Primary right atrial synovial sarcoma manifesting as transient ischemic attacks

Primary tumors of the heart are rare and most of them benign. The majority of benign cardiac tumors are myxomas while almost all malignant cardiac tumors are sarcomas. We present a case of primary right atrial synovial sarcoma, a form of sarcoma particularly rare in the heart. The tumor manifested clinically as transient ischemic attacks probably related to a patent foramen ovale allowing paradoxical tumor embolization.     

Prim?r maligne Knochentumoren

Among human neoplasms, primary malignant bone tumors are fairly rare. They present an incidence rate of roughly 10 cases per 1 million inhabitants per year. During childhood (<15 years), the percentage of malignant bone tumors amounts to 6% of all infantile malignancies. Only leukemia and lymphoma show a higher incidence in adolescence. Of all primary malignant bone tumors, 60% affect patients younger than 45 years and the peak incidence of all bone tumors occurs between 15 and 19 years. The most common primary malignant bone tumors are osteosarcoma (35%), chondrosarcoma (25%), and Ewing's sarcoma (16%). Less frequently (≤?5%) occurring tumors are chordoma, malignant fibrous histiocytoma of bone, and fibrosarcoma of bone. Vascular primary malignant tumors of bone and adamantinoma are very rare. Staging of the lesion is essential for systemic therapeutic decision-making and includes complete imaging and histo-pathological confirmation of the suspected entity. In most cases, this is established by open- or image-guided biopsy. Based on this information, an interdisciplinary tumor board will determine the individual therapeutic approach. Endoprosthetic or biological reconstruction following wide tumor resection is the most common surgical therapy for primary malignant bone tumors. There is vital importance in a thorough postoperative follow-up and continous after-care by a competent tumor center which is permanentely in charge of therapy.     

Primary leiomyosarcoma of the heart, report of a case and review of the literature

Primary cardiac neoplasms are unusual and are found in only about 0.0017% of autopsies. Approximately 25% of primary cardiac neoplasms are malignant. A case of primary leiomyosarcoma arising from the right ventricle and the pulmonary artery is reported. A 37-year-old man had sudden dyspnea and chest pain. Angiocardiography and MRI revealed moving masses throughout the right ventricle and the pulmonary arteries. An emergent surgery was performed. The multiple tumors were observed and incomplete resection was done. The patient was survived with the aid of a veno-arterial bypass as an assisted circulation on the first postoperative day. However, he gradually became deteriorated again and died 8 days after the operation due to the right ventricular failure. Eleven cases of the primary cardiac leiomyosarcoma including our case in the Japanese literature were reviewed briefly.     

Primary leiomyosarcoma of the heart, report of a case and review of the literature]

Primary cardiac neoplasms are unusual and are found in only about 0.0017% of autopsies. Approximately 25% of primary cardiac neoplasms are malignant. A case of primary leiomyosarcoma arising from the right ventricle and the pulmonary artery is reported. A 37-year-old man had sudden dyspnea and chest pain. Angiocardiography and MRI revealed moving masses throughout the right ventricle and the pulmonary arteries. An emergent surgery was performed. The multiple tumors were observed and incomplete resection was done. The patient was survived with the aid of a veno-arterial bypass as an assisted circulation on the first postoperative day. However, he gradually became deteriorated again and died 8 days after the operation due to the right ventricular failure. Eleven cases of the primary cardiac leiomyosarcoma including our case in the Japanese literature were reviewed briefly.     

Epidemiological and pathological characteristics of cardiac tumors: a clinical study of 242 cases

The purpose of this study was to review the current clinical experience and pathological characteristics of cardiac tumors. We retrospectively reviewed 33,108 consecutive cases of cardiac operations performed at our institution from October 1996 to March 2005. There were 242 cases confirmed histologically as cardiac tumors. Among them, 234 patients were diagnosed with primary heart tumors, revealing a prevalence of 0.71% among the corresponding period cardiac operations. Of primary cardiac tumors, the incidence of benign neoplasm was much higher than malignant masses (90.6% vs. 9.4%, P<0.01). The most common benign cardiac tumor was myxoma (86.8%). Mesenchymoma and angiosarcoma were the most common primary malignant cardiac tumors. The prevalence rates of cardiac tumors were quite different among age groups. Rhabdomyoma and fibroma are prone to children. The number of female patients with myxoma was higher than that in male (P<0.01). Myxomas have a special predilection for the left atrium (93.5%). Benign non-myxoma tumors are more likely to occur in the ventricular (64.3%). The primary malignant tumors have a tendency to be of multi-center origination (23%). All the secondary cardiac tumors were located in the right side of the heart. This study, using a relatively large sample, reveals the clinical incidences and pathological characteristics of various cardiac tumors in the Chinese population.     

