A Rare Case of Undifferentiated Pleomorphic Cardiac Sarcoma

Abstract

We present a case of a patient with a four-month history of gradual-onset dyspnea and generalized body weakness. During the clinical evaluation, a mass was found in the left atrium. Coronary angiography was performed and showed normal coronary arteries. We proceeded with a complete surgical excision of the tumoral mass, and histopathology confirmed it as undifferentiated cardiac sarcoma. Six months after the surgical intervention and adjuvant chemotherapy, the patient is in complete remission, with no evidence of a recurrence of the malignant pathology. Cardiac sarcoma is a rare clinical finding and a diagnostic and therapeutic challenge due to its numerous non-specific clinical presentations.

Keywords: cardiac sarcoma; primary cardiac tumours; stable remission; surgical excision of tumour; systemic chemo therapy (stc).

Figure 1. Admission ECG

Figure 2. Transthoracic echocardiography of the cardiac mass pre-surgical intervention

Arrow: the cardiac mass.

Figure 3. Macroscopic view of the mass after surgical excision

Arrow: intraoperative mass.

Figure 4. Histological examination: undifferentiated pleomorphic sarcoma

(A) Small fascicles with marked cellularization with fusicellular cells on a fibro-inflammatory stroma and atypia is observed; (B) marked atypia and atypical mitosis.

Figure 5. CT-scan performed after the surgical intervention, showing no residual gross mass, and minimal pericardial and pleural fluid