Pathological types and age distribution of primary left ventricular tumors_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LIU Xiaoxi ,  SONG Min , MENG Liukun , MENG Yanhai? , WANG Shuiyun , XU Jianping

Adult Cardiac Surgery Center, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases and Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, P.R.China;

Corresponding?author：

SONG Min, Email: mdsongmin@126.com

Keywords：

Primary cardiac tumor; left ventricle; age; surgical treatment; recurrence

DOI：

10.7507/1007-4848.202009080

Video：

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Objective To summarize the age distribution of different pathological types of primary left ventricular tumor and its influence on preoperative diagnosis, surgical methods and therapeutic effect.Methods The clinical data of 35 patients with primary left ventricular tumor admitted to Fuwai Hospital of Chinese Academy of Medical Sciences from January 2008 to March 2019 were retrospectively analyzed. There were 19 males and 16 females with an average age of 33.81±17.56 years. According to the age, the patients were divided into an infant group (less than 7 years), an adolescent group (7-17 years), a young group (18-44 years), a middle-aged group (45-59 years) and an elderly group (over 60 years). The age distribution characteristics of different pathological types of tumor patients were analyzed, and the influence on surgical methods, short-term and long-term curative effect of surgery in different age groups was analyzed. Within 6 months after the operation, the patients returned to the hospital to review the echocardiography, and then were followed up by telephone.Results Of the 35 patients with primary left ventricular tumor, only 1 patient in the middle-aged group had low malignancy carcinoid tumor, and the others were benign tumors. Fibroma and rhabdomyoma accounted for the majority of the infant group and adolescent group. Myxoma was the common tumor in the young group, middle-aged group and elderly group, followed by lipoma. Thirty-three patients were operated under general anesthesia, hypothermia and cardiopulmonary bypass (CPB). Two patients with epicardial lipoma underwent normothermic surgery without CPB. Nine patients underwent partial resection of left ventricular tumors, and 26 patients received complete resection of left ventricular tumor. There was no hospital death, opening stanching, secondary thoracotomy, low cardiac output, embolism or other complications. The postoperative hospital stay was 7.97±2.56 days, and the postoperative reexamination was normal. Subsequently, 35 patients were followed up by telephone or outpatient service. The average follow-up time was 59.87±37.62 months. In the young group, 2 patients with partial resection recurred.Conclusion Surgical resection is the first choice for the treatment of left ventricular benign tumor, and it is safe. The principle of left ventricular tumor surgery is to protect the function of ventricle and valve, prevent damage to the conduction system, and remove the tumor as completely as possible.

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31.	Neragi-Miandoab S, Kim J, Vlahakes GJ. Malignant tumours of the heart: A review of tumour type, diagnosis and therapy. Clin Oncol (R Coll Radiol), 2007, 19(10): 748-756.

