Case Report: Diagnostic challenges and therapeutic approaches in cardiac intimal sarcoma: a rare clinical case study

Primary cardiac tumors are exceedingly rare, with the majority being benign, while malignant tumors are even less common. Cardiac intimal sarcoma represents a rare and aggressive variant of primary cardiac tumors, characterized by its stromal origin and frequent association with genetic abnormalities. They typically present with non-specific symptoms, making early diagnosis difficult.

A 61-year-old female patient with a medical history notable for multiple neoplasms and surgical interventions is discussed. In 2006, she was diagnosed with uterine fibroids and underwent surgical excision. A decade later, in 2016, she was diagnosed with breast cancer, for which she received surgical treatment followed by radiotherapy. In 2023, the patient developed bilateral lower extremity arterial embolism, and a thrombectomy revealed a mixed thrombus. In 2024, she experienced a recurrence of arterial embolism in the left lower extremity. Following a thrombectomy, the embolus was identified as a myxoma, and subsequent echocardiographic evaluation revealed a mass within the left ventricle. Surgical intervention was performed to excise the left ventricular mass, and the final postoperative pathological examination confirmed the diagnosis of cardiac intimal sarcoma.

Cardiac intimal sarcoma of the left ventricle is an uncommon condition, and the absence of specific symptoms complicates early diagnosis, frequently resulting in misdiagnosis. While chemotherapy and gene-targeted therapies may improve patient outcomes, early and complete surgical resection is crucial for achieving long-term survival in individuals with cardiac intimal sarcoma.