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Right atrial synovial sarcoma with thrombocytopenia: A deceptive presentation
Dhiren Shah1, Kishore Gupta1, Dhaval Naik1
1Department of Cardiac Surgery, CIMS Hospital, Ahmedabad, Gujarat, India.
Journal of Cardiac Surgery
|May 13, 2021
Summary
Primary cardiac synovial sarcoma is a rare heart tumor. This case highlights a biphasic synovial sarcoma in the right atrium presenting with heart failure and thrombocytopenia.
Area of Science:
- Cardiology
- Oncology
- Pathology
Background:
- Primary cardiac synovial sarcoma is a rare malignancy of the heart, often presenting with non-specific symptoms.
- This tumor predominantly affects males in their fourth decade and can involve the pericardium or heart chambers.
Observation:
- A 37-year-old male presented with fever, dyspnea, and hematuria, initially treated for dengue fever.
- The patient exhibited signs of right heart failure and hepatomegaly, leading to the diagnosis of a right atrial tumor.
Findings:
- Immunohistochemistry confirmed the tumor as a biphasic synovial sarcoma originating from the right atrium.
- The patient also presented with thrombocytopenia, attributed to increased platelet consumption.
Implications:
- Right atrial biphasic synovial sarcoma associated with tricuspid valve involvement, heart failure, and thrombocytopenia is exceptionally rare.
- The deceptive presentation of cardiac synovial sarcoma underscores the importance of thorough diagnostic evaluation for unexplained symptoms.
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