1. Ren DY, Fuller ND, Gilbert SAB, et al. Cardiac tumors: Clinical perspective and therapeutic considerations. Curr Drug Targets, 2017, 18(15): 1805-1809.
2. Odim J, Reehal V, Laks H, et al. Surgical pathology of cardiac tumors. Two decades at an urban institution. Cardiovasc Pathol, 2003, 12(5): 267-270.
3. 胡盛壽, 王小啟, 許建屏, 等. 心臟腫瘤外科治療經驗總結. 中華醫學雜志, 2006, 86(11): 766-770.
4. Petris AO, Alexandrescu DM, Costache Ⅱ. Cardiac tumors. Rev Med Chir Soc Med Nat Iasi, 2014, 118(2): 289-292.
5. Rivera-Dávila AD, Rodríguez-Ospina L. Primary cardiac and pericardial tumors. Bol Asoc Med P R, 2008, 100(4): 48-54.
6. Uzun O, Wilson DG, Vujanic GM, et al. Cardiac tumours in children. Orphanet J Rare Dis, 2007, 2: 11.
7. Pittman S, Sethi P, Flavell RR, et al. Cardiac fibroma: An uncommon cause of a fixed defect on myocardial perfusion imaging. Clin Nucl Med, 2018, 43(2): e56-e58.
8. 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.
9. Tsukamoto S, Shiono M, Orime Y, et al. Surgical treatment of 22 cardiac myxomas: A review. Ann Thorac Cardiovasc Surg, 1999, 5(3): 146-149.
10. Ramsheri A, Deleuze P, D'Attelis N, et al. Aortic valve myxoma. J Card Surg, 1998, 13(6): 491-493.
11. Bolourian AA, Karimi M, Mirzaie A. Myxoma of the tricuspid valve. J Heart Valve Dis, 2000, 9(2): 288-290.
12. Roberts WC. Primary and secondary neoplasms of the heart. Am J Cardiol, 1997, 80(5): 671-682.
13. Reber D, Birnbaum DE. Recurrent cardiac myxoma: Why it occurs. A case report with literature review. J Cardiovasc Surg (Torino), 2001, 42(3): 345-348.
14. Mariscalco G, Bruno VD, Borsani P, et al. Papillary fibroelastoma: Insight to a primary cardiac valve tumor. J Card Surg, 2010, 25(2): 198-205.
15. Singh VA, Sharif MA, Michael R, et al. Case report papillary fibroelastomas and the conundrum of the benign intracardiac mass. Eplasty, 2012, 12: e28.
16. Ozaki N, Mukohara N, Yoshida M, et al. Cardiac lipoma in the ventricular septum—A case report. Thorac Cardiovasc Surg, 2006, 54(5): 356-357.
17. Reece IJ, Cooley DA, Frazier OH, et al. Cardiac tumors. Clinical spectrum and prognosis of lesions other than classical benign myxoma in 20 patients. J Thorac Cardiovasc Surg, 1984, 88(3): 439-446.
18. Li FP, Wang XF, Xiao J, et al. Myocardial lipomatous infiltration of the left ventricular wall. J Card Surg, 2010, 25(5): 513-515.
19. Naseerullah FS, Javaiya H, Murthy A. Cardiac lipoma: An uncharacteristically large intra-atrial mass causing symptoms. Case Rep Cardiol, 2018, 2018: 3531982.
20. Rainer WG, Bailey DJ, Hollis HW. Giant cardiac lipoma: Refined hypothesis proposes invagination from extracardiac to intracardiac sites. Tex Heart Inst J, 2016, 43(5): 461-464.
21. Law KB, Phillips KR, Cusimano RJ, et al. Multifocal "tapete" papillary fibroelastoma. J Clin Pathol, 2009, 62(12): 1066-1070.
22. Butany J, Nair Naseemuddin A, et al. Cardiac tumours: Diagnosis and management. Lancet Oncol, 2005, 6(4): 2l9-228.
23. Elbardissi AW, Dearani JA, Daly RC, et al. Survival after resection of primary cardiac tumors: A 48-year experience. Circulation, 2008, 118(14 Suppl): S7-S15.
24. Sun JP, Asher CR, Yang XS, et al. Clinical and echocardiographic characteristics of papillary fibroelastomas: A retrospective and prospective study in 162 patients. Circulation, 2001, 103(22): 2687-2693.
25. Thomas-de-Montpréville V, Nottin R, Dulmet E, et al. Heart tumors in children and adults: Clinicopathological study of 59 patients from a surgical center. Cardiovasc Pathol, 2007, 16(1): 22-28.
26. Sobrinho AF, Ferreira JA, Borem MP, et al. Capillary-type cardiac hemangioma, in the left atrium. Braz J Cardiovasc Surg, 2005, 20(4): 445-448.
27. 齊寶林, 杜爾濱, 隋新華. 心臟左室前壁血管瘤1例. 中國罕少疾病雜志, 1998, 5(2): 61-62.
28. Dinesh Kumar US, Shetty SP, Sujay KR, et al. Left ventricular mass: A tumor or a thrombus diagnostic dilemma. Ann Card Anaesth, 2016, 19(4): 728-732.
29. Sevimli S, Erkut B, Becit N, et al. Primary benign schwannoma of the left ventricle coursing under the left anterior descending artery. Echocardiography, 2007, 24(10): 1093-1095.
30. Debourdeau P, Gligorov J, Teixeira L, et al. Malignant cardiac tumors. Bull Cancer, 2004, 91(Suppl 3): 136-146.
31. Neragi-Miandoab S, Kim J, Vlahakes GJ. Malignant tumours of the heart: A review of tumour type, diagnosis and therapy. Clin Oncol (R Coll Radiol), 2007, 19(10): 748-756.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

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