Primary liposarcoma of the heart

Abstract

The author reports a case of a 64-year-old man, who presented with a 4-week history of dyspnoea and dizziness suffering from a large mass in the pericardium. CT of the chest showed a lobulated mass in the pericardial sac located between the pulmonary veins and the ascending aorta reaching the superior vena cava. The tumour was completely resected and histopathological analysis revealed the tumour to be a well-differentiated lipoma-like and focal sclerosing liposarcoma, which was composed predominantly of adipocytes with hyperchromatic nuclei and eosinophilic-to-vacuolated cytoplasm disrupted by fibrous septa. Two years after initial tumour diagnosis the patient is still alive without signs of tumour recurrence.

Figure 1

Chest x-ray with the enlarged heart silhouette.

Figure 2

Chest CT showing the lipomatous tumour mass.

Figure 3

3D reconstruction of the heart with the liposarcoma between truncus pulmonalis and ascendic aorta.

Figure 4

Histological examination revealed adipocytes with eosinophilic-to-vacuolated cytoplasm, fibrous septa and lymphocytic infiltration (H&E staining, (A) – original magnification × 4, (B) – original magnification × 10, (C,D) – original magnification × 40).