Co-existence of primary sarcomatoid carcinoma of the right ventricle and absence of right pulmonary artery" 1 died on April 12, 2016. She had lived a full 2 years after surgery, and most patients who suffer from primary malignant cardiac tumor (PMCT) will die within 1 year. Although the patient had undergone radiotherapy and checkups on a regular basis, ultimately she died from recurrence of the tumor entirely occluding the right ventricular outflow tract. We think this information is very important and so we write this letter for publication in the Echocardiography Journal.PMCT is extremely rare and there are numerous pathological types such as angiosarcomas, leiomyosarcoma, rhabdomyosarcomas, undifferentiated sarcomas, osteosarcomas, fibrosarcomas, malignant fibrous histiocytomas, and spindle-cell sarcomas which have been reported in the existing literature. 2 Primary cardiac sarcomatoid carcinoma has never been reported in the existing literature, and it is the first time we report this pathological type. Unlike most malignant tumors reported in the existing literature, the malignant tumors in our case were not a circumscribed mass but multiple masses filling and obstructing the right ventricular outflow tract. This was confirmed both by TTE and by contrast-enhanced CT. We found that despite the overall poor prognosis of PMCT across all histopathology types, survival appears to have improved slightly over the past five decades because of earlier diagnosis of PMCT as a result of more common use of cardiac imaging.Incidental detection of these tumors when echocardiography is performed for other reasons might lead to earlier treatment with better outcomes than in the past when diagnosis relied predominantly on the presence of symptoms. 3Meanwhile, another unique aspect of our case is that she suffered from unilateral absence of a pulmonary (UAPA), initially misdiagnosed as pulmonary embolism due to those masses in right ventricular outflow tract. In our case, the clinical symptoms of UAPA were masked by PMCT. There were also some different imaging characteristics which had already been depicted in our paper from previous reported cases in the existing literature.In summary, PMCT is extremely rare and currently has limited treatment measures, leading to very poor survival. There may be opportunities to survive for a longer time if detected by medical imaging in good time. REFERENCES 1. Hu G, Song F, Zhu X, Yang B, Liu Y, Liu Y. Co-existence of primary sarcomatoid carcinoma of the right ventricle and absence of right pulmonary artery. Echocardiography. 2015;32:1728-1731. 2. Kiss Z, Galuska L, Tima S. Multiplane transesophageal echocardiographic detection and differential diagnosis of isolated right pulmonary artery agenesis. Echocardiography. 1996;13:411-414. 3. Barreiro M, Renilla A, Jimenez JM, et al. Primary cardiac tumors: 32 years of experience from a Spanish tertiary surgical center. Cardiovasc Pathol.
