Images in cardiovascular medicine: primary cardiac osteosarcoma in right ventricular outflow tract

Huge right ventricular mass lesion associated with genital malignant tumor: a case report

Background

Primary heart tumors are rare, whereas metastatic heart tumors occur more frequently.

Case presentation

We report a case of a 75-year-old Japanese woman who had metastatic heart tumors of the right ventricle. Although she initially received antibiotic therapy following a diagnosis of pneumonia and pleuritis, her symptoms worsened, and she developed dyspnea and bilateral lower limb edema. Echocardiography showed a huge mass lesion occupying the entire right ventricle. Because the patient’s tumor markers were elevated, we used computed tomography to search for the primary lesion, which was located in the vagina or the uterus. Histology demonstrated the presence of basaloid squamous cell carcinoma in the vaginal tissue. Chemotherapy with paclitaxel and carboplatin was initiated.

Conclusions

These data suggest that the tumor in the right ventricle metastasized from the genital organs.

Primary Cardiac Osteosarcoma

BACKGROUND

Primary cardiac osteosarcoma is extremely rare. There is no cohort study on such tumours to date. The aim of this study is to investigate the clinical characteristics and outcome patterns of such tumours.

METHODS

A thorough literature review was performed, and all relevant clinical items were collected. A total of 53 cases of primary cardiac osteosarcoma were enrolled in this study, including 25 males and 28 females.

RESULTS

The age at diagnosis ranged from 14 to 77 years with a mean age of 43.6 years. The clinical manifestations, imaging features, and laboratory tests of the primary cardiac osteosarcomas were similar to other types of primary cardiac tumours. Sex, tumour size and adjunctive chemo-radiotherapy were found to affect the overall survival pattern.

CONCLUSIONS

The present study may provide an effective consultation for the diagnosis and treatment of this tumour.

A primary cardiac osteosarcoma: Case report and review of the literature

Primary cardiac osteosarcoma is a rare and aggressive neoplasm that can be difficult to diagnose. We report a case of a previously healthy 49-year-old woman who presented with dyspnea, atrial flutter, and heart failure. A mass was visualized in her left atrium by echocardiography and cardiac computed tomography, and the diagnosis of cardiac myxoma was raised. The patient subsequently underwent surgical resection of the mass and atrial reconstruction. Surprisingly, histological and immunohistological analyses revealed the mass to be an osteosarcoma. The patient received chemotherapy and radiotherapy. Eight months later, she has shown evidence of local recurrence. We briefly discuss primary osteosarcomas in the cardiac cavity and their management. <Learning objective: Primary cardiac tumors are very rare and most likely benign. Malignant tumors constitute less than 25% of primary cardiac neoplasms. However, both primary sarcomas and benign tumors are often found in the left atrium. As a consequence of their location and similar clinical presentation, primary cardiac sarcomas can be easily confused with a benign myxoma, therefore abnormal imaging features (immobility of the mass, neovascularity, multicentricity, calcification and invasion into the heart structures) should raise suspicion for a cardiac sarcoma.>.

Primary right ventricular osteosarcoma

A 41-year-old man suffering from dyspnea on exertion was found to have a mass located on the right ventricle. Resection of the tumour required reconstruction of the right ventricular outflow tract and replacement of the pulmonary valve. Histopathology confirmed the diagnosis of high-grade osteosarcoma.