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Dual Left Atrial Masses Causing Inflow Obstruction: A Rare Presentation of Primary Cardiac Intimal Sarcoma
Xian Zhang1, Yuejian Zhuo2, Dongdong Zhang1,2,3
1Department of Hematology, Postgraduate Union Training Base of Xiangyang No. 1 People's Hospital, School of Medicine, Wuhan University of Science and Technology, Xiangyang, 441000, People's Republic of China.
Aim:
Primary cardiac intimal sarcoma is a rare entity with a poor prognosis, often requiring distinction from other undifferentiated cardiac sarcomas.
Case Presentation:
A 55-year-old female presented with symptoms of heart failure. Imaging identified dual left atrial masses compromising mitral inflow and pulmonary venous return. Surgical excision was performed, and morphological analysis revealed a high-grade spindle cell sarcoma. Crucially, the diagnostic dilemma was resolved through molecular testing; immunohistochemistry showed diffuse overexpression of MDM2 and CDK4, and fluorescence in situ hybridization (FISH) confirmed the amplification of the MDM2 and CDK4 loci.
Conclusion:
This case illustrates the diagnostic utility of MDM2 and CDK4 as specific biomarkers for cardiac intimal sarcoma. It reinforces the necessity of a multidisciplinary approach involving advanced molecular pathology to ensure accurate classification and appropriate management of rare cardiac malignancies.
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