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Lethal mass mimicking myxoma in the heart
Wern Miin Soo1, Yin Huei Pang2, Kian-Keong Poh3
1Cardiac Department, National University Heart Centre, Singapore Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore wern_miin_soo@nuhs.edu.sg.
Asian Cardiovascular & Thoracic Annals
|June 3, 2014
Summary
A rare high-grade pleomorphic sarcoma presented as a left atrial mass and advanced heart failure. The extensive tumor infiltration led to unresectable disease and liver metastasis.
Area of Science:
- Cardiovascular Pathology
- Oncology
- Surgical Pathology
Background:
- Primary cardiac sarcomas are rare and often present with nonspecific symptoms.
- Advanced heart failure can be a presenting sign of cardiac tumors.
Observation:
- A 70-year-old male presented with advanced heart failure and jaundice.
- Transthoracic echocardiography identified a 21x24 mm left atrial mass attached to the mitral valve.
Findings:
- The left atrial mass was a high-grade pleomorphic sarcoma with malignant fibrous histiocytoma-like features.
- The tumor extensively infiltrated the left atrial wall, rendering it unresectable.
- A concurrent high-grade liver sarcoma was diagnosed via liver biopsy, indicating metastatic disease.
Implications:
- This case highlights the aggressive nature of primary cardiac sarcomas.
- Multidisciplinary management is crucial for these challenging oncological emergencies.
- Further research into novel therapeutic strategies for unresectable cardiac sarcomas is warranted.
