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[Metastasizing round-cell sarcoma of the right atrium]
K P Mellwig1, H Schmidt, U Gleichmann
1Kardiologische Klinik, Herzzentrum Nordrhein-Westfalen, Klinikum der Ruhr-Universität Bochum.
Deutsche Medizinische Wochenschrift (1946)
|October 4, 1991
Summary
A rare right atrial sarcoma caused cardiac enlargement, pericardial effusion, and widespread emboli, leading to fatal cardiogenic shock. Autopsy confirmed the poorly differentiated round-cell sarcoma and paradoxical emboli.
Area of Science:
- Cardiology
- Oncology
- Pathology
Background:
- Cardiac tumors are rare, often presenting with nonspecific symptoms.
- Right atrial masses can lead to significant hemodynamic compromise and embolic events.
Observation:
- A 46-year-old woman presented with dyspnea and global cardiac enlargement on chest roentgenogram.
- Echocardiography revealed a large right atrial tumor (4x5 cm) and pericardial effusion.
- The patient developed septic temperatures, Staphylococcus aureus bacteremia, and recurrent pulmonary and cerebral emboli.
Findings:
- Autopsy identified a poorly differentiated round-cell sarcoma originating in the right atrial wall.
- The tumor infiltrated the myocardium, epicardium, and extended to the tricuspid orifice.
- An open foramen ovale facilitated paradoxical emboli at the atrial level.
Implications:
- This case highlights the aggressive nature of primary cardiac sarcomas.
- Prompt diagnosis and multimodal treatment strategies are crucial for improving outcomes.
- Understanding the potential for paradoxical embolization is vital in managing cardiac masses.