Sudden death due to a cystic atrio-ventricular node tumour

Our plain-English summary of Sudden death due to a cystic atrio-ventricular node tumour, by G. Maujean, A. Tabib, D. Malicier, et al (Journal of Forensic and Legal Medicine, 2010).

The study

• Authors: G. Maujean, A. Tabib, D. Malicier, L. Fanton
• Journal: Journal of Forensic and Legal Medicine
• Published: 2010;17(8):437-8
• Type of article: Case report
• Cited by: 5 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Sudden cardiac deaths constitute a major health problem. Most cases are attributed to cardiomyopathies, coronary artery diseases and functional dysregulations. Sudden death in an adult due to a primitive cardiac tumor is a rare occurrence. In the following, we present a case of an adult male who died from an undiagnosed cystic atrio-ventricular node tumour six years after having a pace maker fitted. We focus on the postmortem diagnosis to underline the importance of a systematic histological examination of the cardiac conduction tissue in forensic pathology.

Copyright © 2010 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

In plain English

This article is a case report from forensic doctors in Lyon, France, about one man's sudden death. It does not concern asbestos. The tumour described, a cystic atrio-ventricular (AV) node tumour, is a rare growth in the heart's electrical conduction system that the authors note is sometimes called benign mesothelioma. A 35-year-old man was found dead on his sofa. Six years earlier, after a fainting episode, an electrocardiogram had shown a type I second degree AV block, and a pacemaker was fitted. At autopsy the heart weighed 420 g. Microscopic examination of serial sections of the conduction system found a benign cystic tumour extensively infiltrating the AV node and His bundle. The tumour was lined by mesothelial cells. The pacemaker showed no apparent failure, and toxicology tests, including alcohol, were negative. The death was diagnosed as arrhythmia-related, directly caused by the tumour despite the pacemaker. The authors described their report as the fifth case of sudden death in patients with a pacemaker. They concluded that forensic pathology should include systematic microscopic examination of the heart's conduction tissue.

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 autopsy case)
• Who was studied: One 35-year-old man found dead at home, examined by forensic doctors at the Institut Universitaire de Médecine Légale, Lyon, France
• Main results:
  • Six years before death, after a fainting (syncopal) episode, the man had a type I second degree AV block and was fitted with a dual-chamber pacemaker
  • At autopsy the heart weighed 420 g
  • Microscopic examination found a benign cystic tumour extensively infiltrating the AV node and His bundle trunk, made of small tubular nodules lined by mesothelial cells
  • Toxicology tests, including alcohol, were all negative
  • The death was diagnosed as arrhythmia-related, directly caused by the AV node tumour despite the pacemaker
• The authors' conclusion: The authors stated that the case underlines the need for systematic microscopic examination of the cardiac conduction tissue in forensic pathology. They also said this tumour should be considered in the differential diagnosis of heart block in children and young adults.

Topics

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

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

Related studies

• Primary mesothelioma of atrioventricular node: cause of sudden death — E.H. Hemsted (1986)
• Synovial sarcoma of the heart arising from a so-called mesothelioma of the atrio-ventricular node — E.A. Sheffield, B. Corrin, et al. (1988)
• Sudden death as the initial manifestation of diffuse pleural mesothelioma — J.T. Lie (1989)
• Sudden death of an elderly man with multiple malignant neoplasms — L.R. Boglioli, M.L. Taff, et al. (1991)
• 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)

Browse return to medical research.