Surgical resection of a rare biatrial giant sarcoma: a case report

Abstract

Primary cardiac undifferentiated sarcoma is an exceptionally rare entity, marked by nonspecific symptoms that considerably challenge its diagnosis and treatment. Surgical resection generally serves as the primary treatment modality. This article describes the case of a 32-year-old female patient admitted to the hospital with symptoms of abdominal distension and pain. Subsequent echocardiography revealed a cardiac tumor that occupied almost the entire left and right atria. The tumor was surgically removed in an emergency procedure, and subsequent pathological examination confirmed an undifferentiated sarcoma. The patient was successfully discharged 17 days after surgery. She then completed six cycles of chemotherapy. A six-month follow-up showed no signs of tumor recurrence or metastasis.

Keywords: Cardiac surgery; Cardiac undifferentiated sarcoma; Malignant cardiac tumor; Tumors of the left and right atria.

Fig. 1

Transthoracic echocardiography, apical four chamber view showing: (A) preoperative huge atrial mass (arrow indicates cardiac mass), (B) postoperative

Fig. 2

(A-D) PET-CT image demonstrating: (B, D) A mass with abnormally increased glucose metabolism in the left and right atria and atrial septum is not demarcated from the ventricular wall. (C, D) Bilateral pleural effusion

Fig. 3

Macroscopic and microscopic images. A: Macroscopic imaging of the tumor. B: Tumor cells displayed an ovoid to short-spindle morphology, with focal significant pleomorphism, high proliferative activity, frequent mitotic figures, and eosinophilic cytoplasm (×100). C: Tumor cells exhibited marked pleomorphism and atypia, with prominent nucleoli (×400)