Primary malignant melanoma of the right colon

The small and large intestines are the most common sites for metastases from cutaneous malignant melanoma. However, primary melanomas in these sites are exceedingly rare. There are several case reports of patients with primary melanoma of the small bowel, but finding of a solitary primary melanoma in the colon is exceedingly rare. We describe a patient that was operated on for bowel obstruction due to colonic intussusception resulting from a right colonic tumor. Histopathological examination confirmed a diagnosis of malignant melanoma. A thorough postoperative investigation did not reveal a primary lesion in any other site. Two years after surgery, there was no evidence for recurrent disease. The treatment and prognosis of metastatic and primary melanoma of the gastrointestinal tract is discussed as well as the embryonic base for development of primary malignant melanoma of the intestine. Primary malignant melanoma of the intestine is an extremely rare lesion that may arise in the large bowel as well. It must be differentiated from other intestinal tumors and mandates a thorough investigation to rule out the possibility of being a metastasis from another more common primary site.     

Primary osteosarcoma of the skull. A report of 3 cases

Osteosarcomas are malignant bone tumors, which commonly affect the long bones of young adults. Primary osteosarcomas of the skull are exceedingly rare. We herein report 3 cases of primary osteosarcoma of the skull involving the calvaria, diagnosed over a period of 8 years at the Department of Pathology of our Institute.     

Epiphyseal primary location for osteosarcoma and Ewing sarcoma in patients with open physis

Conventional osteosarcoma and Ewing sarcoma are the most common childhood malignant tumors of bone. These tumors arise in the metaphysis and diaphysis of long bones and may extend secondarily into the epiphysis. Primary epiphyseal location for these tumors is rare and may constitute a diagnostic and therapeutic challenge. The authors report two skeletally immature patients with an osteosarcoma and Ewing sarcoma limited to the epiphysis. Clinical, radiographic and histopathologic findings are discussed.     

Coexistence of intracranial meningioma and primary malignant lymphoma--case report.

The authors present a case of multiple primary intracranial tumors of different cell types. A 62-year-old female presented with symptoms suggestive of an intracranial mass lesion. Computer tomographic scans revealed two lesions, one in the right temporal lobe and one in the posterior fossa. Both tumors were approached in one operation. The right temporal tumor was diagnosed as primary malignant lymphoma, and the right posterior fossa tumor as meningioma. Phacomatosis was ruled out as a possible etiology. Multiple primary intracranial tumors of different cell types are rare, and this is the first report of coexistent intracranial meningioma and malignant lymphoma.     

Budd-Chiari syndrome and portal vein thrombosis due to right atrial myxoma

Budd-Chiari syndrome is a rare disorder characterized by hepatic venous outflow obstruction. Atrial myxomas account for 35% to 50% of primary cardiac tumors and are usually located in the left atrium. We describe a patient who presented with hepatic inferior vena cava and portal vein thrombosis due to a large myxoma of the right atrium. After the successful removal of the tumor, ascites resolved completely. We conclude that right atrial myxoma is a rare but potentially curable cause of Budd-Chiari syndrome.     

Stellung der Strahlentherapie in der Behandlung der Knochentumoren

Primary malignant bone neoplasms are relatively rare.The most common bone tumors are osteosarcoma,Ewing's sarcoma,chondrosarcoma, fibrosarcoma,malignant fibrous histiocytoma of bone, giant cell tumor, aneurysmal bone cyst and chordoma.These tumors are generally considered to be a radioresistant entities, but it has been suggested that radiotherapy may be effective in a palliative and in some curative situations, if a sufficient dose is given to an adequate volume. Only for the management of primary Ewing's sarcoma the radiation therapy is an essential part in the multimodal therapy concept.The most common bone neoplasms and the role of the radiotherapy are discussed in these chapter.     

Recurrent cardiac metastasis of primary femoral osteosarcoma: a case report

A 17-year-old female patient with a history of surgery for primary femoral and metastatic lung osteosarcoma was admitted to our clinic with palpitations. Upon evaluation, a metastatic osteosarcoma in the left ventricle was diagnosed. Based on the collaborative decision of the oncology and cardiovascular surgery clinics, surgery was performed and the patient was discharged without any problems. According to the recommendation of the oncology clinic, chemotherapy was postponed for 6 months after surgery. Five months postoperatively, however, she had a recurrence with 2 tumors. Based on the collaborative decision, chemotherapy was initiated and in 2 months the size of the recurrent tumors had diminished. The patient is still under the care of the oncology and cardiovascular surgery clinics and continuing her chemotherapy regimen. Osteosarcomas have a high mortality. Metastatic tumors of the heart are not common. The location of the metastasis and the characteristics of the primary tumor determine the treatment modality. In some previously published reports, various treatment choices have been described. In the present case report, we present a rare case with metastatic cardiac osteosarcoma.     

Cerebral metastasis of malignant cardiac myxoma.

A rare case of bona fide cerebral metastasis of malignant cardiac myxoma is presented. The parenchymal brain tumor of a 32-year-old woman with a history of surgical operations on cardiac myxoma and jejunal leiomyosarcoma was surgically extirpated. The initial pathological diagnosis was metastatic sarcoma. Ten months later, an occlusion of bilateral carotid arteries occurred that was due to tumor emboli. The postmortem examination revealed an unusually rapid recurrence of the cardiac tumor containing sarcomatous components that were histologically identical to the tumors of the brain and the jejunum and the emboli of the cerebral vessels. Hence it was deduced that they all originated in the primary malignant cardiac myxoma.     

