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Case Reports
. 2013;40(3):339-42.

Primary cardiac pleomorphic sarcoma presenting as back pain in an 18-year-old man

Osama Alsara  1 , Supratik Rayamajhi, Firas Ghanem, Elias Skaf, George S Abela
Affiliations
Case Reports

Primary cardiac pleomorphic sarcoma presenting as back pain in an 18-year-old man

Osama Alsara et al. Tex Heart Inst J. 2013.

Abstract

Soft-tissue sarcoma is the most prevalent primary malignant cardiac tumor. This sarcoma usually presents with cardiac manifestations secondary to local obstruction or arrhythmias; very rarely does it present with initial symptoms of distant metastasis. We discuss the unusual case of an 18-year-old man who emergently presented with acute-on-chronic back pain. Imaging revealed a lesion on the 12th thoracic vertebra and a large mass arising from the left atrium. The cardiac mass was resected, and immunohistochemical analysis revealed it to be a pleomorphic sarcoma that had metastasized to the spine. The patient died 2 years later of diffuse metastases. In addition to the patient's case, we discuss the nature and treatment of cardiac sarcoma.

Keywords: Bone neoplasms/secondary; heart neoplasms/diagnosis/pathology/surgery; sarcoma/complications/diagnosis/surgery.

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Figures

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Fig. 4 A relatively mobile echodense structure is visible in the left atrium on 2-dimensional echocardiograms in A) parasternal long-axis and B) short-axis views, and in apical 4-chamber views C) without and D) with superimposed color-flow Doppler.
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Fig. 3 Computed tomograms of the thorax and abdomen in A) coronal and B) axial views show an 8.1 × 3.8 × 2.4-cm lobular filling defect with irregular margins within the left atrium. The appearance is that of a soft-tissue mass such as myxoma or sarcoma.
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Fig. 2 Magnetic resonance image of the lumbar spine shows a pathologic-appearing compression fracture of the 12th thoracic vertebra; approximately 1 cm of retropulsion of bone and disk into the spinal canal causes mild-to-moderate compression of the spinal cord.
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Fig. 1 Computed tomogram of the spine shows a lytic destructive process involving the T12 vertebral body (arrows).
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Fig. 6 Photomicrograph of the resected specimen shows neoplastic cells, suggesting the diagnosis of high-grade, undifferentiated pleomorphic sarcoma (H & E, orig. ×200).
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Fig. 5 Photograph shows the gross specimen after resection of the left atrial mass.
See this image and copyright information in PMC

References

    1. Silverman NA. Primary cardiac tumors. Ann Surg 1980;191 (2);127–38. - PMC - PubMed
    1. Molina JE, Edwards JE, Ward HB. Primary cardiac tumors: experience at the University of Minnesota. Thorac Cardiovasc Surg 1990;38 Suppl 2:183–91. - PubMed
    1. Takach TJ, Reul GJ, Ott DA, Cooley DA. Primary cardiac tumors in infants and children: immediate and long-term operative results. Ann Thorac Surg 1996;62(2):559–64. - PubMed
    1. Zhang PJ, Brooks JS, Goldblum JR, Yoder B, Seethala R, Pawel B, et al. Primary cardiac sarcomas: a clinicopathologic analysis of a series with follow-up information in 17 patients and emphasis on long-term survival. Hum Pathol 2008;39 (9):1385–95. - PMC - PubMed
    1. Herhusky MJ, Gregg SB, Virmani R, Chun PK, Bender H, Gray GF Jr. Cardiac sarcomas presenting as metastatic disease. Arch Pathol Lab Med 1985;109(10):943–5. - PubMed

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