Obstructive shock secondary to an unusual cause: primary cardiac lymphoma

Abstract Background The medico-surgical management of cardiac tumors when there is a suspicion of malignancy is complex. Moreover, in a critically ill setting, the choice of diagnostic tools seems crucial. Case presentation We present the case of a sixty-four-year-old patient with no prior medical h...

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Main Authors: Gregoire Ottavy, Laurent Camous, Claire Fieschi, Lucas Della Torre, Jean-David Pommier
Format: Article
Language:English
Published: BMC 2025-01-01
Series:Journal of Cardiothoracic Surgery
Online Access:https://doi.org/10.1186/s13019-024-03261-1
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author Gregoire Ottavy
Laurent Camous
Claire Fieschi
Lucas Della Torre
Jean-David Pommier
author_facet Gregoire Ottavy
Laurent Camous
Claire Fieschi
Lucas Della Torre
Jean-David Pommier
author_sort Gregoire Ottavy
collection DOAJ
description Abstract Background The medico-surgical management of cardiac tumors when there is a suspicion of malignancy is complex. Moreover, in a critically ill setting, the choice of diagnostic tools seems crucial. Case presentation We present the case of a sixty-four-year-old patient with no prior medical history who was admitted to the intensive care unit with obstructive shock secondary to a right heart mass and pulmonary embolism. Clinical and biological features revealed secondary hemophagocytic lympho-histiocytosis (HLH). The patient underwent a diagnostic procedure with dual thoracoscopic and mediastinoscopy with biopsies. Following the diagnosis of primary cardiac lymphoma, the patient received sequential chemotherapy without undergoing cardiac surgery leading to initial improvement, with reductions in intracardiac obstruction and in biomarkers associated with hemophagocytic lympho-histiocytosis. Conclusion When a cardiac mass is associated with extracardiac symptoms indicative of a hematological malignancy, the preferred treatment is chemotherapy, and cardiac surgery should be avoided.
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institution Kabale University
issn 1749-8090
language English
publishDate 2025-01-01
publisher BMC
record_format Article
series Journal of Cardiothoracic Surgery
spelling doaj-art-1fb408e6b7a546bc852bbda24db9dc732025-01-05T12:45:43ZengBMCJournal of Cardiothoracic Surgery1749-80902025-01-012011310.1186/s13019-024-03261-1Obstructive shock secondary to an unusual cause: primary cardiac lymphomaGregoire Ottavy0Laurent Camous1Claire Fieschi2Lucas Della Torre3Jean-David Pommier4Réanimation Médicale et Chirurgicale, CHU de GuadeloupeRéanimation Médicale et Chirurgicale, CHU de GuadeloupeImmuno-pathologie clinique, CHU Saint Louis, Assistance Publique Hôipitaux de ParisService d’Hématologie Biologique, CHU de GuadeloupeRéanimation Médicale et Chirurgicale, CHU de GuadeloupeAbstract Background The medico-surgical management of cardiac tumors when there is a suspicion of malignancy is complex. Moreover, in a critically ill setting, the choice of diagnostic tools seems crucial. Case presentation We present the case of a sixty-four-year-old patient with no prior medical history who was admitted to the intensive care unit with obstructive shock secondary to a right heart mass and pulmonary embolism. Clinical and biological features revealed secondary hemophagocytic lympho-histiocytosis (HLH). The patient underwent a diagnostic procedure with dual thoracoscopic and mediastinoscopy with biopsies. Following the diagnosis of primary cardiac lymphoma, the patient received sequential chemotherapy without undergoing cardiac surgery leading to initial improvement, with reductions in intracardiac obstruction and in biomarkers associated with hemophagocytic lympho-histiocytosis. Conclusion When a cardiac mass is associated with extracardiac symptoms indicative of a hematological malignancy, the preferred treatment is chemotherapy, and cardiac surgery should be avoided.https://doi.org/10.1186/s13019-024-03261-1
spellingShingle Gregoire Ottavy
Laurent Camous
Claire Fieschi
Lucas Della Torre
Jean-David Pommier
Obstructive shock secondary to an unusual cause: primary cardiac lymphoma
Journal of Cardiothoracic Surgery
title Obstructive shock secondary to an unusual cause: primary cardiac lymphoma
title_full Obstructive shock secondary to an unusual cause: primary cardiac lymphoma
title_fullStr Obstructive shock secondary to an unusual cause: primary cardiac lymphoma
title_full_unstemmed Obstructive shock secondary to an unusual cause: primary cardiac lymphoma
title_short Obstructive shock secondary to an unusual cause: primary cardiac lymphoma
title_sort obstructive shock secondary to an unusual cause primary cardiac lymphoma
url https://doi.org/10.1186/s13019-024-03261-1
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AT clairefieschi obstructiveshocksecondarytoanunusualcauseprimarycardiaclymphoma
AT lucasdellatorre obstructiveshocksecondarytoanunusualcauseprimarycardiaclymphoma
AT jeandavidpommier obstructiveshocksecondarytoanunusualcauseprimarycardiaclymphoma