Insuficiencia cardíaca como presentación de sarcoma cardíaco: caso clínico y revisión de la literatura / Cardiac sarcoma associated to heart failure: case report and review

RESUMEN: Los tumores cardíacos primarios malignos son infrecuentes en la práctica clínica. Suelen ser oligosintomáticos y de diagnóstico tardío lo que tiene como consecuencia una alta mortalidad. El caso clínico que se presenta a continuación es un ejemplo de esta patología, que debe ser especialmente considerada cuando la insuficiencia cardíaca no tiene una etiología clara. Se describen los hallazgos clínicos y de laboratorio, como también los resultados de estudios de imágenes y la histología. Se ilustra los hallazgos en la operación y la evolución clínica del paciente. Se incluye una revisión de la literatura.

ABSTRACT: Malignant primary cardiac tumors are infrequent in clinical practice. They are usually oligosymptomatic and a late diagnosis leads to a high mortality rate. The clinical case of a patient presenting with heart failure with unclear etiology is presented. Clinical and laboratory findings are described along with the results of imaging studies. Findings at the time of surgery and histopathological characteristics are illustrated. A review of the literature is included.

Pleomorphic rhabdomyosarcoma of the left atrium mimicking myxoma.

Primary rhabdomyosarcoma (RMS) of the heart is a rare malignant tumor which has poor prognosis and survival despite surgery and adjuvant chemotherapy. The preoperative diagnosis is often difficult in view of nonspecific clinicoradiological findings. This report describes a case of a 60‑year‑old woman who was clinically diagnosed as left atrial myxoma. A diagnosis of pleomorphic RMS was made on histopathology after excision. Our case discusses the clinicopathological features and treatment options of cardiac RMS emphasizing the fact that histopathology and immunohistochemistry are essential to confirm the diagnosis of such an aggressive malignant tumor.

Primary intracardiac malignant peripheral nerve sheath tumor: A rare case report.

Myxomas are the most common benign cardiac tumors constituting approximately 75% of all the cardiac tumors. Rest 25% are malignant and sarcomas being the commonest. Among the sarcomas primary cardiac malignant peripheral nerve sheath tumors are extremely rare. They usually arise in relation to the branches of vagus or phrenic nerves, 5‑42% being associated with neurofibromatosis type 1. Clinical signs and symptoms depend on the location and extent of involvement. Complete resection is the treatment of choice but local recurrence is common.

Primary cardiac sarcoma with metastases to thyroid and brain.

Primary cardiac sarcomas are extremely rare with only a few large case series and isolated case reports in the literature. In spite of their aggressive nature with high chances of local recurrence and distant metastases, these tumors and their treatment strategies remain incompletely defi ned. We report an unsuspected case of primary cardiac pleomorphic undifferentiated sarcoma in a 52-year-old female who presented with progressive dyspnea and palpitation. In the postoperative period, she was detected to have secondaries in brain and thyroid, confirmed thereafter, by fine-needle aspiration cytology.

Metastatic Leiomyosarcoma Causing Right Ventricular Outflow Stenosis / 日本心臓血管外科学会雑誌

We report a rare case of cardiac metastases of leiomyosarcoma. A 64-year-old woman presented with chest pain. Nineteen years ago, she had undergone resection of uterine leiomyosarcoma 19 years pveviously and 9 years previously, resecting of colon metastases. Echocardiogram and computed tomogram revealed tumor in the right ventricular outflow tract, which moved into the pulmonary artery. Because obstruction of the main pulmonary artery was possible, the tumor was resected. The tumor was leiomyosarcoma, which suggested metastasis from the uterine tumor. No recurrence of the tumor was seen 9 months after surgery despite lack of any treatment.

A Primary Cardiac Sarcoma Preoperatively Presented as a Benign Left Atrial Myxoma

Primary cardiac sarcomas are extremely rare. We report a case of a primary cardiac sarcoma with myxoid change, which originally presented as a benign cardiac myxoma on a two- dimensional echocardiogram. On operating, the mass was found to extend into the posterior left atrial wall, the left pulmonary vein, and the mitral valve. The patient underwent wide resection of the left atrium, a mitral valve replacement and a left pneumonectomy. The histological diagnosis was of an undifferentiated primary cardiac sarcoma. The patient had postoperative chemotherapy. The patient expired 11 months after surgery due to a recurrence of the cardiac sarcoma. Although most tumors that develop in the left atrium are benign myxomas, we should make a preoperative differential diagnosis.

A Case of Right Atrial Sarcoma Complicated with Hemopericardium and Cardiac Tamponade

The incidence of primary malignant cardiac tumor, especially a primary cardiac sarcoma is extremely rare and seldom causes symptoms until late in its course. Early recognition of tumor is vital because it allows prompt and proper management. We report a rare case of cardiac sarcoma who presented as a hemopericardium after straining. Right atrial mass was diagnosed by transesophageal echocardiography (TEE) that was performed to investigate the cause of hemopericardium.