Recurrent primary cardiac osteosarcoma: a case report and literature review

Area of Science:

• Cardiovascular Surgery
• Surgical Oncology
• Cardiac Pathology

Background:

• Primary malignant cardiac tumors are exceptionally rare, with sarcomas being the most common subtype.
• Primary cardiac osteosarcoma is exceedingly rare, with only 42 cases documented globally.
• Surgical management of cardiac sarcomas is complex due to tumor location and proximity to vital structures, often yielding suboptimal results.

Observation:

• A case of recurrent primary cardiac osteosarcoma in a young male is presented.
• The patient underwent a complex surgical procedure involving trans-sternal right pneumonectomy and wide resection of the left and right atrium.
• Reconstruction was performed using heterologous pericardium under extracorporeal circulation.

Findings:

• Despite aggressive surgical intervention, the patient experienced local and systemic disease recurrence.
• The patient succumbed to the disease six months post-operation.
• This case underscores the aggressive nature and poor prognosis associated with recurrent primary cardiac osteosarcoma.

Implications:

• Current multimodality treatment strategies for cardiac sarcoma remain suboptimal.
• The challenges in achieving complete tumor resection with adequate margins necessitate further research into novel therapeutic approaches.
• Improved surgical techniques and adjuvant therapies are crucial for enhancing outcomes in patients with primary cardiac osteosarcoma.