Left atrial metastasis presenting as recurrent embolic strokes.

Area of Science:

• Oncology
• Pathology
• Neurology

Background:

• Endometrial stromal sarcoma is a rare malignant neoplasm originating from the uterine endometrium.
• Endocardial metastases, tumors on the heart's inner lining, are infrequent occurrences.
• Tumour emboli are fragments of a tumor that travel through the bloodstream.

Observation:

• A 40-year-old woman presented with recurrent, ultimately fatal strokes.
• The strokes were attributed to tumour emboli originating from an endocardial metastasis.
• The primary tumour was identified as an endometrial stromal sarcoma.

Findings:

• This case demonstrates endocardial metastases from endometrial stromal sarcoma can cause systemic arterial embolization.
• The emboli led to recurrent cerebral events, a previously undocumented presentation.
• The rarity of endocardial metastases and their embolic potential to the brain is highlighted.

Implications:

• This case expands the known clinical manifestations of endometrial stromal sarcoma.
• It underscores the importance of considering rare embolic sources in cryptogenic strokes.
• Further research into the embolic potential of rare cardiac and oncological conditions is warranted.