Abstract
A large intra-cardiac tumor from the right ventricle to pulmonary trunk was detected by contrast-enhanced computed tomography and transthoracic echocardiography in a 59-year-old woman with progressive dyspnea on effort and acute congestive right-sided heart failure. Emergent surgical management was performed with cardiopulmonary bypass under cardiac arrest, however, tumor resection was incomplete, because it originated from the interventricular septum. Concomitant tricuspid valve replacement using a bioprosthesis was required due to the involvement of the septal leaflet of the tricuspid valve. Although large pulmonary thromboembolism was initially suspected, a pathological examination confirmed undifferentiated cardiac sarcoma. The patient did not consent to additional neoadjuvant chemotherapy or radiation therapy. After palliative surgical management, she was discharged. Recurrence rapidly progressed and the patient died approximately 2 months after surgery. We herein present a successful palliative surgical case of large cardiac undifferentiated sarcoma originating from the intraventricular septum and involving the right ventricle to pulmonary trunk.
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Simpson L, Kumar SK, Okuno SH, Schaff HV, Porrata LF, Buckner JC, et al. Malignant primary cardiac tumors. Review of a single institution experience. Cancer. 2008;112:2440–6
Barreiro M, Renilla A, Jimenez JM, Martin M, Al Musa T, Garcia L, et al. Primary cardiac tumors: 32 years of experience from Spanish tertiary surgical center. Cardiovasc Pathol. 2013;22:424–7.
Isambert N, Ray-Coquard I, Italiano A, Rios M, Kerbrat P, Gauthier M, et al. Primary cardiac sarcomas: a retrospective study of the French Sarcoma Group. Eur J Cancer. 2014;50:128–36.
Ramlawi B, Leja MJ, Abu Saleh WK, Al Jabbari O, Benjamin R, Ravi V, et al. Surgical treatment of primary cardiac sarcomas: review of a single-institution experience. Ann Thorac Surg. 2016;101:698–702.
Varadharajan R, Paridas S, Adinarayanan S, Badhe AS. Transesophageal echocardiography images of right ventricular sarcoma. Ann Card Anaesth. 2013;16:302–3.
Yamamoto H, Yamamoto F, Ishibashi K, Matsukawa M, Liu KX, Hasegawa H. Primary sarcoma of the right ventricle: surgical and adjuvant therapy. Gen Thorac Cardiovasc Surg. 2009;57:421–5.
Talbot SM, Taub RN, Keohan ML, Edwards N, Galantowicz ME, Schulman LL. Combined heart and lung transplantation for unresectable primary cardiac sarcoma. J Thorac Cardiovasc Surg. 2002;124:1145–8.
Uberfuhr P, Meiser B, Fuchs A, Schulze C, Reichenspurmer H, Falk M, et al. Heart transplantation: an approach to treating primary cardiac sarcoma? J Heart Lung Transplant. 2002;21:1135–9.
Wu Y, Million L, Moding EJ, Scott G, Berry M, Ganjoo KN. The impact of postoperative therapy on primary cardiac sarcoma. J Thorac Cardiovasc Surg. 2018;156:2194–203.
Abu Saleh WK, Ramlawi B, Shapira OM, Al Jabbari O, Ravi V, Benjamin R, et al. Improved outcomes with the evolution of a neoadjuvant chemotherapy approach to right heart sarcoma. Ann Thorac Surg. 2017;104:90–7.
Hirooka K, Oonuki M, Manabe S, Hiraoka D, Yasukawa T, Suzuki K. Radiation therapy for recurrent cardiac undifferentiated pleomorphic sarcoma after three operations. Gen Thorac Cardiovasc Surg. 2018;66:168–71.
Ramnarine IR, Davidson L, van Doorn CA. Primary cardiac sarcoma: a rare, aggressive tumor. Ann Thorac Surg. 2001;72:927–9.
Devbhandari MP, Meraj S, Jones MT, Kadir I, Bridgewater B. Primary cardiac sarcoma: reports of two cases and a review of current literature. J Cardiothorac Surg. 2007;2:34.
Sogabe O, Ohya T. Right ventricular failure due to primary right ventricle osteosarcoma. Gen Thorac Cardiovasc Surg. 2007;55:19–22.
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Furukawa, H., Honda, T., Yamasawa, T. et al. Surgical management of large undifferentiated cardiac sarcoma involving the right ventricle to pulmonary trunk. Gen Thorac Cardiovasc Surg 68, 1031–1036 (2020). https://doi.org/10.1007/s11748-019-01208-1
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DOI: https://doi.org/10.1007/s11748-019-01208-1