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Invasive Metastatic Well-Differentiated Liposarcoma to the Heart, Found in Intraoperative Transesophageal
Junshi Kawakami1, Daisuke Sugiyama1, Erina Terao1
1Department of Anesthesiology, Kameda Medical Center, Kamogawa, JPN.
Insights
Hematogenous liposarcoma metastasis to the heart is rare. Transesophageal echocardiography (TEE) uniquely identified a cardiac tumor mimicking lipomatous hypertrophy, guiding surgical decisions.
Area of Science:
- Cardiology
- Oncology
- Medical Imaging
Background:
- Cardiac tumors are rare, with metastatic tumors being more common than primary ones.
- Hematogenous metastasis of liposarcoma to the heart is an exceptionally infrequent occurrence.
- Distinguishing cardiac masses requires advanced imaging techniques.
Observation:
- A case of liposarcoma metastasis to the right interatrial septum presented atypically.
- Initial transthoracic echocardiography (TTE) and computed tomography (CT) failed to detect the cardiac mass.
- Transesophageal echocardiography (TEE) was crucial in suspecting and characterizing the cardiac tumor.
Findings:
- TEE identified a right interatrial septum mass, mimicking lipomatous hypertrophy.
- The mass was confirmed as a liposarcoma metastasis.
- TEE accurately assessed tumor invasion, aiding surgical planning.
Implications:
- This case highlights the diagnostic utility of TEE in rare cardiac metastases.
- TEE can be essential when conventional imaging is inconclusive for cardiac tumors.
- Accurate diagnosis and staging of cardiac liposarcoma metastasis are vital for patient management.
Abstract:
Hematogenous metastasis of liposarcoma to the heart is rare, even though other types of distant metastatic cardiac tumors are relatively more common than primary cardiac tumors. We experienced a case of distant metastasis of liposarcoma to the right interatrial septum, mimicking lipomatous hypertrophy in transesophageal echocardiography (TEE). There were no significant findings in the preoperative transthoracic echocardiography (TTE) or computed tomography (CT). TEE was the only tool to suspect the presence of a cardiac tumor. It also helped evaluate the spread of tumor invasion and make a decision for operation.
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