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Desmoid tumour of the chest wall in paediatric post-operatory of heart transplant

We will report a case of a desmoid tumour (DT), which developed at the surgical site of the pacemaker after a late childhood heart transplant. Patients with idiopathic dilated cardiomyopathy followed up in the paediatric cardiology service. It evolved with the dissociation of ventricular rhythm caus...

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Autores principales: de Freitas Filho, Orival, Nakahira, Evelyn Sue, Schmidt Junior, Aurelino Fernandes, Azeka, Estela, Jatene, Marcelo Biscegli, Pego-Fernardes, Paulo Manuel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9742589/
https://www.ncbi.nlm.nih.gov/pubmed/36518783
http://dx.doi.org/10.3389/fped.2022.860394
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author de Freitas Filho, Orival
Nakahira, Evelyn Sue
Schmidt Junior, Aurelino Fernandes
Azeka, Estela
Jatene, Marcelo Biscegli
Pego-Fernardes, Paulo Manuel
author_facet de Freitas Filho, Orival
Nakahira, Evelyn Sue
Schmidt Junior, Aurelino Fernandes
Azeka, Estela
Jatene, Marcelo Biscegli
Pego-Fernardes, Paulo Manuel
author_sort de Freitas Filho, Orival
collection PubMed
description We will report a case of a desmoid tumour (DT), which developed at the surgical site of the pacemaker after a late childhood heart transplant. Patients with idiopathic dilated cardiomyopathy followed up in the paediatric cardiology service. It evolved with the dissociation of ventricular rhythm caused by severe heart failure, which led to the implantation of a cardiac resynchronization device prior to heart transplantation. The progression to end-stage heart disease culminated in a heart transplant at 12 years old. One year after the transplant, at the age of 13 years, he presented a progressively growing mass on the generator site of the resynchronization device. The initial decision was to remove the device. During the removal surgery, there was no haematoma or fluid collection. However, there was a progression of the lesion. The lesion was biopsied with the anatomopathological diagnosis of a DT. Resection surgery happened 4 months after the start of the mass growth. At that time, the tumour reached 20 cm in diameter. The lesion infiltrated the pectoralis major muscle and this muscle was resected partially en bloc with the lesion. The defect had primary closure. The patient evolved without postoperative complications and was discharged on the 14th postoperative day. The surgical specimen came with negative circumferential margins. However, the deep margin was microscopically positive. Due to deep involvement, the patient underwent adjuvant radiotherapy. Currently, the patient is under clinical follow-up and has no evidence of tumour recurrence. DT is a rare tumour, with unpredictable courses. Surgery can be considered in the progression of lesions. Treatment is justified by long survival after a heart transplant and in DT patients. DT is a differential diagnosis to be considered in progressive growth lesions.
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spelling pubmed-97425892022-12-13 Desmoid tumour of the chest wall in paediatric post-operatory of heart transplant de Freitas Filho, Orival Nakahira, Evelyn Sue Schmidt Junior, Aurelino Fernandes Azeka, Estela Jatene, Marcelo Biscegli Pego-Fernardes, Paulo Manuel Front Pediatr Pediatrics We will report a case of a desmoid tumour (DT), which developed at the surgical site of the pacemaker after a late childhood heart transplant. Patients with idiopathic dilated cardiomyopathy followed up in the paediatric cardiology service. It evolved with the dissociation of ventricular rhythm caused by severe heart failure, which led to the implantation of a cardiac resynchronization device prior to heart transplantation. The progression to end-stage heart disease culminated in a heart transplant at 12 years old. One year after the transplant, at the age of 13 years, he presented a progressively growing mass on the generator site of the resynchronization device. The initial decision was to remove the device. During the removal surgery, there was no haematoma or fluid collection. However, there was a progression of the lesion. The lesion was biopsied with the anatomopathological diagnosis of a DT. Resection surgery happened 4 months after the start of the mass growth. At that time, the tumour reached 20 cm in diameter. The lesion infiltrated the pectoralis major muscle and this muscle was resected partially en bloc with the lesion. The defect had primary closure. The patient evolved without postoperative complications and was discharged on the 14th postoperative day. The surgical specimen came with negative circumferential margins. However, the deep margin was microscopically positive. Due to deep involvement, the patient underwent adjuvant radiotherapy. Currently, the patient is under clinical follow-up and has no evidence of tumour recurrence. DT is a rare tumour, with unpredictable courses. Surgery can be considered in the progression of lesions. Treatment is justified by long survival after a heart transplant and in DT patients. DT is a differential diagnosis to be considered in progressive growth lesions. Frontiers Media S.A. 2022-11-28 /pmc/articles/PMC9742589/ /pubmed/36518783 http://dx.doi.org/10.3389/fped.2022.860394 Text en © 2022 Freitas Filho, Nakahira, Schmidt Junior, Azeka, Jatene and Pego-Fernardes. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pediatrics
de Freitas Filho, Orival
Nakahira, Evelyn Sue
Schmidt Junior, Aurelino Fernandes
Azeka, Estela
Jatene, Marcelo Biscegli
Pego-Fernardes, Paulo Manuel
Desmoid tumour of the chest wall in paediatric post-operatory of heart transplant
title Desmoid tumour of the chest wall in paediatric post-operatory of heart transplant
title_full Desmoid tumour of the chest wall in paediatric post-operatory of heart transplant
title_fullStr Desmoid tumour of the chest wall in paediatric post-operatory of heart transplant
title_full_unstemmed Desmoid tumour of the chest wall in paediatric post-operatory of heart transplant
title_short Desmoid tumour of the chest wall in paediatric post-operatory of heart transplant
title_sort desmoid tumour of the chest wall in paediatric post-operatory of heart transplant
topic Pediatrics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9742589/
https://www.ncbi.nlm.nih.gov/pubmed/36518783
http://dx.doi.org/10.3389/fped.2022.860394
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