Hayrettin SAĞLAM, Bahadır ŞARLI, Ahmet Oğuz BAKTIR, Hüseyin ARINÇ, Murat ÇİÇEK, Mustafa Serkan KARAKAŞ

Primer kardiyak leiomiyosarkom ile birlikte olan mezotelyal/monositik rastlantısal kardiyak tümör: İlk vaka sunumu

Nefes darlığı ve bayılma şikayeti ile kardiyoloji polikliniğine başvuran 74 yaşındaki erkek hastanın yapılan transtorasik ekokardiyografisinde sol atriyum içerinde kitle saptandı. Transözefageal ekokardiyografide bir tanesi sol atriyum duvarı ve mitral kapak arka yaprakçığının atriyal yüzüne geniş tabanlı olarak bağlanmış, diğeri ise ilk parçaya bitişik olan 2 parçalı sol atriyal kitle saptandı ve hasta operasyon amaçlı kalp damar cerrahisine devredildi. Cerrahi olarak çıkarılan kitlenin histopatolojik incelemesi mezotelyal/monositik rastlantısal kardiyak tümör MRKT ve düşük grade’li leiomiyosarkom olarak rapor edildi. Yapılan literatür incelemesinde, MRKT ve primer kardiyak leiomiyosarkom birlikteliği bildirilmemiştir. Bu yazıda nefes darlığı ve bayılma şikayeti sonrası tanı konulan bu nadir kardiyak kitle ekokardiyografik ve histopatolojik bulguları ile birlikte sunulmuştur.

Anahtar Kelimeler:

Kardiyak tümör, kardiyak leiomiyosarkom, sol atriyal kitle, mezotelyal/monositik rastlantısal kardiyak tümör

Mesothelial/Monocytic incidental cardiac excrescences MICE with primary cardiac leiomyosarcoma: Report of the first case

A 74-year-old man was admitted to outpatient cardiology clinic with the compliant of shortness of breath. After evaluation of the patient, transthorasic echocardiography revealed left atrial mass. Transesophageal echocardiography demonstreated a left atrial mass with two lobule, one attached to left atrial wall and atrial side of posterior mitral leaflet with a wide base, the other one was adjacent to the first one and patient refered to cardiac surgery. Histopathological diagnosis of masses revealed Mesothelial/monocytic incidental cardiac excrescence MICE and low grade leiomyosarcoma. According to our search of literature did not yield any report of a case with occurance of primary cardiac leiomyosarcoma MICE together. Thus, we discuss herein this rare cardiac mass presented with shortness of breath and syncope, together with the findings on echocardiography and histopathology.

Keywords:

Cardiac tumors, cardiac leiomyosarcoma, left atrial mass, Mesothelial/monocytic incidental cardiac excrescence,

PDF

___

1. Silverman NA. Primary cardiac tumors. Ann Surg. 1980;191:127–38.
2. 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;19:748-56.
3. Hu ZL, Lü H, Yin HL, Wen JF, Jin O. A case of mesothelial/monocytic incidental cardiac excrescence and literature review. Diagnostic Pathology 2010;5:40.
4. Kauczor HU, Schwickert HC, Mayer E, Kersjes W, Moll R, Schweden F. Pulmonary artery sarcoma mimicking chronic thromboembolic disease: Computed tomography and magnetic resonance imaging findings. Cardiovasc Intervent Radiol 1994;17:185–9.
5. Burke A, Virmani R: Fascicle 16, 3rd series: Tumors of the heart and the great vessels. Atlas of Tumor Pathology, Washington, DC, Armed Forces Institute of Pathology, 1996.
6. Ishikawa K, Takanashi S, Mihara W, Fukui T, Hosoda Y. Surgical treatment for primary cardiac leiomyosarcoma causing right ventricular outflow obstruction. Circ J 2005;69:121.
7. Clarke NR, Mohiaddin RH, Westaby S, Banning AP. Multifocal cardiac leiomyosarcoma. Diagnosis and surveillance by transoesophageal echocardiography and contrast enhanced cardiovascular magnetic resonance. Postgrad Med J 2002;78:492.
8. Türkyilmaz E, Yilmaz F, Ozkan A, Keles N, Saglam M, Karakaya O, Yakut C, Kaymaz C. Complete resection of a leiomyosarcoma of the left atrium invading the mitral anterior leaflet and obstructing the mitral orifice. Eur J Echocardiogr. 2008;9:123-5.
9. Jain D, Maleszewski JJ, Halushka MK. Benign cardiac tumors and tumorlike conditions. Ann Diagn Pathol 2010;14:215–30.
10. Censi S, Dell'Amore A, Conti R, Lorenzini P. Cardiac mesothelial/monocytic-incidentalexcrescence: more than an artifactual lesion? Interact Cardiovasc Thorac Surg. 2008;7:1201-3.