"Mesothelioma of the atrioventricular node" with long-standing complete heart block. Report of a case

Our plain-English summary of "Mesothelioma of the atrioventricular node" with long-standing complete heart block. Report of a case, by I.R. Wanless, B.W. Mielke, B. Jugdutt, et al (American Journal of Clinical Pathology, 1975).

The study

• Authors: I.R. Wanless, B.W. Mielke, B. Jugdutt, R.E. Rossall
• Journal: American Journal of Clinical Pathology
• Published: 1975;63(3):377-83
• Cited by: 15 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

A case of mesothelioma of the atrioventricular node is presented. The patient had complete heart block for many years before death. The origin of the tissue in this apparently congenital tumor is discussed with reference to the literature.

In plain English

This case report about one man does not mention asbestos. The tumor it describes, "mesothelioma of the atrioventricular node," is a small benign growth in the heart near the atrioventricular node, part of the heart's electrical system. The authors, at the University of Alberta Hospital in Edmonton, put the name in quotation marks and said the origin of its cells is not known. The patient was a 55-year-old Caucasian linotype operator. At 21 he had been turned down for military service because of a "slow heart and a murmur." Complete heart block was recorded in 1961, and a permanent pacemaker was inserted in 1967. He died in July 1973 after a sudden collapse in hospital, when pacemakers no longer captured the heart. The autopsy found a tumor of about 15 by 12 by 3 mm in the right atrial wall. It was made of epithelial-like cells with no mitoses, and only scant node tissue remained. The authors counted about 39 earlier reported cases, all benign. They concluded that the evidence did not establish where these tumors come from.

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 (single patient), with a discussion of previously reported cases
• Who was studied: One 55-year-old male Caucasian linotype operator, admitted in July 1973 and examined at autopsy; authors from the University of Alberta Hospital, Edmonton, Alberta, Canada
• Exposure: No asbestos exposure is mentioned or studied. The article reports that the patient's raised urinary lead (0.56 mg per litre) was thought to be related to his occupation.
• Main results:
  • At age 21, in 1939, the patient was not accepted for military service because of a slow heart and a murmur.
  • A permanent right ventricular transvenous pacemaker was inserted in 1967.
  • At his final admission he collapsed suddenly. Neither a transthoracic nor a transvenous pacemaker captured the ventricle, and he died.
  • At autopsy the heart weighed 580 g, the coronary arteries were severely compromised by atheromas, and the aortic valve was massively calcified.
  • A tumor measuring about 15 x 12 x 3 mm (printed with stray spaces in the scan) lay in the right atrial wall, in the region of the A-V node.
  • The tumor was made of cords, ducts and sinuses of epithelial-like cells, some resembling transitional urothelium. No mitoses were seen, and only scant remnants of A-V node tissue remained within it.
  • In the authors' review of earlier reports (not this patient), about 39 cases of mesothelioma of the A-V node had been reported, 27 of the 39 patients were female, and all tumors had been benign.
• The authors' conclusion: The authors concluded that the available evidence was not sufficient to establish where these tumors arise. They said treatment will probably remain symptomatic and diagnosis will probably remain a postmortem exercise.

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, Standing.

Related studies

• 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)
• Mesothelioma of the atrioventricular node: first successful follow-up after excision — S. Balasundaram, S.A. Halees, et al. (1992)
• 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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