Cardiac metastasis of a soft tissue sarcoma: Case report and review of literature

Abstract

Cardiac metastases are the most frequent cardiac tumors. They can cause dysrhythmia, myocardial dysfunction, pericardial effusion, and heart failure. In decreasing order, the major primary malignancies associated with cardiac metastases are pleural mesothelioma, lung adenocarcinoma, undifferentiated carcinomas, lung squamous cell carcinoma, and breast carcinoma. Cardiac metastasis of sarcomas is uncommon, and only a limited number of cases have been found in literature. We report the case of an incidentally discovered cardiac metastasis when assessing the extension of a thigh mass in a 45-year-old man.

Keywords: cardiac metastasis; cardiac tumors; case report; soft tissue sarcoma.

Figure 1.

(a) STIR-weighted coronal image showing the voluminous thigh mass with irregular borders and heterogeneous high signal. (b) Enhanced T1WI coronal image showing peripheral enhancement of the voluminous thigh mass with central necrosis.

Figure 2.

Histological appearance at medium magnification (×20) showing a largely necrotic, pleomorphic, and hyperchromatic sarcomatous proliferation. The immunohistochemical results are consistent with a pleomorphic rhabdomyosarcoma grade 3 according to the FNCLCC classification.

Figure 3.

Axial enhanced CT image displaying a cystic myocardial mass, which enhances after contrast injection and appears to be attached to the left ventricle, consistent with a cardiac metastasis.

Figure 4.

(a) Axial CT image showing hepatic metastasis and muscular paravertebral metastasis. (b) Axial CT image with lung window and maximal intensity projection (MIP) showing multiple pulmonary metastasis.