Cardiac cavernous hemangioma mimicking pericardial cyst: atypical echocardiographic appearance of a rare cardiac tumor

Cavernous hemangioma is a rare tumor with infrequent cardiac involvement. Preoperative or antemortem diagnosis may be difficult. Several prior case reports have described echocardiographic findings of cavernous hemangioma. We report here a 50-year-old white female patient with this tumor. Transesophageal echocardiography detected a mass with an echocardiographic appearance not previously described for cavernous hemangioma. The tumor appeared as a large echolucent unilocular cystic mass, leading to an erroneous preoperative diagnosis of pericardial cyst. This previously unreported finding should be recognized by echocardiographers in the evaluation of cardiac masses.     

Some new concepts of cardiac myxoma

The surgical treatment of cardiac myxoma in 211 consecutive cases (single tumor in 204 cases, multiple in 7, and recurrent in 3) from Dec. 1975 through Dec. 1993 was reviewed. Totally 228 myxomas were found and 215 operations performed. Data from this series and literature show that there were some complicated cases so that cardiac myxoma can not be simply regarded as a benign tumor only, but may be classified into two kinds: simple (or sporadic) cardiac myxoma and complicated cardiac myxoma. The latter includes myxoma complex, familial myxoma, and myxoma from multicenters. The clinical features, main points of diagnosis and surgery are concisely summarized.     

Localized fibroma: a rare tumor of pleural origin

Localized fibroma represents a rare entity arising from the pleura. Currently its histogenesis and clinical behaviour are still controversial. A case of a 64-year-old male is here presented; clinical and histopathological features are then discussed on the basis of a review of the Literature. At present, an en-bloc resection of the tumor, including wide margins of the surrounding lung tissue, seems to be the most appropriate surgical choice.     

Biliary duct granular cell tumor: a rare but surgically curable benign tumor

Granular [correction of Granulosa] cell tumors are rare benign tumors which may be found throughout the body. Rare cases are isolated within the biliary tree. If completely resected, surgical excision is curative. A case of biliary duct granular [correction of granulosa] cell tumor is presented with review of the world's literature on this topic.     

Simulation of right atrial cardiac myxoma by silent hepatocellular carcinoma

A clinically silent hepatocellular carcinoma presenting as a mixoma of the right atrium is described. Intra-atrial growth has been reported in advanced, clinically manifested cases of liver carcinomas in African and Japanese subjects, but very occasionally in Caucasian people. Our case further suggests that this occurrence should also be considered in Western Countries.     

Eosinophilic cystitis: a rare case which presented as an invasive bladder tumor

Eosinophilic cystitis is a rare inflammatory lesion of the bladder of unknown etiology. It can be confused clinically and cytoscopically with invasive bladder cancer. We report a case in which the lesion presented as an invasive bladder tumor and we discuss the literature in brief.     

Spindle cell hemangioendothelioma: a case presentation and literature review of a rare lower extremity tumor

The authors present a rare soft tissue mass of the lower extremity that has been presented in the podiatric literature only once. Spindle cell hemangioendothelioma was first identified 9 years ago, and approximately 45 cases have been documented in the literature. This lesion presents as a slow growing and often painless lesion of the extremities, with low malignant potential and high local recurrence. This patient was treated with surgical excision after a mass, which had been present for more than 10 years, began enlarging and became painful. A review of the literature and the case presentation will be given.     

Bladder paraganglioma (pheochromocytoma): a rare tumor in children. Apropos of a case

The authors report the first case of bladder paraganglioma in a child admitted to their department successfully treated by partial cystectomy. The diagnosis was established histologically, after failure of clinical diagnosis. Retrospectively' the authors think that preoperative diagnosis should have been possible and emphasize the importance of a thorough clinical examination.     

Cardiac myxoma: a diagnostic challenge for the neurologist

Three patients with left atrial myxoma presented with prominent neurologic symptoms and signs (cerebrovascular disease and/or syncope) within the past year. Two patients died because antemortem diagnosis was late or missed. One patient was successfully treated. Cardiac myxoma produces protean clinical manifestations that do not always include cardiac signs and symptoms. Neurologists may be called on for diagnostic consultation in patients who will prove to have cardiac myxoma. Unexplained transient ischemic attacks, cerebral infarction, or syncope (with possible features of seizure activity) are common neurologic manifestations of this disease. Additionally, systemic symptoms, signs, and laboratory data suggestive of collagen vascular disease or vasculitis are also often present. Echocardiography is a dependable noninvasive procedure for a confirmation of diagnosis in suspected cases.     

An unusual site of cardiac myxoma. Apropos of a case in an 11-year old child

Cardiac myxoma, a relatively common condition in adults, is exceptionally rare in childhood. It is usually observed in the left atrium. The condition may be latent and a chance echocardiographic finding or present with arrhythmias, intermittent mitral obstruction or embolic phenomena. The authors report the case of an 11-year old child with no previous medical history, admitted to hospital after sudden right hemiplegia due to an ischaemic cerebrovascular accident. The investigation of a cardiac embolic abnormality led to the finding of a very large left ventricular tumour inserted into the mitral annulus and prolapsing into the left ventricular outflow tract, the histological examination of which confirmed the diagnosis of myxoma. Cardiac myxomas in children seem to have a much more variable site of implantation than in adults, especially in the right heart in infancy. Treatment is always surgical. Echocardiography should be requested early in children presenting with a murmur of recent origin, malaises, or unexplained inflammatory syndromes, and would seem to be the only means of avoiding the severe embolic complications of these histologically benign tumours.     

Duplication of the stomach as a rare cause of cystic epigastric tumor

Duplications of the gastrointestinal tract are congenital anomalies seen in about 0.2% of all children. These include the rare gastric duplications. Latter diagnosis is usually made in the first months after birth on recurrent vomiting by detection of an abdominal tumor. The most important imaging modality is ultrasonography. The case of a prematurely born child weighing 1900 g is presented in whom at the age of three weeks a gastric duplication of the greater curvature was diagnosed and who was successfully treated by resection. The postoperative follow-up for 24 months was uncomplicated.     

A rare case of a thyrotropin-secreting pituitary tumor which responded to methimazole

A 52-year-old Japanese male complained of palpitations and excessive sweating. He showed evidence of hyperthyroidism, but without suppression of the serum thyroid-stimulating hormone (TSH). On admission, the serum level of the alpha-subunit of TSH was elevated, but tests for thyroid autoantibodies were negative. The TSH response to thyrotropin-releasing hormone (TRH) was blunted. Imaging studies revealed a pituitary tumor 2 cm in diameter. Administration of methimazole lowered the serum levels of thyroid hormones, and elevated the serum level of TSH. These findings led to the diagnosis of a thyrotropin-secreting pituitary tumor. Immunohistochemical analysis and electron microscopic findings verified the diagnosis.     

Use of neurosurgical techniques for removal of a cardiac tumor

A 6-week-old male infant with a capillary hemangioma of the right atrioventricular groove adjacent to the right coronary artery and conduction system underwent successful resection with the aid of microneurosurgical instrumentation. The technical challenge was thought to be analogous to that encountered by microneurosurgeons in their dissection of brain tumors.