A 36-year-old man died suddenly. At age 9 he had a pacemaker implanted, but at age 20 it was removed and not replaced. Autopsy showed the following lesion in the AV node.
Thank you to Dr. Greg Fishbein for sharing this case.
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Cystic tumor of the AV node.
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Cystic tumor of the AV node is a benign heterotopia of endodermal origin. They can cause heart block and, as seen in this case, are a cause of sudden cardiac death. They have been described as the smallest tumor that can kill The tumor is comprised of cysts lined by cuboidal cells in a two-cell population. More information can be found in the AFIP Atlas of Tumor Pathology Series 4 - Tumors of the Heart and Great Vessels.
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