Mesothelioma of the atrioventricular node: first successful follow-up after excision

Our plain-English summary of Mesothelioma of the atrioventricular node: first successful follow-up after excision, by S. Balasundaram, S.A. Halees, C. Duran (European Heart Journal, 1992).

The study

• Authors: S. Balasundaram, S.A. Halees, C. Duran
• Journal: European Heart Journal
• Published: 1992;13(5):718-9
• Type of article: Case report
• Cited by: 25 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Mesothelioma of atrioventricular nodes may cause congenital heart block and diagnosis is usually confirmed at post-mortem. Awareness of the possibility of the development of this tumour and selective coronary arteriography may help to diagnose this in life.

In plain English

This case report came from King Faisal Specialist Hospital and Research Centre in Riyadh, Saudi Arabia. It described a 21-year-old woman with palpitations, breathlessness on moderate exertion and a heart murmur. Her electrocardiogram showed first degree AV block (a delay in the electrical signal between the heart's upper and lower chambers), with a PR interval of 0.26 s. Echocardiography showed an ostium secundum atrial septal defect, a hole between the upper chambers. Neither echocardiography nor catheterization showed a tumour. During surgery to close the defect, surgeons unexpectedly found a small mass measuring 0.5 cm x 0.5 cm x 0.3 cm near the atrioventricular node, and removed it completely. Microscopic examination found it consistent with mesothelioma of the atrioventricular node, which the authors described as a benign tumour. After surgery her heart was in third degree AV block, later recorded as AV dissociation. At follow-up, echocardiography showed no remaining mass, and she later had a pregnancy with a normal delivery. The authors concluded this may be the first successful removal of this tumour. The article does not mention asbestos.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report
• Who was studied: One 21-year-old woman referred to the Department of Cardiovascular Diseases, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia. She had palpitations, breathlessness on moderate exertion (NYHA class II) and a heart murmur. Dates of care are not given; the paper was submitted in April 1991.
• Main results:
  • Before surgery, the patient's electrocardiogram showed first degree AV block with a PR interval of 0.26 s (printed as "0-26 s" in the scanned text) and incomplete right bundle branch block.
  • Echocardiography showed an ostium secundum atrial septal defect but no abnormal mass in the AV node area. Selective coronary arteriography was not performed.
  • At surgery, a small soft mass measuring 0.5 cm x 0.5 cm x 0.3 cm (printed as "0-5 cm x 0-5 cm x 0-3 cm") was found in the interatrial septum in the triangle of Koch, between the coronary sinus and the atrioventricular node. It was excised together with a piece of the septum.
  • Histology was consistent with mesothelioma of the atrioventricular node, and the excision was complete.
  • After bypass the heart was in third degree AV block. The patient remained in AV dissociation with a ventricular response of 55-60 beats per minute.
  • At follow-up, echocardiography showed no residual mass, and the patient later had a pregnancy with a normal delivery.
• The authors' conclusion: The authors concluded that this may be the first case of mesothelioma of an AV node being successfully excised. They suggested that awareness of this tumour and selective coronary arteriography may help diagnose it in life.
• Limitations the authors state:
  • The tumour could not be seen on echocardiography or angiography, even when the authors reviewed the images after surgery, possibly because of its small size.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma.

Medical terms in this study, explained in our Lexicon: Mesothelioma.

Related studies

• "Mesothelioma of the atrioventricular node" with long-standing complete heart block. Report of a case — I.R. Wanless, B.W. Mielke, et al. (1975)
• Mesothelioma of the atrioventricular node and congenital complete heart block — R. Subramanian, B. Flygenring (1989)
• Fatal heart block due to mesothelioma of the atrioventricular node — D.W. Evans, P.G. Stovin (1986)
• Mesothelioma of the atrioventricular node — K. Nishida, G. Kamijima, et al. (1985)
• Congenital polycystic tumor of the atrioventricular node (endodermal heterotopia, mesothelioma): a histogenetic appraisal with evidence for its endodermal origin — G. Fine, U. Raju (1987)
• Corpora amylacea in mesothelioma of the atrioventricular node — R. David, Y. Hiss (1978)

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