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Superior vena caval approach for resecting intracardially extended Ewing sarcoma
Yusuke Yamamoto1, Daiki Harada1, Kentaro Yamashita1
1Department of Pediatric Cardiovascular Surgery, 204953Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.
Asian Cardiovascular & Thoracic Annals
|March 2, 2022
Summary
Intracardiac extension of Ewing sarcoma is rare. This case report details successful surgical resection and adjuvant therapy for a pediatric mediastinal Ewing sarcoma extending into the right atrium.
Area of Science:
- Pediatric Oncology
- Cardiovascular Surgery
- Sarcoma Research
Background:
- Ewing sarcoma is a rare bone and soft tissue cancer primarily affecting children and young adults.
- Intracardiac extension of mediastinal Ewing sarcoma is an exceptionally uncommon presentation.
- Early diagnosis and multidisciplinary treatment are crucial for improving outcomes in pediatric cancer.
Observation:
- A pediatric patient presented with mediastinal Ewing sarcoma.
- The tumor demonstrated extension into the right atrium through the azygos vein.
- Surgical resection was achieved via cardiopulmonary bypass with a superior vena cava incision.
Findings:
- The tumor was resected successfully due to its elasticity and lack of adherence to the endocardium.
- Postoperative treatment included chemotherapy and proton beam radiation therapy.
- The patient remained disease-free with no recurrence for 5 years post-surgery.
Implications:
- This case highlights the feasibility of surgical intervention for rare intracardiac Ewing sarcoma.
- Successful management underscores the importance of a comprehensive treatment approach combining surgery, chemotherapy, and radiation.
- Long-term surveillance is essential for patients treated for advanced Ewing sarcoma with intracardiac extension.
