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Intratibial Osteosarcoma Cell Injection to Generate Orthotopic Osteosarcoma and Lung Metastasis Mouse Models
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Large, mobile, transmitral metastastic osteosarcoma presenting as cardiac arrest
Clare M Jackson1, Helen E Ellis2, Mark C Dodd3
1Department of Cardiology, Northern General Hospital , Herries Road, Sheffield, S5 7AU , UK.
Echo Research and Practice
|December 23, 2015
Summary
A rare case of osteosarcoma with lung metastasis presented with cardiac arrest. Transthoracic echocardiography (TTE) revealed a mobile tumor prolapsing through the mitral valve, highlighting the need for urgent intervention and TTE availability in critical care.
Area of Science:
- Cardiology
- Oncology
- Diagnostic Imaging
Background:
- A 21-year-old female with osteosarcoma and lung metastasis experienced pulseless electrical activity cardiac arrest.
- Initial electrocardiogram was unremarkable; computed tomography pulmonary angiogram (CTPA) identified a tumor in the left inferior pulmonary veins.
Observation:
- Transthoracic echocardiography (TTE) revealed a severely hypokinetic left ventricle.
- A mobile, multi-lobulated mass was observed originating from the left pulmonary veins, prolapsing through the mitral valve into the left ventricle during diastole and retracting into the left atrium during systole.
Findings:
- TTE demonstrated a dynamic tumor prolapsing across the mitral valve, posing a risk of acute obstruction.
- The findings underscored the diagnostic utility of TTE in emergency presentations and its role in guiding treatment decisions, including withdrawal of life support.
Implications:
- This case highlights the critical importance of TTE in emergency settings for rapid diagnosis and management of deteriorating patients.
- It emphasizes the need for urgent intervention in cases of mobile cardiac tumors prolapsing through the mitral valve due to the risk of sudden obstruction.
- The study advocates for 24/7 availability of TTE, especially in district general hospitals lacking out-of-hours cardiology support, for effective critical care management.
