Primary Osteosarcoma of the Heart: Experience of an Unusual Case

ÖZEN, Düriye Sıla KARAGÖZ; Öztürk, Mehmet Akif; Selçukbiricik, Fatih; Esatoğlu, Sinem Nihal; Turna, Zeynep Hande; Beyaz, Pınar; Dervışoğlu, Sergülen; Özgüroǧlu, Mustafa

doi:10.1159/000351123

Cited by 8 publications

(3 citation statements)

References 5 publications

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“…Most commonly they present in the extremities, but have been reported in the breast, heart, and colon amongst other visceral organs [10,[34][35][36]. There may be an association with prior radiation.…”

Section: Gross and Histologic Subtypesmentioning

confidence: 99%

Osteosarcoma

Moore

Luu

2014

Cancer Treatment and Research

318

251

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Section: Gross and Histologic Subtypesmentioning

confidence: 99%

Osteosarcoma

Moore

Luu

2014

Cancer Treatment and Research

318

251

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“…Although the number of reported cardiac sarcoma cases metastatic to the brain is too small to suggest a mechanism of spread of the neoplasm, it is possible that haematogenous spread with intracerebral invasion is a common route of dissemination [4]. A few cases of spinal metastasis, even a case of brain stem metastasis, have also been reported in the literature [5,7], but we did not find any case describing cerebellar metastasis. The difficulty in long-term treatment of cardiac sarcoma is prevention of metastasis and local recurrence [3].…”

Section: Discussionmentioning

confidence: 71%

Cerebellar and bone metastasis from primary cardiac sarcoma: an unusual case

et al. 2015

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Dear Editor, Primary cardiac tumours are uncommon [3]. The incidence in autopsy series ranged from 0.001 to 0.3 % [5]. About threequarters of these are benign, the other quarter malignant [6]. Because of the few reported cases and poor prognosis of primary cardiac sarcomas, the metastatic potential and behaviour of these tumours are not fully understood [4].We present the case of a 28-year-old male who came acutely to our hospital because of congestive heart failure. He required an emergent thoracotomy to resection of a left atrium mass. The surgical excision was complete. The histological examination showed a diffusely infiltrating mass compatible with a pleomorphic high-grade sarcoma. After heart surgery the patient had chemotherapy and local radiation. One year later he was admitted to the neurosurgical department because of a 10-day history of headache, vomiting and instability. The cranial magnetic resonance imaging revealed a right cerebellar mass with ring contrast-enhancing and surrounding edema that compressed the fourth ventricle. The patient underwent an infratentorial craniectomy with complete resection of the lesion. Histopathologically the tumour was mainly composed of pleomorphic malignant cells with irregular nuclei and prominent nucleoli, areas of necrosis and a significant degree of anaplasia. Tumour cells were inmunoreative for vimentin, desmin, smooth muscle actin and neuronal specific enolase and negative for myo D1, CD99, CD68 and AE1/AE3. It was compatible with a metastasis of pleomorphic undifferentiated sarcoma with a positive muscle marker, suggesting leiomyosarcoma differentiation. The proliferation marker Ki67 was 60 %. The patient had subsequent chemotherapy and radiotherapy. Four years after complaining of left hip pain, the patient underwent hip magnetic resonance imaging, which revealed a well-demarcated mass at the left femoral neck, with heterogeneous gadolinium enhancement. There were no other bone, cardiac or brain lesions in the total body scan. He received palliative radiotherapy for the initial management of pain. Then a left proximal femoral resection and total hip replacement were performed. The histological analysis confirmed an osteolytic lesion composed of atypical giant undifferentiated cells compatible with a metastasis from cardiac pleomorphic sarcoma. More than 6 years after the initial diagnosis, the patient remains alive and healthy. DiscussionPrimary cardiac tumours represent between 5 % and 10 % of all cardiac tumours. The majority are benign, with only a small portion being malignant. Undifferentiated pleomorphic sarcoma is extremely rare. Most have been published as single case reports [6] and minimal epidemiological data have been collected. Usually, they present in young patients and have a poor prognosis, often fatal, considerably worse than that of * Aida Antuña Ramos

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“…Surgical resection is usually the initial treatment. Complete surgical excision is important for improving the survival rate and prognosis of patients with primary cardiac sarcoma (8,9). Unfortunately, in our case, the tumor was not resected completely because it had extended into adjacent structures, including the LA wall and the posterior mitral valve leaflet.…”

Section: Discussionmentioning

confidence: 90%

Imaging Findings of a Primary Cardiac Osteosarcoma Arising From the Left Atrium and Mitral Posterior Leaflet with Multiple Metastases in A 58-Year-Old Woman

et al. 2016

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Primary cardiac osteosarcoma is a very rare malignancy with nonspecific symptoms, making early diagnosis a challenge. We report the computed tomography and magnetic resonance imaging findings of a primary cardiac osteosarcoma arising from the left atrium and posterior mitral leaflet in a 58-year-old woman with multiple metastases to the brain, skull, clavicle, lung, ribs, liver, lymph nodes, and thyroid gland.

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Primary Osteosarcoma of the Heart: Experience of an Unusual Case

Cited by 8 publications

References 5 publications

Osteosarcoma

Osteosarcoma

Cerebellar and bone metastasis from primary cardiac sarcoma: an unusual case

Imaging Findings of a Primary Cardiac Osteosarcoma Arising From the Left Atrium and Mitral Posterior Leaflet with Multiple Metastases in A 58-Year-Old Woman

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