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Calcified amorphous tumor of the heart with purple digit.

Sabzi F, Karim H, Eizadi B, Faraji R, Javid N - J Cardiovasc Thorac Res (2014)

Bottom Line: A calcified amorphous tumor (CAT) of the right atrium (RA) is an exceedingly rare non-neoplastic cardiac mass.It was initially described in 1997 and only a handful of cases has been published so far.We present a case of tumor in 77-year-old male, in the RA that attached to the rim of the fossa ovalis, with classic pathological and clinical findings.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Cardiovascular Surgery, Imam Ali Heart Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.

ABSTRACT
A calcified amorphous tumor (CAT) of the right atrium (RA) is an exceedingly rare non-neoplastic cardiac mass. It was initially described in 1997 and only a handful of cases has been published so far. We present a case of tumor in 77-year-old male, in the RA that attached to the rim of the fossa ovalis, with classic pathological and clinical findings. Under cardiopulmonary bypass (CPB) and bicaval and aortic cannulation and cardioplegic arrest, right atrial mass, was resected and septal defect was repaired with a fresh pericardial patch. Pathological exam of the mass revealed CAT. The patient had an uneventful hospitalization and his blue discoloration of finger recovered normally.

No MeSH data available.


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Mentions: A 77-year-old man presented with progressive dyspnea, fatigue and cough and purple digit. He was diagnosed as having a calcified right atrial mass. Routine laboratory investigations were within normal limits. Complete blood count and blood biochemistry were within normal limits, except for prolonged erythrocyte sedimentation. The protein C level was 78% (normal: >70) and protein S level was 80% (normal: 65%).There are no abnormal values of antithrombin III, lupus anticoagulant, and anticardiolipin antibodies, HLA-B5, HLA-B27, anti-nuclear antibody and rheumatoid factor were negative. Electrocardiogram was normal and chest radiograph showed a calcified shadow retrosternally. Tran esophageal echocardiography showed a right atrial mass measuring 4 × 4 cm with calcification but small fossa ovals defect that was masked by tumor was not reported (Figure 1). Angiography revealed normal coronary artery with mobile calcified mass in RA that feeds by a small collateral artery (Figure 2). A clinical possibility of calcified right atrial myxoma was considered. A physical exam revealed cool and cyanotic left fingers. Our patient underwent cardiac exploration and removal of the mass. Intra-operatively, a calcified mass measuring 4 × 4 cm was noted in the RA with a single site of attachment to fossa ovalis septum (Figure 3). The mass was well-circumscribed with massive calcification more in the basal attaching site (Figure 4). The entire tissue was processed for histopathology. Sections showed a lesion composed of a background of eosinophilic amorphous material, possibly degenerated fibrin, with areas of dense calcification and focal chronic inflammation (Figure 5). No myxomatous or lipomatous or fibromatous tissue was seen and a final diagnosis of CAT of the heart was rendered. The patient was started on aspirin, pentoxifylline and heparin. The cyanotic left hands were kept warm and undue handling was avoided. In 5th operating days, extremity became warm with normal texture and colors.


Calcified amorphous tumor of the heart with purple digit.

Sabzi F, Karim H, Eizadi B, Faraji R, Javid N - J Cardiovasc Thorac Res (2014)

© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4291607&req=5

Mentions: A 77-year-old man presented with progressive dyspnea, fatigue and cough and purple digit. He was diagnosed as having a calcified right atrial mass. Routine laboratory investigations were within normal limits. Complete blood count and blood biochemistry were within normal limits, except for prolonged erythrocyte sedimentation. The protein C level was 78% (normal: >70) and protein S level was 80% (normal: 65%).There are no abnormal values of antithrombin III, lupus anticoagulant, and anticardiolipin antibodies, HLA-B5, HLA-B27, anti-nuclear antibody and rheumatoid factor were negative. Electrocardiogram was normal and chest radiograph showed a calcified shadow retrosternally. Tran esophageal echocardiography showed a right atrial mass measuring 4 × 4 cm with calcification but small fossa ovals defect that was masked by tumor was not reported (Figure 1). Angiography revealed normal coronary artery with mobile calcified mass in RA that feeds by a small collateral artery (Figure 2). A clinical possibility of calcified right atrial myxoma was considered. A physical exam revealed cool and cyanotic left fingers. Our patient underwent cardiac exploration and removal of the mass. Intra-operatively, a calcified mass measuring 4 × 4 cm was noted in the RA with a single site of attachment to fossa ovalis septum (Figure 3). The mass was well-circumscribed with massive calcification more in the basal attaching site (Figure 4). The entire tissue was processed for histopathology. Sections showed a lesion composed of a background of eosinophilic amorphous material, possibly degenerated fibrin, with areas of dense calcification and focal chronic inflammation (Figure 5). No myxomatous or lipomatous or fibromatous tissue was seen and a final diagnosis of CAT of the heart was rendered. The patient was started on aspirin, pentoxifylline and heparin. The cyanotic left hands were kept warm and undue handling was avoided. In 5th operating days, extremity became warm with normal texture and colors.

Bottom Line: A calcified amorphous tumor (CAT) of the right atrium (RA) is an exceedingly rare non-neoplastic cardiac mass.It was initially described in 1997 and only a handful of cases has been published so far.We present a case of tumor in 77-year-old male, in the RA that attached to the rim of the fossa ovalis, with classic pathological and clinical findings.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Cardiovascular Surgery, Imam Ali Heart Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.

ABSTRACT
A calcified amorphous tumor (CAT) of the right atrium (RA) is an exceedingly rare non-neoplastic cardiac mass. It was initially described in 1997 and only a handful of cases has been published so far. We present a case of tumor in 77-year-old male, in the RA that attached to the rim of the fossa ovalis, with classic pathological and clinical findings. Under cardiopulmonary bypass (CPB) and bicaval and aortic cannulation and cardioplegic arrest, right atrial mass, was resected and septal defect was repaired with a fresh pericardial patch. Pathological exam of the mass revealed CAT. The patient had an uneventful hospitalization and his blue discoloration of finger recovered normally.

No MeSH data available.


Related in: MedlinePlus