We are going to present a case of malignant fibrous histiocytoma in the right
atrium, which is a very rare entity. The patient had a right atrial mass, which
prolapsed through the tricuspid valve into the right ventricle, causing
functional tricuspid valve stenosis. The tumor was completely resected and the
patient had an uneventful postoperative period. Histopathological examination
reported malignant fibrous histiocytoma. The patient presented to the emergency
department five weeks after discharge with dyspnea and palpitation.
Echocardiography and magnetic resonance imaging revealed recurrent right atrial
tumor mass. His clinical status has worsened, with syncope and acute renal
failure. On the repeated echocardiography, suspected tumor recurrence was
observed in left atrium, which probably caused systemic embolization.
Considering the aggressive nature of the tumor and systemic involvement, our
Heart Council decided to provide palliative treatment by nonsurgical management.
His status deteriorated for the next few days and the patient succumbed to a
cardiac arrest on the 4
th
day.
Although novel coronavirus-2019 (COVID-19) primarily affects the respiratory system, it can affect multiple organ systems, leading to serious complications, such as acute respiratory distress syndrome (ARDS) and multiple organ failure. Nearly 20 to 55% of patients with COVID-19 experience coagulation disorders that cause high mortality in line with the severity of the clinical picture. Thromboembolism can be observed in both venous and arterial systems. The vast majority of thromboembolic events are associated with the venous system and are often observed as pulmonary embolism. Arterial thromboembolisms often involve the arteries in the lower extremities, followed by those in the upper extremities. Herein, we report a rare case of COVID-19 pneumonia whose left arm was amputated at the forearm level after arterial thromboembolism in the left upper extremity. This case report is valuable, as it is the first reported case of upper extremity arterial thromboembolism in Turkey, as well as the only case in the literature in which the patient underwent four surgical interventions and is still alive.
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