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Thorac Cardiovasc Surg 2003; 51(6): 347-350
DOI: 10.1055/s-2003-45429
Original Paper
© Georg Thieme Verlag Stuttgart · New York

Left Atrial Thrombus Mistaken as a Tumor after Heart Transplantation

K.  M.  Dunst1 , H.  Antretter1 , G.  M.  Huemer2 , G.  Poelzl3 , G.  Laufer1
  • 1Department of Cardiac Surgery,
  • 2Department of Plastic Surgery and
  • 3Department of Cardiology, University Hospital Innsbruck, Leopold-Franzens University Innsbruck, Austria
Further Information

Publication History

Received June 30, 2003

Publication Date:
11 December 2003 (online)

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Abstract

The occurrence of neoplastic malignancy due to chronic immunosuppression in heart transplant recipients is a well-known threat. Continuous check-ups are therefore mandatory in this patient group. We describe the case of a 58-year-old man transplanted for dilated cardiomyopathy. During regular diagnostic check-up, a solid mass in the left atrium was discovered on the transesophageal echocardiogram. Since the mass became progressively larger over three years and showed features of neither myxoma nor thrombus, a cardiac sarcoma was suspected. A secondary diagnostic magnetic resonance tomography (MRT) investigation was contraindicated due to an implanted pacemaker. Intraoperatively, the mass proved to be an organized thrombus. Surgery had to be performed without an established accurate diagnosis due to a suspected malignancy in chronically immunosuppressed patients.

Key words

Heart transplantation - immunosuppression - tumor - atrial thrombus

References

  • 1 Cole W. The increase in immunosuppression and its role in the development of malignant lesions.  J Surg Oncol. 1985;  30 139-144
    PubMedSearch in Google Scholar
  • 2 Catena F, Nardo B, Liviano d'Arcangelo G. et al . De novo malignancies after organ transplantation.  Transplant Proc.. 2001;  33 1858-1859
    CrossrefPubMedSearch in Google Scholar
  • 3 Chitwood W R. Cardiac neoplasms: current diagnosis, pathology and therapy.  J Cardiac Surg. 1988;  3 119-154
    PubMedSearch in Google Scholar
  • 4 Mueller J, Eubel A, Dandel M, Hummel M, Hetzer R. Non-invasive monitoring of rejection after cardiac transplantation.  Dtsch Med Wochenschr. 2001;  126 1223-1228
    Thieme ConnectPubMedSearch in Google Scholar
  • 5 Starzl T E, Groth C G, Brettschneider L. et al . Orthotopic homotransplantation of the human liver.  Ann Surg. 1968;  168 416
    PubMedSearch in Google Scholar
  • 6 Penn I, Hammond W, Brettschneider L, Starzl T E. Malignant lymphomas in transplantation patients.  Transplant Proc. 1969;  1 106-112
    PubMedSearch in Google Scholar
  • 7 Caforio A LP, Tursi V, Brombin M, Feltrin G, Anmgelini A, Livi U. Heart transplantation in patients with neoplastic disease.  Transplant Proc. 1998;  30 1928
    CrossrefPubMedSearch in Google Scholar
  • 8 Edwards B S, Hunt S A, Fowler M B, Valantine H A, Stinson E B, Schroeder J S. Cardiac transplantation in patients with preexisting neoplastic disease.  Am J Cardiol. 1990;  65 501-504
    CrossrefPubMedSearch in Google Scholar
  • 9 Meyding-Lamade U, Krieger D, Schnabel P. Cerebral metastases of an allogenic renal cell carcinoma in a heart recipient without renal cell carcinoma.  J Neurol. 1996;  243 425-427
    PubMedSearch in Google Scholar
  • 10 Rankin J M, Hartland G D, Ireland M A. Right atrial thrombus mimicking myxoma in a heart transplant recipient.  Am Heart J. 1996;  132 452-454
    CrossrefPubMedSearch in Google Scholar
  • 11 Kinney E L, Wright R J. Efficacy of treatment of patients with echocardiographically detected right-sided heart thrombi: a metaanalysis.  Am Heart J. 1989;  118 569-573
    CrossrefPubMedSearch in Google Scholar

Correspondence

MD Karin M. Dunst

Department of Cardiac Surgery, Leopold-Franzens University

Anichstrasse 35

6020 Innsbruck

Austria

Phone: +43/512/504 38 06

Fax: +43/512/504 59 53

Email: karin.dunst@uibk.ac.at