ABSTRACT
Uterine leiomyosarcoma (ULMS) is a rare malignancy arising from the myometrial smooth muscle wall, and cardiac metastases are extremely rare. Metastasis to the heart is a very unusual finding, and atrial metastasis is even rarer. Here, we report a case of a 45 year old woman who presented with dyspnea and pleural effusion and had a significant history of hysterectomy done for ULMS. Magnetic resonance imaging revealed a left atrial mass, which was resected and revealed to be a metastasis of leiomyosarcoma on histopathology and immunohistochemistry. Metastatic ULMS may rarely present as a left atrial mass with acute clinical presentation. Detailed clinical history and accurate diagnosis are vital for further management.
ABSTRACT
Cardiac myxoma is the most common type of primary cardiac neoplasm. Over 70% of all cardiac myxomas originate from the left atrium (LA) and 18% from the right atrium (RA). Most myxomas present with constitutional, embolic, and obstructive manifestations. We are presenting a case where a part of myxoma got embolized intra-operatively. Using trans-oesophageal echocardiography, we were able to diagnose and image the transit of the tumor from the left ventricle to the left atrium. We removed the embolized tumor from the left atrium and prevented a dreaded complication like stroke, mesenteric ischemia, renal infarct or limb ischemia, which would have resulted in increased morbidity or mortality of the patient.
ABSTRACT
We report the case of an 81-year-old man with sudden incomplete left hemianopsia. Brain computed tomography (CT) showed a right occipital hypodensity which did not seem related to the consequences of embolic stroke as atrial fibrillation consequence (the patients suffered from permanent atrial fibrillation, CHA2DS2-VASc score=5, but rather showed the characteristics of ischemic lesion due to other causes. Therefore, diagnostic work up was performed and revealed advanced non-small cell lung cancer invading left atrium through upper pulmonary veins. No others secondary lesions were detected. Cardiac involvement in cancer is an unusual finding in clinical practice and rarely stroke is the first manifestation. There are no reported cases of neoplastic embolism to the brain from cancer in the left atrium whose origin is into the lung. The patient started palliative chemotherapy. This report highlights the need for a holistic approach in medicine as the obvious diagnosis could not be the right one.
ABSTRACT
Mass detached partially or completely from left atrial wall, may produce systemic embolus. If embolus is too large and mitral stenosis is coincidentally present, emblous may obstruct inflow tract of the left ventricle and result in rapid decrease of cardiac output and sudden death subsequently. We experienced a 59-year-old male victim with sudden cardiac arrest from obstruction(“hole-in-one embolus”) of stenotic mitral valve by left atrial mass(ball thrombus). which was detected by transesophageal echocardiography during cardiopulmonary resuscitation.