Герминогенные опухоли средостения (тератодермоидные новообразования)

Представлены в историческом аспекте герминогенные опухоли средостения (тератодермоидные новообразования), их терминология, клинико-морфологическая характеристика, диагностика и лечение.Подано в історичному аспекті герміногенні пухлини середостіння (тератодермоїдні новоутворення), їх термінологію, клініко-морфологічну характеристику, діагностику та лікування.Germenogenic tumors of the mediastinum (teratodermoid neoplasms), their terminology, clinical morphological characteristics, diagnosis and treatment are presented in historical aspect

Cardiac Masses on Cardiac CT: A Review

Cardiac masses are rare entities that can be broadly categorized as either neoplastic or non-neoplastic. Neoplastic masses include benign and malignant tumors. In the heart, metastatic tumors are more common than primary malignant tumors. Whether incidentally found or diagnosed as a result of patients’ symptoms, cardiac masses can be identified and further characterized by a range of cardiovascular imaging options. While echocardiography remains the first-line imaging modality, cardiac computed tomography (cardiac CT) has become an increasingly utilized modality for the assessment of cardiac masses, especially when other imaging modalities are non-diagnostic or contraindicated. With high isotropic spatial and temporal resolution, fast acquisition times, and multiplanar image reconstruction capabilities, cardiac CT offers an alternative to cardiovascular magnetic resonance imaging in many patients. Additionally, cardiac masses may be incidentally discovered during cardiac CT for other reasons, requiring imagers to understand the unique features of a diverse range of cardiac masses. Herein, we define the characteristic imaging features of commonly encountered and selected cardiac masses and define the role of cardiac CT among noninvasive imaging options

Intrapericardial Extralobar Pulmonary Sequestration Presenting as a Prenatal Intrathoracic Mass

An intrathoracic mass, which persisted during the remaining pregnancy, was first seen during routine ultrasound examination performed at 20 weeks gestation. After birth, the child was asymptomatic. Echocardiography showed the mass to be located intrapericardially. The mass was electively resected via sternotomy 3 weeks after the birth. Microscopic examination showed normal lung tissue surrounded by pleura corresponding to the diagnosis of extralobar pulmonary sequestration. To the authors’ knowledge, this is the earliest described detection of such a lesion. Furthermore, this article reports the unique finding of a feeding vessel from the right pulmonary artery

Fetal intrapericardial teratomas

Fetal intrapericardial teratomas are rare and benign. However, they can be life-threatening owing to the complicated massive pericardial effusions, tamponade, or cardiorespiratory distress. The purpose of this review is to give an overview on clinical features, management and prognoses of fetal intrapericardial teratomas. The materials of this study were based on a comprehensive literature retrieval of fetal intrapericardial teratomas published in the past two decades. It was noteworthy that fetal pericardial/pleural effusions or ascites were detected since 19-week gestation, and tumors could be found since 21-week gestation. A growing trend of tumors was observed in more than half of the cases. Prenatal centesis and postnatal tumor resection were required in most of the cases. Fetoneonatal deaths (including fetal demise, termination of pregnancy and neonatal death) occurred in one-third of the cases. The neonatal survival rate was 59.4%. Symptomatic fetuses usually required perinatal maneuvers, such as pericardiocentesis, or thoraco-/ pericardio-amniotic shunt in order to improve fetal hemodynamic status and prolong the pregnancy for lung maturity. Open fetal surgery and ex utero intrapartum treatment (EXIT) procedure can be considered, however, impact of EXIT procedure on later delivery remains uncertain. Postnatal operation is a curative and symptom-relieving method for those cases with prenatally diagnosed intrapericardial teratomas. As a result, the fetoneonatal outcomes are somewhat promising

Cardiac tumours in children

Cardiac tumours are benign or malignant neoplasms arising primarily in the inner lining, muscle layer, or the surrounding pericardium of the heart. They can be primary or metastatic. Primary cardiac tumours are rare in paediatric practice with a prevalence of 0.0017 to 0.28 in autopsy series. In contrast, the incidence of cardiac tumours during foetal life has been reported to be approximately 0.14%. The vast majority of primary cardiac tumours in children are benign, whilst approximately 10% are malignant. Secondary malignant tumours are 10–20 times more prevalent than primary malignant tumours. Rhabdomyoma is the most common cardiac tumour during foetal life and childhood. It accounts for more than 60% of all primary cardiac tumours. The frequency and type of cardiac tumours in adults differ from those in children with 75% being benign and 25% being malignant. Myxomas are the most common primary tumours in adults constituting 40% of benign tumours. Sarcomas make up 75% of malignant cardiac masses. Echocardiography, Computing Tomography (CT) and Magnetic Resonance Imaging (MRI) of the heart are the main non-invasive diagnostic tools. Cardiac catheterisation is seldom necessary. Tumour biopsy with histological assessment remains the gold standard for confirmation of the diagnosis. Surgical resection of primary cardiac tumours should be considered to relieve symptoms and mechanical obstruction to blood flow. The outcome of surgical resection in symptomatic, non-myxomatous benign cardiac tumours is favourable. Patients with primary cardiac malignancies may benefit from palliative surgery but this approach should not be recommended for patients with metastatic cardiac tumours. Surgery, chemotherapy and radiotherapy may prolong survival. The prognosis for malignant primary cardiac tumours is generally extremely poor

Intrapericardial teratoma in a newborn: a case report

We report a successfully surgically intervened case of intrapericardial teratoma, which was diagnosed prenatally. Intrapericardial teratomas are rare cases, and surgical management of those tumors are challenging in this age group. The compression effect of the mass led to misdiagnosis of the anomaly as a transposition of the great vessels. We conclude that intrauterine echocardiography in experienced hands is an essential tool for the follow-up of these patients to detect the pericardial effusion and compression of the cardiac structures, which may cause tamponade and heart failure

Volume 26, index

The mission of CJS is to contribute to the effective continuing medical education of Canadian surgical specialists, using innovative techniques when feasible, and to provide surgeons with an effective vehicle for the dissemination of observations in the areas of clinical and basic science research. Visit the journal website at http://canjsurg.ca/ for more.https://ir.lib.uwo.ca/cjs/1193/thumbnail.jp