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Successful surgical treatment for recurrent cardiac fibroma 21 years after resection

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      Abstract

      Cardiac fibromas are rare benign tumors usually seen in the pediatric population. Generally, long-term survival after surgical resection is favorable, and recurrence of fibroma has been hardly reported. Herein, we report a case of a 34-year-old woman who presented with ventricular tachycardia 21 years after resection of a cardiac fibroma and was found to have a recurrent giant cardiac fibroma. We performed a complete resection of the recurrent fibroma. At the 2-year follow-up, she remains asymptomatic with no evidence of ventricular tachycardia or recurrence of fibroma.

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      Most cited references 8

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      Surgery for primary cardiac tumors in children: early and late results in a multicenter European Congenital Heart Surgeons Association study.

      To evaluate indications and results of surgery for primary cardiac tumors in children.
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        Surgical resection of ventricular cardiac fibromas: early and late results.

        Cardiac fibromas are rare tumors. Indications for and preferred type of operation are controversial, and little is known about early and late results of operation. We retrospectively reviewed records of 18 patients who underwent resection of ventricular cardiac fibromas from 1964 to October 2002. Follow-up was obtained from current medical records and recent telephone and written correspondence. Seventeen patients had complete resection and 1 had subtotal resection of one or more fibromas. Tumors were located in the left ventricle (n = 12), septum (n = 4), or right ventricle (n = 2). A 2-month-old infant died intraoperatively. None of the surviving 17 patients had complete heart block. Follow-up lasted up to 33.7 years for a total of 172.1 patient-years. There were no late deaths. Fourteen patients were asymptomatic, 1 was in New York Heart Association functional class II, and 2 were in class III. There was no recurrence of tumor after complete resection and no change in size of residual tumor in the 1 patient who underwent subtotal resection. Although cardiac transplantation has been suggested by some as a preferable operation, most ventricular fibromas, even though extensive, can be completely resected with excellent early and late results. For patients with tumors extending into critical locations, subtotal excision can also give excellent late survival.
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          The clinical spectrum of cardiac fibroma with diagnostic and surgical considerations: noninvasive imaging enhances management.

          A cardiac fibroma was successfully resected from the interventricular septum of a 25-year-old woman. The clinical data were correlated with a review of the data on 144 other patients, thereby providing a clinical profile and management strategy for this type of tumor. Initial manifestations of a fibroma were determined to be congestive heart failure (21%), tachyarrhythmias (13%), and chest pain (3.5%). A majority of patients were asymptomatic (36%) with abnormal physical findings or an abnormal chest roentgenogram. Finding the tumor at autopsy incidentally or on sudden death (23%) indicated the lethal potential. A few (3.5%) of the reports on patients with cardiac fibroma were without clinical data. Noninvasive imaging by echocardiography, computed tomography, and nuclear magnetic resonance improved the diagnosis. Surgical treatment was successful in 53 of the 84 patients for whom it was attempted.
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            Author and article information

            Affiliations
            [ ]Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Japan
            [ ]Department of Pathology, National Cerebral and Cardiovascular Center, Suita, Japan
            Contributors
            kunio555@gmail.com
            hatahiro@ncvc.go.jp
            tomofujita@nifty.com
            victorin@ncvc.go.jp
            satosyun@outlook.com
            hueda@ncvc.go.jp
            jkobayas@ncvc.go.jp
            Journal
            Surg Case Rep
            Surg Case Rep
            Surgical Case Reports
            Springer Berlin Heidelberg (Berlin/Heidelberg )
            2198-7793
            16 May 2015
            16 May 2015
            December 2015
            : 1
            26943406
            4747971
            43
            10.1186/s40792-015-0043-3
            © Kusajima et al.; licensee Springer. 2015

            This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.

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            Case Report
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            © The Author(s) 2015

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