Successful operation for solitary fibrous tumor of the epicardium

Our plain-English summary of Successful operation for solitary fibrous tumor of the epicardium, by D. Segawa, H. Yoshizu, Y. Haga, et al (The Journal of Thoracic and Cardiovascular Surgery, 1995).

The study

• Authors: D. Segawa, H. Yoshizu, Y. Haga, N. Hatori, S. Tanaka, S. Aida
• Journal: The Journal of Thoracic and Cardiovascular Surgery
• Published: 1995;109(6):1246-8
• Type of article: Case report
• Cited by: 21 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

This case report from the National Defense Medical College in Saitama, Japan, described one patient with a solitary fibrous tumor growing from the epicardium, the outer surface of the heart. The authors noted that this tumor type has also been known as localized fibrous mesothelioma. The article does not mention asbestos or any exposure history. A 50-year-old woman was referred in November 1990 with a suspected ventricular aneurysm. Ultrasound showed it was a solid mass attached to the right ventricle by a stalk. Having no symptoms, she declined surgery. About two and a half years later she had shortness of breath and palpitations, and the mass had enlarged. In June 1993 surgeons removed it, together with part of the right ventricular muscle, using cardiopulmonary bypass. The tumor measured 12.5 by 10.5 by 8.0 cm and weighed 530 grams. Its microscopic features were compatible with solitary fibrous tumor. The patient left hospital on the fourteenth day after surgery and had been free of recurrence for 19 months. The authors concluded that surgical resection is the best treatment when such tumors are resectable.

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)
• Who was studied: One 50-year-old woman referred to the National Defense Medical College Hospital, Saitama, Japan, in November 1990; operated on June 15, 1993
• Exposure: None reported; the article does not mention asbestos or any exposure history
• Main results:
  • The patient was initially thought to have a ventricular aneurysm, but ultrasound showed a solid mass attached to the right ventricle by a stalk. She declined surgery because she had no symptoms.
  • About two and a half years later she was admitted with shortness of breath and palpitation when lying on her right side, and the mass had enlarged.
  • The tumor grew from the right ventricular wall on a narrow-based pedicle and did not stick to the pericardium. It was removed with cardiopulmonary bypass, together with the adjoining right ventricular muscle.
  • Because the defect in the heart wall was close to the left anterior descending coronary artery, it was repaired between two strips of Dacron felt so that the artery would not be blocked.
  • The encapsulated tumor measured 12.5 by 10.5 by 8.0 cm and weighed 530 g.
  • Under the microscope, nuclear shapes were irregular and dividing cells were relatively frequent (2 to 5 per 10 high-power fields).
  • Tumor cells tested positive for vimentin and negative for cytokeratin, actin, and S-100 protein. The findings were compatible with solitary fibrous tumor.
  • Recovery was uneventful. The patient was discharged on the fourteenth postoperative day and had been free from recurrence for 19 months.
  • The authors stated that they found no previously reported case of an epicardial solitary fibrous tumor in the literature, although three tumors arising from the pericardium had been reported.
• The authors' conclusion: The authors considered surgical resection, with a margin free of tumor cells, the best treatment for resectable solitary fibrous tumors. For epicardial tumors near a coronary artery, they considered it important to repair the ventricular wall defect without damaging the artery.

Topics

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

Medical terms in this study, explained in our Lexicon: Solitary Fibrous Tumor.

Related studies

• Extrapericardial solitary fibrous tumour of the pericardium — S.M. Andreani, L. Tavecchio, et al. (1998)
• Mesothelioma of the atrioventricular node: first successful follow-up after excision — S. Balasundaram, S.A. Halees, et al. (1992)
• Successful palliation for an aged patient with primary pericardial mesothelioma — R. Isoda, H. Yamane, et al. (2015)
• Nuclear expression of STAT6 distinguishes solitary fibrous tumor from histologic mimics — L.A. Doyle, M. Vivero, et al. (2014)
• Solitary fibrous tumor of the mediastinum. A report of 14 cases — G.B. Witkin, J. Rosai (1989)
• Solitary fibrous tumor of the upper respiratory tract. A report of six cases — G.B. Witkin, J. Rosai (1991)

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