Undifferentiated pleomorphic sarcoma with focal myogenic differentiation mimicking left atrial myxoma

Abstract

Primary cardiac tumors are very rare. Cardiac sarcomas can be detected at any age, regardless of gender. At diagnosis, these are mostly symptomatic and one-third metastatic. Undifferentiated pleomorphic sarcomas account for 1.7% of all cardiac tumors, are typically localized in the left atrium, and involve the mitral valve. Here we present a case of left atrial undifferentiated pleomorphic sarcoma with myogenic differentiation that clinically and radiologically mimicked myxoma.

Keywords

• Left atrium
• Myogenic differentiation
• Myxoma
• Sarcoma

References

1. 1. Akishima S, Imai A, Enomoto Y, Shigeta O. Combined treatment for a large primary cardiac sarcoma: a case report. Surg Case Rep. 2019;5(1):1-5. doi: 10.1186/s40792-019-0658-x.
2. 2. Vallés-Torres J, Izquierdo-Villarroya MB, Vallejo-Gil JM, Casado-Domínguez JM, Latasa ABR, Auquilla-Clavijo P. Cardiac undifferentiated pleomorphic sarcoma mimicking left atrial myxoma. J Cardiothorac Vasc Anesth. 2019;33(2):493-6. doi: 10.1053/j.jvca.2018.02.010.
3. 3. Orlandi A, Ferlosio A, Roselli M, Chiariello L, Spagnoli LG. Cardiac sarcomas: an update. J Thorac Oncol. 2010;5(9):1483-9. doi: 10.1097/JTO.0b013e3181e59a91.
4. 4. Piazza N, Chughtai T, Toledano K, Sampalis J, Liao C, Morin JF. Primary cardiac tumours: eighteen years of surgical experience on 21 patients. Can J Cardiol. 2004;20(14):1443-8.
5. 5. Burke A, Tavora F. The 2015 WHO classification of tumors of the heart and pericardium. J Thorac Oncol. 2016;11(4):441-52. doi: 10.1016/j.jtho.2015.11.009.
6. 6. Chauhan A, Agarwal A, Naqvi SEH, Geelani MA. Malignant Tumors of Heart: A Review. World Journal of Cardiovascular Surgery. 2018;8(11):204. doi: 10.4236/wjcs.2018.811020
7. 7. Castorino F, Masiello P, Quattrocchi E, Di Benedetto G. Primary cardiac rhabdomyosarcoma of the left atrium: an unusual presentation. Tex Heart Inst J. 2000;27(2):206.
8. 8. Cipriani NA, Kurzawa P, Ahmad RA, Deshpande V, Hornicek FJ, Mullen JT et al. Prognostic value of myogenic differentiation in undifferentiated pleomorphic sarcomas of soft tissue. Hum Pathol. 2014;45(7):1504-8. doi: 10.1016/j.humpath.2014.03.002.

9. 9. Kavakbasi E, Scheld HH, Kessler T, Sindermann JR, Kösek V, Tjan TDT et al. Postoperative complications and long-term results after primary cardiac sarcoma resection. Thorac Cardiovasc Surg. 2018;66(8),637-44. doi: 10.1055/s-0037-1603790.
10. 10. Bakaeen FG, Jaroszewski DE, Rice DC, Walsh GL, Vaporciyan AA, Swisher SS et al. Outcomes after surgical resection of cardiac sarcoma in the multimodality treatment era. J Thorac Cardiovasc Surg. 2009;137(6):1454-60. doi: 10.1016/j.jtcvs.2008.11.026.