[Cardiac fibrosarcoma discovered by cerebral metastases]

Primary heart tumors are rare, and the fibrosarcomas are exceptional. We present the findings in a 78 year old female who has been hospitalized in April 1997 with a history of 4 months of malaise, headaches and weight loss. Clinical examination showed a right lateral homonymous hemi-anopsia. Computed tomography (CT-Scan) of the brain showed two lesions in the occipital and temporal lobe, consistent with metastasis. Thoracic and abdominal-pelvic CT-Scan revealed a voluminous mass of the left auricle that has been interpreted as a probable sarcoma. Biopsy specimen of one of the cerebral lesions, performed at the Centre hospitalier universitaire vaudois (CHUV) on April 29th 1997, revealed fragments of a poorly differentiated sarcoma. After referral back to Neuchâtel, the patient suffered suddenly three weeks later from a cerebral vascular insult with instant onset of deep coma. She deceased on May 27. At autopsy we found a neoplastic lesion of the left auricle with invasion of the pulmonary veins. The histological appearance is similar to the appearance of the cerebral metastasis, showing a proliferation of spindled cells with a partial positivity for Vimentine. It was classified as a fibrosarcoma. Metastasis were found only in the brain with postoperative ischemic left occipitotemporal necrosis and neoplastic emboli.--We are discussing the various incidences of cardiac neoplasms in autopsies or biopsies.