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Case Reports
. 2018 Oct 7:2018:bcr2018226112.
doi: 10.1136/bcr-2018-226112.

Pericardial sarcoma

Mahmoud Abdelnaby  1 , Abdallah Almaghraby  2 , Yehia Saleh  2   3 , Rasha Abayazeed  2
Affiliations
Case Reports

Pericardial sarcoma

Mahmoud Abdelnaby et al. BMJ Case Rep. .

Abstract

Pericardial sarcomas are extremely rare aggressive neoplasms. Non-specific symptoms and incidental discovery are usually the rule. Multimodality imaging is extremely important for diagnosis and tissue characterisation of all cardiac masses. Despite treatment, pericardial sarcomas are considered extremely fatal. We encountered a 27-year-old female patient who presented to our facility with progressive dyspnoea. On examination, clinical signs of cardiac tamponade were appreciated, transthoracic echocardiography revealed a tamponading pericardial effusion and a large heterogeneous pericardial mass. Pericardiocentesis revealed haemorrhagic fluid. Subsequently, CT revealed a pericardial mass compressing the right atrium. Excision biopsy showed a well-circumscribed mass, and cut sections showed friable grey-white tissue with areas of haemorrhage and necrosis. Pathological examination confirmed the diagnosis of high-grade undifferentiated sarcoma of the pericardium. The patient was started on adjuvant chemotherapy and radiotherapy. Follow-up after 1 year showed no relapse.

Keywords: cancer - see oncology; cancer intervention; pericardial disease.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Transthoracic echocardiogram showing a large mass in the pericardium measuring 9.3×7.2 cm.
Figure 2
Figure 2
Intraoperative image of the pericardial mass.
Figure 3
Figure 3
Gross pathology of the mass revealed a well-defined encapsulated tumour with friable grey–white tissue with areas of haemorrhage and necrosis.
Figure 4
Figure 4
Histopathology showing spindle-shaped cells with spindle-shaped nuclei and scanty cytoplasm.
Figure 5
Figure 5
Histopathology showing tumour cells arranged in bundles forming a whirly pattern in foci.
See this image and copyright information in PMC

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