A rare case of ventricular tachycardia caused by an intramyocardial fibroma with successful surgical resection in an adult.
Cardiac fibroma
Cardiothoracic surgery
Multimodality imaging
Ventricular tachycardia
Journal
Journal of cardiothoracic surgery
ISSN: 1749-8090
Titre abrégé: J Cardiothorac Surg
Pays: England
ID NLM: 101265113
Informations de publication
Date de publication:
05 Sep 2024
05 Sep 2024
Historique:
received:
15
04
2024
accepted:
13
08
2024
medline:
6
9
2024
pubmed:
6
9
2024
entrez:
5
9
2024
Statut:
epublish
Résumé
Cardiac fibromas are extremely rare in adults. The preferred treatment is surgical resection, but antiarrhythmic medications or heart transplantation have also been used previously. The cardiac imaging, particularly MRI, can be useful to help delineate between primary cardiac tumors, and surgical factors such as the extent/size of the fibroma, involvement of the coronary arteries or mitral apparatus and amount of residual myocardium influence whether surgical resection is feasible. A 42-year-old male presented with a wide-complex tachycardia, unresponsive to amiodarone. An echocardiogram was performed which showed a possible posterior wall mass. A cardiac MRI showed a well circumscribed lateral wall intracardiac fibroma, measuring 5.2 × 5.1 × 3.8 cm with preserved function. Surgical resection was successful, and he was discharged without a defibrillator. Cardiac fibromas are encapsulated tumors which do not infiltrate myocardium and should be surgically resected if possible.
Sections du résumé
BACKGROUND
BACKGROUND
Cardiac fibromas are extremely rare in adults. The preferred treatment is surgical resection, but antiarrhythmic medications or heart transplantation have also been used previously. The cardiac imaging, particularly MRI, can be useful to help delineate between primary cardiac tumors, and surgical factors such as the extent/size of the fibroma, involvement of the coronary arteries or mitral apparatus and amount of residual myocardium influence whether surgical resection is feasible.
CASE PRESENTATION
METHODS
A 42-year-old male presented with a wide-complex tachycardia, unresponsive to amiodarone. An echocardiogram was performed which showed a possible posterior wall mass. A cardiac MRI showed a well circumscribed lateral wall intracardiac fibroma, measuring 5.2 × 5.1 × 3.8 cm with preserved function. Surgical resection was successful, and he was discharged without a defibrillator.
CONCLUSIONS
CONCLUSIONS
Cardiac fibromas are encapsulated tumors which do not infiltrate myocardium and should be surgically resected if possible.
Identifiants
pubmed: 39238037
doi: 10.1186/s13019-024-02986-3
pii: 10.1186/s13019-024-02986-3
doi:
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
515Informations de copyright
© 2024. The Author(s).
Références
Gatti M, D’Angelo T, Muscogiuri G, et al. Cardiovascular magnetic resonance of cardiac tumors and masses. World J Cardiol. 2021;13(11):628–49.
doi: 10.4330/wjc.v13.i11.628
pubmed: 34909128
pmcid: 8641001
Burke A, Virmani R. Pediatric heart tumors. Cardiovasc Pathol. 2008;17(4):193–8.
doi: 10.1016/j.carpath.2007.08.008
pubmed: 18402818
Zheng X, Song B. Left ventricle primary cardiac fibroma in an adult: a case report. Oncol Lett. 2018;16(4):5463–5.
pubmed: 30250618
pmcid: 6144884
Covington MK, Young PM, Bois MC, et al. Clinical Impact of cardiac fibromas. Am J Cardiol. 2022;182:95–103.
doi: 10.1016/j.amjcard.2022.06.062
pubmed: 36055811
Jones J, Ramcharan T, Chaudhari M, et al. Ventricular fibromas in children, arrhythmia risk, and outcomes: a multicenter study. Heart Rhythm. 2018;15(10):1507–12.
doi: 10.1016/j.hrthm.2018.06.018
pubmed: 29906523
Waller B, Bradley S, Crumbley A, Wiles H, McQuinn T, Bennett A. Cardiac fibroma in an infant: single ventricle palliation as a bridge to heart transplantation. Ann Thorac Surg. 2003;75(4):1306–8.
doi: 10.1016/S0003-4975(02)04655-6
pubmed: 12683582
Saleh WKA, Ramlawi B, Shapira OM, et al. Improved outcomes with the evolution of a neoadjuvant chemotherapy approach to right heart sarcoma. Ann Thorac Surg. 2017;104(1):90–6.
doi: 10.1016/j.athoracsur.2016.10.054
pubmed: 28189277
Elbardissi A, Dearani J, Daly R, et al. Survival after resection of primary cardiac tumors: a 48-year experience. Circulation. 2008;118(14 Suppl):S7–15.
pubmed: 18824772
Torimitsu S, Nemoto T, Wakayama M, et al. Literature survey on epidemiology and pathology of cardiac fibroma. Eur J Med Res. 2012;17(1):5.
doi: 10.1186/2047-783X-17-5
pubmed: 22472419
pmcid: 3351722
Burke AP, Rosado-de-Christenson M, Templeton PA, Virmani R. Cardiac fibroma: clinicopathologic correlates and surgical treatment. J Thorac Cardiovasc Surg. 1994;108(5):862–70.
doi: 10.1016/S0022-5223(94)70184-9
pubmed: 7967668
Cho JM, Danielson GK, Puga FJ, et al. Surgical resection of ventricular cardiac fibromas: early and late results. Ann Thorac Surg. 2003;76(6):1929–34.
doi: 10.1016/S0003-4975(03)01196-2
pubmed: 14667615
Elbayomi M, Nooh E, Weyand M, Agaimy A, Harig F. Dysphonia as a presenting symptom of a giant left atrial sarcoma developing within five years. Thorac Cardiovasc Surg Rep. 2022;11(1):e50–3.
doi: 10.1055/s-0042-1751028
pubmed: 36032935
pmcid: 9402287