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Cystic tumour of the atrioventricular node: three cases of sudden death

Junaid Patel1, Mary N Sheppard

  • 1CRY Centre for Cardiac Pathology, National Heart and Lung Institute, Imperial College, London, UK. junaid.patel@ic.ac.uk

International Journal of Legal Medicine
|December 19, 2009
PubMed

Insights

Cystic tumours of the atrioventricular node are rare causes of sudden cardiac death, often missed before autopsy. Early diagnosis and surgical removal of these benign heart tumours are critical but challenging.

Area of Science:

  • Cardiology
  • Pathology
  • Cardiac Surgery

Background:

  • Cystic tumours of the atrioventricular nodal region are rare primary cardiac tumours.
  • These tumours can lead to sudden cardiac death due to conductive and haemodynamic abnormalities.
  • Antemortem diagnosis and surgical excision of these tumours are exceptionally uncommon.

Observation:

  • Three cases of sudden death are presented: a 25-year-old and a 40-year-old with a history of heart block, and a 60-year-old with no prior medical history.
  • Over 120 cases of sudden death attributed to primary cardiac tumours have been reported in the literature.
  • More than 100 of these cardiac lesions were histologically benign.

Findings:

  • Cystic tumours of the atrioventricular node are the most common intracardiac lesion causing sudden death.
  • These tumours may remain undiagnosed until microscopic examination of the atrioventricular node post-mortem.
  • The intracardiac location of even benign tumours can precipitate fatal abnormalities.

Implications:

  • Highlights the importance of considering rare cardiac tumours in cases of sudden cardiac death, even in young individuals.
  • Underscores the diagnostic challenges and rarity of successful surgical intervention for atrioventricular nodal cystic tumours.
  • Suggests the need for enhanced diagnostic strategies to detect these lesions antemortem, potentially improving patient outcomes.

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