Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0231807 (exertional dyspnea)
 3,402 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Intimal sarcoma of the pulmonary artery is rare, but false diagnosis of this sarcoma as pulmonary embolism is not infrequent. The present study reports a case of pulmonary artery intimal sarcoma misdiagnosed as pulmonary artery embolism in a 37-year-old female patient. The patient was admitted to the cardiac intensive care unit of Guangdong General Hospital (Guangzhou, China) with the complaint of progressive exertional dyspnea over the past two years. Multi-slice spiral computed tomography, transthoracic echocardiography, right-heart catheterization and cardiac magnetic resonance imaging revealed mimicking severe pulmonary embolism in the pulmonary trunk and right pulmonary artery, with symptoms including chest pain, cough and breathing difficulties. In addition, positron emission tomography-computed tomography results did not identify increased 18F-fluorodeoxyglucose uptake and failed to distinguish whether the mass was a thrombus or a malignancy. The patient was diagnosed with pulmonary embolism and a subcutaneous injection of 5,000 AxaIU enoxaparin sodium (100 AXAIU/kg) was administered every 12 h, but no improvement was achieved after 5 days of treatment. Finally, pulmonary endarterectomy was performed to relieve the worsening clinical symptoms. The clinicopathological diagnosis was pulmonary artery intimal sarcoma with poor clinical outcome. For this type of tumor with fatal prognosis, early and correct diagnosis may lead to appropriate intervention and prolong survival.
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PMID:Pulmonary artery intimal sarcoma misdiagnosed as pulmonary embolism: A case report. 2845 56

Primary cardiac tumors are a rare entity. The presence of a mass in the left atrium suggests myxoma as a first differential diagnosis. Here we present a rare case of a woman with exertional dyspnea with a large tumor in the left atrium. The patient was extensively studied with echocardiography, cardiac MRI, coronary angiography and computed tomography. Extracardiac neoplastic involvement was ruled out. The patient underwent surgery, the mass was removed, and the final diagnosis was an undifferentiated pleomorphic sarcoma.
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PMID:A Rare Cause of Dyspnea: Undifferentiated Pleomorphic Sarcoma in the Left Atrium. 2911 88

Pulmonary artery sarcomas (PAS's) are extremely rare malignant tumors that arise from the endothelial lining of the pulmonary arteries. On CT scans PAS's appear as intraluminal filling defects in the pulmonary arteries, mimicking pulmonary embolism (PE). Due to the similarities in radiographic features as well as in clinical presentation, PAS's are usually misdiagnosed as pulmonary embolism. Since PASs are F-18 FDG avid, F-18 FDG PET/CT scan is a useful imaging tool for differentiating between these two conditions, as shown in this case report. We report a case of a 60-year-old woman presented with a 6-month history of chest pain, dyspnea on exertion, non-productive cough and weight loss. The initial CT pulmonary artery angiography showed extensive intraluminal mass in the pulmonary trunk and left pulmonary artery, diagnosed as massive pulmonary embolism. Since there was no clinical improvement after anticoagulant therapy, CT pulmonary angiography was repeated, and with no change observed in the intraluminal filling defect in pulmonary trunk, the possibility of tumor was raised. For further evaluation of a possible malignancy, F-18 FDG PET/CT was performed. It showed increased FDG uptake, suspicious for an aggressive tumor, in the intraluminal lesion of the pulmonary trunk and along the wall of the left pulmonary artery. There was no extrathoracic abnormality seen on PET/CT scan. Histopathological finding after complete pulmonary artery resection showed high grade undifferentiated pleomorphic sarcoma. F-18 FDG PET/CT is a useful tool for differentiating between pulmonary embolism and malignant intraluminal mass, and at the same time it enables the proper staging of the malignancy. < p > < /p >.
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PMID:F-18 FDG PET/CT in pulmonary artery sarcoma: clinical vignette. 2944 47

We report two patients with primary cardiac sarcomas. The first patient was admitted for dyspnea on exertion secondary to congestive heart failure. She was later diagnosed with intimal pleomorphic sarcoma involving the right ventricular outflow tract extending into the pulmonary artery, which was further complicated by metastasis to the lung. The second patient was admitted for left-sided weakness secondary to a right frontal lobe ischemic stroke. The patient was later diagnosed with left atrial intimal pleomorphic sarcoma, which was further complicated by metastasis to the small bowel and right femur.
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PMID:Primary Cardiac Undifferentiated High-Grade Intimal Pleomorphic Sarcoma: A Case Series Report. 3225 20

A 55-year-old woman presented with a history of constitutional symptoms with exertional dyspnea, orthopnea, and cough for one month. She developed progressive heart failure symptoms. Initial computed tomography revealed a large left atrial mass with compression of pulmonary veins and mitral valve. Surgical resection was performed, and histologic examination revealed an intimal sarcoma. The most effective treatment has been found to be a surgical resection, with chemotherapy and radiotherapy. The objective of this report is to describe a common presentation of a rare disease, and to discuss the significance of appropriate diagnosis, pathological findings, and timely interventional management. <Learning objective: Cardiac intimal sarcomas are rare primary malignant tumors. It requires a clinical suspicion for timely diagnosis and intervention, which could result in a good prognosis.>.
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PMID:A rare disease of primary cardiac intimal sarcoma at the left atrium presented with mimicking mitral stenosis in a patient with polycystic kidney disease. 3263 60

Cardiac myxoma is a benign neoplasm composed of stellate to plump, cytologically bland mesenchymal cells set in a myxoid stroma. Although benign, as they can lead to severe complications, they are often removed surgically. A 39-year-old female presented with a chief complaint of generalized fatigue. Patient had a history of a large 7cm x 2.5cm left atrial myxoma resected at the age of 32 years after she presented with symptoms of dyspnea on exertion. The dyspnea was due to prolapse of the mass through the mitral valve during diastole, leading to functional severe mitral stenosis. The mass was resected with clear margins confirmed on biopsy. On physical examination, heart rate was regular with no murmurs. No signs of congestive heart failure were noted. A 2D echo revealed a mobile structure in the left atrium along with mild mitral regurgitation. Cardiac MRI showed a 21mm x 9mm well defined, pedunculated, mobile mass in the left atrium arising from inter-atrial septum. The mass was hyperintense on T2 weighted images with patchy delayed hyper-enhancement consistent with recurrence of a myxoma. The patient underwent a repeat median sternotomy with the removal of left atrial mass and repair of atrial septum with hemashield patch. The mass was sent for pathological evaluation confirming the diagnosis of recurrent myxoma. On genetic testing, patient tested negative for mutations in PRKAR1A gene (mutated in up to 60%-80% cases with Carney complex), MEN1, RET and sarcoma (TP53) genes. Cardiac myxomas are rare primary benign tumors of the heart with a small recurrence rate. Follow-up studies have rarely reported recurrences after complete resection. However, in our case not only did the patient have the sporadic form of myxoma with recurrence, but it also occurred within three years of the previous resection despite complete removal with clear margins.
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PMID:Sporadic Form of Recurrent Atrial Myxoma: The Blob Strikes Back. 3294 60


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