Myocardial sarcomas may involve all the chambers of the heart, the mitral valve, and the coronary and pulmonary arteries. 1-5 Synovial sarcomas can not only be found within the myocardium 6 but also in the pericardium. 7 We present images of a synovial sarcoma which presented as an aortopulmonary (AP) window mass, associated with pericardial tamponade. A 45-year-old female presented with hypotension and jugular venous distention. Transthoracic echocardiography revealed a large pericardial effusion with collapse of the right atrium and ventricle. A chest computed tomography (CT) scan revealed a 5.3 × 3-cm mass in the AP window compressing the origin of the right pulmonary artery (RPA) (Figures 1A and 1B). A positive emission tomogram demonstrated intense metabolic activity (standardized uptake value = 26) of the AP window suggestive of a malignancy (Figure 1C). A pericardiocentesis yielded 300 mL of serosanguinous fluid with negative cytology. At the time of surgery, a mediasternotomy was performed and cardiopulmonary bypass was established with ascending aortic and FIGURE 1 Mediastinal mass limited between both pulmonary arteries, cava vein, aorta, and carina (A). Moderate hemopericardium (B). High metabolic activity of the mediastinal mass (C) J Card Surg. 2018;33:797-798.wileyonlinelibrary.com/journal/jocs
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