[Malignant fibrous histiocytoma of the heart]

A 59-year-old woman was referred to our hospital by a local cardiologist, with unknown cause of congestive heart failure and respiratory failure. No significant heart murmur was heard and a cardioechogram from the anterior chest was insufficient for diagnosis. On the night of admission, cardio-respiratory shock was found, and Swan-Gantz catheter data showed severe pulmonary hypertension. Transesophageal echo-cardiography (TEE) revealed a left atrial tumor, with wide neck anchored onto the posterior wall of the left atrium, and which was floating into the left ventricle during the diastolic phase. An emergency operation was performed and the tumor, (80 by 50 by 48 mm) was resected. The patient recovered well in the postoperation period. However the residual tumor continued to grow gradually in the pericardial cavity and the patient died 3 months after the operation. Primary MFH of the heart is rare and 29 cases have been reported. The prognosis of MFH is poor despite surgery. Whenever a left atrial tumor with a wide neck is attached to the posterior wall, it must be considered to be possibly malignant and surgical resection is recommended.