Cystic Tumor of the Atrioventricular Node
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mandana Chitsazan, M.D. [2]
Synonyms and keywords: Mesothelioma of the atrioventricular node
Overview
Historical Perspective
Cystic tumor of the atrioventricular (AV) node was first reported by Armstrong and Mönckeberg in 1911. [1]
Classification
There is no established system for the staging of the cystic tumor of the atrioventricular node.
Pathophysiology
[Disease or malignancy name] arises from [cell name]s, which are [cell type] cells that are normally involved in [function of cells].
On gross pathology, small multiocular cysts are characteristic findings of CTAVN.The tumor may be invisible from the endocardial surface of the heart. Therefore, sectioning through the infero-medial tricuspid annulus might be required.[2] [3]
On microscopic histopathological analysis, solid cell nests and cystic structures lined by flattened cuboidal or squamous epithelium mixed with rare neuroendocrine cells are characteristic findings of CTAVN.</ref> [2] [3]
The female to male ratio is approximately 3 to 1 [4].
Causes
Risk Factors
There are no established risk factors for [disease name].
OR
The most potent risk factor in the development of [disease name] is [risk factor 1]. Other risk factors include [risk factor 2], [risk factor 3], and [risk factor 4].
OR
Common risk factors in the development of [disease name] include [risk factor 1], [risk factor 2], [risk factor 3], and [risk factor 4].
OR
Common risk factors in the development of [disease name] may be occupational, environmental, genetic, and viral.
Screening
There is insufficient evidence to recommend routine screening for cystic tumor of the atrioventricular node.
Natural History, Complications, and Prognosis
If left untreated, [#]% of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
OR
Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].
OR
Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [#]%.
Diagnosis
Diagnostic Study of Choice
The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].
OR
The diagnosis of [disease name] is based on the [criteria name] criteria, which include [criterion 1], [criterion 2], and [criterion 3].
OR
The diagnosis of [disease name] is based on the [definition name] definition, which includes [criterion 1], [criterion 2], and [criterion 3].
OR
There are no established criteria for the diagnosis of [disease name].
History and Symptoms
The majority of patients with [disease name] are asymptomatic.
OR
The hallmark of [disease name] is [finding]. A positive history of [finding 1] and [finding 2] is suggestive of [disease name]. The most common symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3]. Common symptoms of [disease] include [symptom 1], [symptom 2], and [symptom 3]. Less common symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3].
Physical Examination
Patients with [disease name] usually appear [general appearance]. Physical examination of patients with [disease name] is usually remarkable for [finding 1], [finding 2], and [finding 3].
OR
Common physical examination findings of [disease name] include [finding 1], [finding 2], and [finding 3].
OR
The presence of [finding(s)] on physical examination is diagnostic of [disease name].
OR
The presence of [finding(s)] on physical examination is highly suggestive of [disease name].
Laboratory Findings
The cysts contain a clear to mucoid material and mucinous, ciliated, goblet and transitional type cells may also be present in the lining (Fig. 29). The cells express CK7, but not CK20, and also stain positive for EMA and CEA. Miller
Electrocardiogram
There are no ECG findings associated with [disease name].
OR
An ECG may be helpful in the diagnosis of [disease name]. Findings on an ECG suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
X-ray
There are no x-ray findings associated with cystic tumor of the atrioventricular tumor.
Echocardiography or Ultrasound
There are no echocardiography/ultrasound findings associated with [disease name].
OR
Echocardiography/ultrasound may be helpful in the diagnosis of [disease name]. Findings on an echocardiography/ultrasound suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
OR
There are no echocardiography/ultrasound findings associated with [disease name]. However, an echocardiography/ultrasound may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].
CT scan
There are no CT scan findings associated with cystic tumor of the atrioventricular tumor.
MRI
There are no MRI findings associated with [disease name].
OR
[Location] MRI may be helpful in the diagnosis of [disease name]. Findings on MRI suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
OR
There are no MRI findings associated with [disease name]. However, a MRI may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].
Other Imaging Findings
There are no other imaging findings associated with cystic tumor of the atrioventricular tumor.
Other Diagnostic Studies
There are no other diagnostic studies associated with cystic tumor of the atrioventricular tumor.
Treatment
Medical Therapy
There is no medical treatment for cystic tumor of the atrioventricular tumor.
Surgery
Because of the critical location of the tumor and its unfavorable prognosis, surgical excision is the mainstay of treatment for cystic tumor of the atrioventricular node. Anti-arrhythmic drugs and lifelong pacemaker placement may be necessary after excision to manage any post-surgical AV block. [2] [5]
Primary Prevention
There are no established measures for the primary prevention of cystic tumor of the atrioventricular tumor.
Secondary Prevention
There are no established measures for the secondary prevention of cystic tumor of the atrioventricular node.
References
- ↑ Armstrong H, Mönckeberg JG (1911). "Herzblock, bedingt durch primären Herztumor, bei einem 5 jährigen Kinde". Dtsch Arch Klin Med. 102: 144–146.
- ↑ 2.0 2.1 2.2 Miller DV (2012). "Cardiac Tumors". Surg Pathol Clin. 5 (2): 453–83. doi:10.1016/j.path.2012.04.007. PMID 26838113.
- ↑ 3.0 3.1 Burke A, Tavora F (2016). "The 2015 WHO Classification of Tumors of the Heart and Pericardium". J Thorac Oncol. 11 (4): 441–52. doi:10.1016/j.jtho.2015.11.009. PMID 26725181.
- ↑ Burke A, Tavora F (2016). "The 2015 WHO Classification of Tumors of the Heart and Pericardium". J Thorac Oncol. 11 (4): 441–52. doi:10.1016/j.jtho.2015.11.009. PMID 26725181.
- ↑ Luc JGY, Phan K, Tchantchaleishvili V (2017). "Cystic tumor of the atrioventricular node: a review of the literature". J Thorac Dis. 9 (9): 3313–3318. doi:10.21037/jtd.2017.08.101. PMC 5708412. PMID 29221317.