Recurrent epicardial fibrosarcoma which arose 12 years after the first resection

Primary malignant tumours of the heart are very rare, with an incidence of only 0.0017%-0.03% in consecutive autopsy series. Fibrosarcoma of the heart is also rare, representing only about 0.3% of all cardiac tumours. We observed a case of epicardial fibrosarcoma which developed 12 years after the first resection of an epicardial tumour. A 31-year-old woman was referred to our hospital because of fatigue, nausea and right back pain. She had had surgery to resect an epicardial tumour when she was 19 years old. On admission, there was a huge, heterogeneous tumour on the right inferior side of the heart. At surgery, the tumour was totally resected and a pathological diagnosis of fibrosarcoma was made. The patient was free of symptoms for 6 months, but died of a recurrence 11 months after the operation. It is postulated that the epicardial tumour had only been partially resected and had been latent for a rather long period but began to grow rapidly 12 years after the initial resection.