Right ventricular obstruction secondary to intracardiac metastatic osteosarcoma

Abstract

Summary:A 30-year-old female with a history of surgically treated osteosarcoma 2 years prior to admission presented with progressive dyspnea and cyanosis. Physical examination was otherwise negative. Cardiac catheterization demonstrated a right ventricular mass lesion. At surgery, a metastatic osteosarcoma filling the entire right ventricle and extending from the pulmonary valve across the tricuspid valve and into the right atrial cavity was partially excised. Despite marked improvement postoperatively, she died 33 dafter surgery. Postmortem findings were unusual in that the heart represented the sole site of metastasis. The diagnostic approach to cardiac symptoms from malignancy is discussed in relation to this patient.

Cardiac Neoplasms: Current Diagnosis, Pathology, and Therapy

“…Multiple cases of ventricular outflow obstruction from metastatic lesions have been reported. Primary lesions that have caused metastatic cham be r obstruction have i n cI ud ed me I ano m a, chondrosarcoma, osteosarcoma, and leiomyosarcoma as well as carcinoma of the colon, lung, and kidney 149,[159][160][161][162] Therapy for cardiac metastases Surgical treatment for metastatic cardiac malignancies has been limited to isolated lesions causing ventricular obstruction. Wise et al treated a patient with isolated metastases from an osteosarcoma by local r e~e c t i 0 n .…”

Left ventricular metastasis of osteosarcoma: A report of an unusual case

“…The sizes of metastatic osteosarcomas vary from small nodules accidentally discovered to large masses filling the entire LV, extending into the aortic valve and across the mitral valve. 6 In most cases, patients are asymptomatic. However, they may present with arrhythmia, congestive heart failure, infective endocarditis, and embolic accidents according to the location and size of the tumor.…”

“…The sizes of metastatic osteosarcomas vary from small nodules accidentally discovered to large masses filling the entire LV, extending into the aortic valve and across the mitral valve 6 …”

Parosteal osteosarcoma with myocardial metastasis 13 years after follow-up

“…Concerning cases of OS, there are reports of several instances in which cardiac metastases were diagnosed 14,[21][22][23][24][25][26][27][28][29] . The diagnoses in most of those cases were performed postmortem and were associated with a significant concurrence of pulmonary lesions 30 .…”