A Case of Ewing Sarcoma Presenting With Cardiac Metastasis

Abstract

Ewing sarcoma is the second most prevalent primary malignant bone tumor. Metastases from Ewing sarcoma to the heart are very rare. Herein, we present a case of undiagnosed Ewing sarcoma in a 12-year-old boy who presented with metastasis to the left atrium. The mass was prolapsing across the mitral valve. In view of the potential risk of embolization, urgent cardiac surgery was performed before the establishment of a definitive diagnosis. Histopathology was consistent with Ewing sarcoma. Subsequent magnetic resonance imaging revealed a mass in his left fibula. The patient was referred to the oncology center and received chemotherapy. One year later, he is alive with no evidence of recurrent cardiac involvement.

Cardiac tumours in children: a single-centre experience and literature review

“…Besides these osteosarcomas also appear to be an important primary lesion in children. [76][77][78] Cardiac involvement occurs mainly through the lymphatic and haematogenous routes, and the right side of the heart is more affected. Unexplained cardiomegaly, congestive heart failure, arrhythmia, or symptoms of right or left cardiac dysfunction in an oncological patient without previous heart disease should prompt an investigation for cardiac metastases.…”

Primary and metastatic primitive neuroectodermal tumor of the heart: A systematic review

“…The most common treatment interventions in metastatic PNET were chemotherapy plan only ( n = 6) 26–31 and surgical plan (tumor resection) with chemotherapy ( n = 5). 32–36 One patient had only tumor resection, 37 one patient underwent both chemotherapy and radiotherapy, 38 and one patient was without any intervention. 39…”

“…The most common treatment interventions in metastatic PNET were chemotherapy plan only (n = 6) [26][27][28][29][30][31] and surgical plan (tumor resection) with chemotherapy (n = 5). [32][33][34][35][36] One patient had only tumor resection, 37 one patient underwent both chemotherapy and radiotherapy, 38 and one patient was without any intervention. 39 36% of patients were alive (n = 5); two of them had no evidence of disease after 12 months (NED = 12), two had NED = 15 and NED = 2, and one of them was with no specified duration mentioned.…”

Cardiac metastasis of lung cancer diagnosed by fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT)

“…In theory, any cancer can lead to cardiac metastases. The most common cancers are melanoma, lung, breast, esophageal, and hematological malignancies [4]. These metastases are most often located in the right heart [5].…”