Case report: The diagnostic challenge of primary cardiac intimal sarcoma

Abstract

Primary cardiac intimal sarcoma, an extremely rare cardiac tumor subtype, is often mis-diagnosed owing to its rarity and non-specific clinical and radiological features. We report a case of cardiac intimal sarcoma mimicking atrial myxoma in which the clinical presentation and multimodality imaging are described in detail, and diagnostic challenges are highlighted.

Cardiac intima sarcoma: a rapid review of case reports

“…Through a backward citation search, 24 additional articles were retrieved, bringing the total to 74 articles included in this study. Figure 1 shows the preferred reporting items for systematic reviews and meta-analyses (PRISMA) flowchart and screening methods, while Table 1 displays the general characteristics of the patient population [18–85] .…”

“…Pyo and Kim [53] F Dyspnea and circulatory shock NA Died Pomp et al [54] M Symptoms of stroke None Alive with stable disease Rehman et al [55] M Dyspnea on exertion, lightheadedness, midsternal chest tightness, and chest pressure/ heaviness Liver and kidney Alive with controlled disease Ho et al [56] F Paroxysmal atrial fibrillation Thoracolumbar vertebra Alive as at data cutoff Chang et al [57] M Palpitation and dyspnea on exertion, chest tightness, wheezing, sitting breathing, lower limb edema, and bilateral bloody pleural effusion Pericardium, mediastinum lymph nodes, and left lung nodules Alive as at data cutoff Diamond et al [7] F Fatigue, subjective fever, headache, and dyspnea None Alive as at data cutoff Hwang [58] F Dyspnea on exertion and orthopnea None Alive as at data cutoff Ku et al [59] F Cough None Alive as at data cutoff Al-Hajri et al [60] M Dizziness on exertion None Alive as at data cutoff Clemens et al [61] M Dyspnea on exertion None Alive as at data cutoff Kuurstra et al [62] M Sudden onset of severe fatigue, shortness of breath, non-productive cough, and general malaise None Alive as at data cutoff Al-Azzam et al [63] F Dyspnea and progressive exercise intolerance None Alive as at data cutoff Vinod et al [8] F Progressive exertional dyspnea, orthopnea, paroxysmal nocturnal dyspnea (PND) and exercise intolerance NA Alive as at data cutoff Li et al [1] M Shortness of breath and diminished exercise tolerance NA Alive as at data cutoff Modi et al [2] M Multiple recurrences of left atrial mass NA Alive as at data cutoff Shah et al [64] M Worsening shortness of breath, chills, night sweats, and weight loss NA Alive as at data cutoff Al Umairi et al [65] 55 M Dizziness NA Alive as at data cutoff Dotsenko et al [66] 47 M Shortness of breath NA Alive as at data cutoff Fu et al [67] 70 F Cough and nocturnal orthopnea NA Alive as at data cutoff Sugiyama et al [68] 60 M Fever, limb arthralgia, and progressive bilateral leg edema NA Alive as at data cutoff Durieux et al [69] 37 M Exertional dyspnea, anorexia and epigastric pain Left adrenal gland Alive as at data cutoff Ye et al [70] 52 F Progressive cough and shortness of breath Femur Alive as at data cutoff Valecha et al [71] 70 F Routine follow-up visits Lungs, axillary and thoracic adenopathy, thoracic and lumbar spine, peritoneum, liver, kidneys, and the adrenal Alive and wide spread metastasis Romanowska et al…”

A case of left atrial intimal sarcoma with rhabdomyosarcoma differentiation: a case report and literature review

“…Furthermore, the attachment of the mass was broad, which indicates a sign of malignancy. CT can assess tissue features, vascularity, adjacent infiltrates and extracardiac metastases, and cardiac magnetic resonance imaging (MRI) is the standard diagnostic tool ( 14 ). 18F-FDG positron emission computed tomography (PET/CT) infers the presence of a malignant process based on the FDG uptake of the mass, and IS has a high FDG uptake ( 15 , 16 ).…”

Case report: Cardiac intimal sarcoma in a young child

“…The lymphadenopathy could happen due to multiple reasons, as inflammation, a recent infection or more likely due to congestion caused by the sarcoma blocking the flow in the right ventricle and causing the effusions in the pericardium and the pleura, as well as causing the ascites. In the diagnostic work-up of intimal sarcomas CT and MRI are optimal for assessing tissue characteristics, infiltration and metastases ( 25 ). Given the high probability of occult dissemination at the time of diagnosis in this type of malignancy adjuvant chemotherapy was proposed, which was refused by the parents.…”