Tactics of the treatment of left atrial angiosarcoma

The aim – to characterize the difficulties of diagnosis, the choice of tactics and the application of a new approach to the surgical treatment of malignant neoplasms, aimed at reducing the likelihood of recurrent intracardiac tumor growth. Materials and methods. The article presents a case of obser...

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Main Authors: R.M. Vitovskyi, V.V. Isaіenko, D.М. Dyadyun, O.A. Pishchurin, V.F. Onishchenko, Ya.R. Ivanov, O.V. Kupchinskyi
Format: Article
Language:English
Published: TOV Chetverta Khvylia 2019-10-01
Series:Кардіохірургія та інтервенційна кардіологія
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Online Access:http://csic.com.ua/images/pdf/2019/3-2019/tactics-of-the-treatment-of-left-atrial-angiosarcoma.pdf
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author R.M. Vitovskyi
V.V. Isaіenko
D.М. Dyadyun
O.A. Pishchurin
V.F. Onishchenko
Ya.R. Ivanov
O.V. Kupchinskyi
author_facet R.M. Vitovskyi
V.V. Isaіenko
D.М. Dyadyun
O.A. Pishchurin
V.F. Onishchenko
Ya.R. Ivanov
O.V. Kupchinskyi
author_sort R.M. Vitovskyi
collection DOAJ
description The aim – to characterize the difficulties of diagnosis, the choice of tactics and the application of a new approach to the surgical treatment of malignant neoplasms, aimed at reducing the likelihood of recurrent intracardiac tumor growth. Materials and methods. The article presents a case of observation of a malignant tumor of the left atrium (LA) – angiosarcoma – in a patient aged 41 years, hospitalized with a previously established diagnosis of stage II lung sarcoidosis and myxoma of the LA. Results. Taking into account the severe obstruction of the mitral valve by the neoplasm, a decision was made on emergency surgical treatment. Neoplasm was visualized in the LA cavity, filling almost its entire cavity. A tumor 12 × 7 × 5 cm was removed. Histological examination of the tumor revealed a low-grade angiofibrosarcoma. Two weeks after discharge, computed tomography revealed atrial tumor recurrence. Given the observed fast recurrence, it was decided to separate the tumor tissue from the lumen of the LA and to avoid direct contact with blood. Therefore, the mouth of the right lower pulmonary vein was closed with a patch from the autopericardium. The control CT studies after a course of chemotherapy recorded moderate tumor growth in the projection of the lung tissue; there was no recurrent tumor growth in the cavity of the LA. Conclusions. Surgical treatment of malignant heart tumors should be aimed at the most radical removal of the neoplasm, the restoration of adequate intracardiac hemodynamics, and in cases of the impossibility of performing a radical operation, at isolating the tumor tissue from direct contact with the blood to prevent rapid recurrent intracardiac growth of the neoplasm.
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institution Kabale University
issn 2305-3127
language English
publishDate 2019-10-01
publisher TOV Chetverta Khvylia
record_format Article
series Кардіохірургія та інтервенційна кардіологія
spelling doaj-art-78cdb09f4bb846bcbe21286d84c98bd02025-02-03T00:51:12ZengTOV Chetverta KhvyliaКардіохірургія та інтервенційна кардіологія2305-31272019-10-013384510.31928/2305-3127-2019.3.3845Tactics of the treatment of left atrial angiosarcomaR.M. Vitovskyi0V.V. Isaіenko1D.М. Dyadyun2O.A. Pishchurin3V.F. Onishchenko4Ya.R. Ivanov5O.V. Kupchinskyi6Shupyk National Medical Academy of Postgraduate Education, Kyiv, Ukraine; M.M. Amosov National Institute of Cardiovascular Surgery of NAMS of Ukraine, Kyiv, UkraineShupyk National Medical Academy of Postgraduate Education, Kyiv, Ukraine; M.M. Amosov National Institute of Cardiovascular Surgery of NAMS of Ukraine, Kyiv, UkraineM.M. Amosov National Institute of Cardiovascular Surgery of NAMS of Ukraine, Kyiv, UkraineShupyk National Medical Academy of Postgraduate Education, Kyiv, UkraineShupyk National Medical Academy of Postgraduate Education, Kyiv, UkraineM.M. Amosov National Institute of Cardiovascular Surgery of NAMS of Ukraine, Kyiv, UkraineM.M. Amosov National Institute of Cardiovascular Surgery of NAMS of Ukraine, Kyiv, UkraineThe aim – to characterize the difficulties of diagnosis, the choice of tactics and the application of a new approach to the surgical treatment of malignant neoplasms, aimed at reducing the likelihood of recurrent intracardiac tumor growth. Materials and methods. The article presents a case of observation of a malignant tumor of the left atrium (LA) – angiosarcoma – in a patient aged 41 years, hospitalized with a previously established diagnosis of stage II lung sarcoidosis and myxoma of the LA. Results. Taking into account the severe obstruction of the mitral valve by the neoplasm, a decision was made on emergency surgical treatment. Neoplasm was visualized in the LA cavity, filling almost its entire cavity. A tumor 12 × 7 × 5 cm was removed. Histological examination of the tumor revealed a low-grade angiofibrosarcoma. Two weeks after discharge, computed tomography revealed atrial tumor recurrence. Given the observed fast recurrence, it was decided to separate the tumor tissue from the lumen of the LA and to avoid direct contact with blood. Therefore, the mouth of the right lower pulmonary vein was closed with a patch from the autopericardium. The control CT studies after a course of chemotherapy recorded moderate tumor growth in the projection of the lung tissue; there was no recurrent tumor growth in the cavity of the LA. Conclusions. Surgical treatment of malignant heart tumors should be aimed at the most radical removal of the neoplasm, the restoration of adequate intracardiac hemodynamics, and in cases of the impossibility of performing a radical operation, at isolating the tumor tissue from direct contact with the blood to prevent rapid recurrent intracardiac growth of the neoplasm.http://csic.com.ua/images/pdf/2019/3-2019/tactics-of-the-treatment-of-left-atrial-angiosarcoma.pdfmalignant heart tumorsangiosarcomasurgical treatment
spellingShingle R.M. Vitovskyi
V.V. Isaіenko
D.М. Dyadyun
O.A. Pishchurin
V.F. Onishchenko
Ya.R. Ivanov
O.V. Kupchinskyi
Tactics of the treatment of left atrial angiosarcoma
Кардіохірургія та інтервенційна кардіологія
malignant heart tumors
angiosarcoma
surgical treatment
title Tactics of the treatment of left atrial angiosarcoma
title_full Tactics of the treatment of left atrial angiosarcoma
title_fullStr Tactics of the treatment of left atrial angiosarcoma
title_full_unstemmed Tactics of the treatment of left atrial angiosarcoma
title_short Tactics of the treatment of left atrial angiosarcoma
title_sort tactics of the treatment of left atrial angiosarcoma
topic malignant heart tumors
angiosarcoma
surgical treatment
url http://csic.com.ua/images/pdf/2019/3-2019/tactics-of-the-treatment-of-left-atrial-angiosarcoma.pdf
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AT dmdyadyun tacticsofthetreatmentofleftatrialangiosarcoma
AT oapishchurin tacticsofthetreatmentofleftatrialangiosarcoma
AT vfonishchenko tacticsofthetreatmentofleftatrialangiosarcoma
AT yarivanov tacticsofthetreatmentofleftatrialangiosarcoma
AT ovkupchinskyi tacticsofthetreatmentofleftatrialangiosarcoma