Sarcoma metastatic to the right ventricle: surgical intervention followed by prolonged survival

Abstract

Malignant tumors that metastasize to the heart pose a formidable therapeutic challenge. Recent advances in surgical treatment have improved the management and prognosis of patients with cardiac metastases. We report the case of a 45-year-old man who had a high-grade pleomorphic sarcoma of the right ventricle. We completely resected the neoplasm, reconstructed the right ventricle, and replaced the mitral valve. Upon late follow-up, 67 months (5.6 years) later, the patient was alive and well. This case shows that aggressive surgical management of malignant disease metastatic to the heart can enable prolonged survival.

Fig. 1 Echocardiography, 4-chamber view, shows a large, heterogeneous, echo-dense mass that occupies the entire right ventricular cavity. The mass extends at least to the pulmonary valve level, causing subtotal obliteration of the right ventricular outflow tract. The lesion involves the tricuspid papillary muscle and chordal apparatus; during systole, small fronds prolapse across the tricuspid valve into the right atrium.