A very rare cardiac hibernoma in the right atrium: a case report

Cardiac lipomas are rare tumors often detected incidentally during routine examinations. They usually remain asymptomatic for a long time and cause arrhythmia, heart valve dysfunction, or embolization in the later stages. In this article, we report a case of a 64-year-old patient with a very rare cardiac hibernoma located in the right atrium. Transesophageal echocardiography and computed tomography have been shown to be useful for differentiating between benign and malignant tumors in order to plan surgery. The treatment of choice for these tumors is resection. The tumor was excised with the use of cardiopulmonary bypass surgery. Histology confirmed diagnosis of a benign cardiac hibernoma.     

Cardiac rhabdomyomas with atrial septal defect and tricuspid insufficiency: A case report

Primary cardiac tumors are very rare and generally benign. The most common type, cardiac rhabdomyoma, comprises 45% to 75% of primary cardiac tumors. Cardiac rhabdomyoma is a rare benign tumor that commonly presents with tuberous sclerosis. We present a case of an infant with multifocal cardiac rhabdomyomas with an atrial septal defect and tricuspid insufficiency and no sign of tuberous sclerosis. She was successfully treated with an operation, the treatment plan included mass resection, tricuspid annuloplasty, and closure of the patent foramen ovale. The right atrial lesion was resected entirely, while the lobulated lesion in the right ventricle was resected as two pieces. There was no evidence of recurrence 1 year after the surgery.     

Obstructive neonatal atrial myxoma

IntroductionCardiac myxoma is a benign neoplasm representing the most common primary cardiac tumor in adults, however it is unusual in neonates. It is represented by an endocardial mass that occupies the cardiac chamber. Although the majority of myxomas are attached to the fossa ovalis of the interatrial septum, they also attach to the walls of the cardiac chambers and to valve leaflets surfaces. Approximately 75% of myxomas are found in the left atrium, 20% are located in the right atrium, and rarely in the ventricles.Presentation of caseWe describe a rare case of neonatal cardiac myxoma arising from interatrial septum, causing significant mechanical obstruction to blood flow through tricuspid valve, in an otherwise normal newborn. The patient underwent successful excision of the myxoma with an uneventful recovery [1].DiscussionCardiac tumors are rare in children, thus an understanding of the common types of benign and malignant paediatric cardiac tumors and their imaging features, is important because the epidemiology and tumor types differ from those encountered in adults.ConclusionLarge neonatal myxoma is exceptionally rare and even more infrequent is the surgical excision in the first day of life.     

Osteosarcoma of the testis

This report describes a case of primary osteosarcoma of the testis in a 60-year-old man. Treatment consisted of an inguinal orchiectomy with no adjuvant therapy. The patient is alive and doing well without recurrent disease at 18 months after diagnosis. Only three reports have been published on primary osteosarcoma of the testis. The origin of this tumor from undifferentiated mesenchymal cells or from a malignant transformation of pre-existing teratomatous elements is still unclear. Management guidelines are difficult to establish due to the rarity of such tumors, but inguinal orchiectomy with careful follow up appears to be sufficient treatment.     

Distinctive Head and Neck Bone and Soft Tissue Neoplasms

Benign and malignant primary bone and soft tissue lesions of the head and neck are rare. The uncommon nature of these tumors, combined with the complex anatomy of the head and neck, pose diagnostic challenges to pathologists. This article describes the pertinent clinical, radiographic, and pathologic features of selected bone and soft tissue tumors involving the head and neck region, including angiofibroma, glomangiopericytoma, rhabdomyosarcoma, biphenotypic sinonasal sarcoma, chordoma, chondrosarcoma, and osteosarcoma. Emphasis is placed on key diagnostic pitfalls, differential diagnosis, and the importance of correlating clinical and radiographic information, particularly for tumors involving bone.     

Low grade central osteosarcoma--a diagnostic dilemma

Low grade central osteosarcoma is a rare primary bone tumor. This fibro-osseous lesion shares some radiological and histopathological resemblance with fibrous dysplasia, which is a more common entity. Thus it may be mistaken as fibrous dysplasia and may receive inadequate treatment resulting in a more malignant recurrent bone tumor. We present a case of low grade central osteosarcoma of the right tibia, which was initially treated as fibrous dysplasia with curettage and bone grafting. Three years later the tumor recurred with greater soft tissue and bony involvement but without metastasis. The patient was treated with above knee amputation and has been asymptomatic for the last two years.     

Case report: A rare case of Ewing's sarcoma and osteosarcoma at different sites 10 years apart

Ewing's sarcoma of bone and osteosarcoma are rare tumors. A combination of high-grade osteosarcoma and Ewing's sarcoma of bone in anatomically unrelated sites is unique, especially in the absence of previous radiation or retinoblastoma. We present a patient with a rare case of Ewing's sarcoma of the scapula that showed no evidence of recurrence (after 10 years of continued followup) and who subsequently presented with a primary osteosarcoma of the femur.