. Cerebral ischemia as initial neurological manifestation of atrial myxoma: case report. Arq Neuropsiquiatr, 2006, 64(3A): 660-663.
16.	Byon JH, Kwak HS, Chung GH, et al. Acute stroke from tumor embolus in a patient with cardiac sarcoma: Aspiration thrombectomy with penumbra catheter. Interv Neuroradiol, 2016, 22(1): 88-90.
17.	Mitomi M, Kimura K, Iguchi Y, et al. A case of stroke due to tumor emboli associated with metastatic cardiac liposarcoma. Intern Med, 2011, 50(14): 1489-1491.
18.	Beroukhim RS, Prakash A, Buechel ER, et al. Characterization of cardiac tumors in children by cardiovascular magnetic resonance imaging: a multicenter experience. J Am Coll Cardiol, 2011, 58(10): 1044-1054.
19.	Kumar N, Agarwal S, Ahuja A, et al. Spectrum of cardiac tumors excluding myxoma: Experience of a tertiary center with review of the literature. Pathol Res Pract, 2011, 207(12): 769-774.
20.	Mackie AS, Kozakewich HP, Geva T, et al. Vascular tumors of the heart in infants and children: case series and review of the literature. Pediatr Cardiol, 2005, 26(4): 344-349.
21.	Bonnamy L, Perrotin F, Megier P, et al. Fetal intracardiac tumor(s): prenatal diagnosis and management. Three case reports. Eur J Obstet Gynecol Reprod Biol, 2001, 99(1): 112-117.

1. Yanagawa B, Mazine A, Chan EY, et al. Surgery for tumors of the heart. Semin Thorac Cardiovasc Surg, 2018, 30(4): 385-397.
2. Butany J, Nair V, Naseemuddin A, et al. Cardiac tumours: diagnosis and management. Lancet Oncol, 2005, 6(4): 219-228.
3. Goldberg AD, Blankstein R, Padera RF. Tumors metastatic to the heart. Circulation, 2013, 128(16): 1790-1794.
4. Bahnson HT, Newman EV. Diagnosis and surgical removal of intracavitary myxoma of the right atrium. Bull Johns Hopkins Hosp, 1953, 93(3): 150-163.
5. Chitwood WR Jr. Clarence Crafoord and the first successful resection of a cardiac myxoma. Ann Thorac Surg, 1992, 54(5): 997-998.
6. Strecker T, Rösch J, Weyand M, et al. Primary and metastatic cardiac tumors: imaging characteristics, surgical treatment, and histopathological spectrum: a 10-year-experience at a German heart center. Cardiovasc Pathol, 2012, 21(5): 436-443.
7. Wang JG, Wang B, Hu Y, et al. Clinicopathologic features and outcomes of primary cardiac tumors: a 16-year-experience with 212 patients at a Chinese medical center. Cardiovasc Pathol, 2018, 33: 45-54.
8. Lau C, Leonard JR, Schwann AN, et al. A 20-year experience with resection of primary cardiac tumors and metastatic tumors of the heart. Ann Thorac Surg, 2019, 107(4): 1126-1131.
9. Yuan SM. Fetal primary cardiac tumors during perinatal period. Pediatr Neonatol, 2017, 58(3): 205-210.
10. Bonavia L, Jackson J, Pui-Yee Law J, et al. Brainstem stroke caused by left atrial cardiac papillary fibroelastoma: an increasingly recognized rare cause of stroke. Cardiovasc Pathol, 2019, 40: 65-67.
11. Wang Q, Yang F, Zhu F, et al. A case report of left atrial myxoma-induced acute myocardial infarction and successive stroke. Medicine (Baltimore), 2018, 97(51): e13451.
12. Szerszyńska A, Nowak R, Łaskawski G, et al. Recurrent pneumonia and pulmonary embolism in a young patient as a presentation of right ventricular myxoma. Kardiol Pol, 2019, 77(1): 63.
13. Akgun T, Gulsen K, Cinier G, et al. Electrocardiographic characteristics of metastatic cardiac tumors presenting with ST-segment elevation. J Electrocardiol, 2019, 59: 93-99.
14. Koźma M, Stokłosa P, Kuśmierczyk M, et al. Cardiac papillary fibroelastoma mimicking infective endocarditis. Kardiol Pol, 2019, 77(1): 61.
15. de Almeida LA, Hueb JC, de Moraes Silva MA, et al. Cerebral ischemia as initial neurological manifestation of atrial myxoma: case report. Arq Neuropsiquiatr, 2006, 64(3A): 660-663.
16. Byon JH, Kwak HS, Chung GH, et al. Acute stroke from tumor embolus in a patient with cardiac sarcoma: Aspiration thrombectomy with penumbra catheter. Interv Neuroradiol, 2016, 22(1): 88-90.
17. Mitomi M, Kimura K, Iguchi Y, et al. A case of stroke due to tumor emboli associated with metastatic cardiac liposarcoma. Intern Med, 2011, 50(14): 1489-1491.
18. Beroukhim RS, Prakash A, Buechel ER, et al. Characterization of cardiac tumors in children by cardiovascular magnetic resonance imaging: a multicenter experience. J Am Coll Cardiol, 2011, 58(10): 1044-1054.
19. Kumar N, Agarwal S, Ahuja A, et al. Spectrum of cardiac tumors excluding myxoma: Experience of a tertiary center with review of the literature. Pathol Res Pract, 2011, 207(12): 769-774.
20. Mackie AS, Kozakewich HP, Geva T, et al. Vascular tumors of the heart in infants and children: case series and review of the literature. Pediatr Cardiol, 2005, 26(4): 344-349.
21. Bonnamy L, Perrotin F, Megier P, et al. Fetal intracardiac tumor(s): prenatal diagnosis and management. Three case reports. Eur J Obstet Gynecol Reprod Biol, 2001, 99(1): 112-117.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Clinical characteristics and surgical treatment of cardiac tumors in 28 patients

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