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Successful Robotic Excision and Early Chemotherapy for Primary Cardiac Lymphoma
Emmanuel Moss1, Daniel A Goldstein2, Kyle T Bradley3
1Division of Cardiac Surgery, McGill University, Montreal, Quebec, Canada.
Insights
A 67-year-old patient had a cancerous left ventricular mass successfully removed using robotic surgery. Early chemotherapy and follow-up imaging confirmed complete remission, demonstrating a successful treatment approach for cardiac lymphoma.
Area of Science:
- Cardiovascular Surgery
- Oncology
- Cardiac Pathology
Background:
- Left ventricular masses are rare and can be challenging to diagnose and treat.
- Incidental echocardiography findings necessitate further investigation and management strategies.
- Robotic surgery offers minimally invasive options for cardiac procedures.
Observation:
- A 67-year-old patient presented with an incidentally discovered mobile left ventricular mass.
- Intraoperative findings revealed a pedunculated mass infiltrating the interventricular septum.
- Frozen section pathology suggested malignancy.
Findings:
- Final pathology confirmed diffuse large B-cell lymphoma, a type of non-Hodgkin lymphoma.
- Robotic excision via a lateral endoscopic approach provided excellent visualization.
- Early chemotherapy was initiated post-operatively.
Implications:
- This case highlights the feasibility of robotic surgery for complex cardiac tumors.
- Successful management included surgical resection followed by early chemotherapy.
- Complete remission was achieved, as confirmed by follow-up cardiac positron emission tomography/computed tomography (PET/CT).
Abstract:
We present a 67-year-old patient who underwent robotic excision of a mobile left ventricular mass found incidentally on echocardiography. Intraoperative findings revealed a pedunculated mass infiltrating the interventricular septum, and the results of pathologic examination of the frozen section were consistent with malignancy. The final pathologic examination showed a diffuse large B-cell lymphoma, and early chemotherapy was initiated. Follow-up cardiac positron emission tomography/computed tomography showed completely normal myocardium without evidence of malignancy. The lateral endoscopic robotic approach across the mitral valve permitted optimal tumor visualization and early chemotherapy initiation without concern for cardiac rupture or related adverse events.
