Surgical Treatment for Epicardial Metastasis of Myxoid Liposarcoma Involving Atrioventricular Sulcus

Abstract

We report the case of a 52-year-old man who presented with a cardiac metastasis of myxoid liposarcoma invading the atrioventricular sulcus. The tumor was arising from the anterior wall of the right atrium and basal right ventricle. After complete resection of the tumor (14 x 7.5 x 6 cm, 279 g), the annulus had no strong supporting tissue because of invasion of the atrioventricular sulcus. The tricuspid valve was reconstructed with reinforcement of the annulus using an autologous pericardial strip. The defect of the right atrial wall was reconstructed with a pericardial patch. After the reconstruction, echocardiography showed grade 1 tricuspid regurgitation. Although the patient had a small metastasis to the lung after surgery, he is doing well after 31-month follow-up. We believe that it is justified to perform aggressive resection with annuloplasty, when it is feasible, for cardiac metastasis of myxoid liposarcoma.

Round Cell Liposarcoma Metastatic to the Heart

“…Chemotherapy for metastatic liposarcoma is either ifosfamide based or doxorubicin based (DOX) with or without adjuvant methotrexate. Radiotherapy has usually been used pre‐ or postoperation in ranges between 50 and 61 Gy …”

Undiagnosed Primary Cardiac Liposarcoma in an Adult

“…The myxoid variety is characterized by a slow growth and consists of proliferating lipoblasts in varying stages of differentiation, a delicate plexiform capillary pattern, and myxoid matrix. 11 Enterline et al 12 studied 53 cases of liposarcoma and listed metastases, in order of frequency, to lung, liver, lymph nodes, brain, peritoneum, and skeletal system. 3 Round cell and pleomorphic liposarcomas are aggressive tumors that are characterized by infiltrative growth, early metastasis to the lungs, and frequent local recurrence after surgical resection.…”