Primary cardiac sarcoma mimicking benign myxoma: a case report

Area of Science:

• Cardiology
• Oncology
• Pathology

Background:

• Primary cardiac tumors are rare, with myxomas being the most common benign type.
• Malignant cardiac tumors, such as sarcomas, can present with symptoms mimicking benign conditions, delaying diagnosis and treatment.
• Accurate differentiation between benign and malignant cardiac masses is critical for patient outcomes.

Observation:

• A 53-year-old woman presented with progressive heart failure due to a primary cardiac sarcoma.
• Transesophageal echocardiography revealed multiple left atrial tumors resembling myxoma but with distinct origins and growth patterns.
• Surgical findings confirmed three separate tumors arising from different locations within the left atrium, histologically diagnosed as undifferentiated sarcoma.

Findings:

• The patient experienced rapid disease progression, with local recurrence and brain metastasis six months post-surgery.
• The clinical course, multiple tumor sites, and non-septal attachment were indicative of a malignant cardiac tumor.
• The patient's death occurred six months after surgery due to complications of the recurrent cardiac tumor and metastasis.

Implications:

• Echocardiography plays a crucial role in identifying features suggestive of malignant cardiac tumors, differentiating them from benign myxomas.
• Preoperative evaluation, including detailed echocardiographic assessment of tumor origin and multiplicity, is essential for accurate diagnosis.
• Prompt recognition and appropriate management of malignant cardiac tumors are vital for improving patient prognosis and survival rates.