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Expansive intracardiac leiomyosarcoma - a combined therapeutic approach resulting in survival with complete remission. A literature review and case report. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2022. [PMID: 35296871 DOI: 10.5507/bp.2022.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Primary cardiac sarcomas are extremely rare and often with dismal prognosis. Only a few case series and retrospective studies regarding its biological characteristics, diagnostics, and treatment were reported. The multi-modality therapeutic strategy has been discussed in the published literature, but often with contradictory results. There is thus, no consensus on the optimal therapeutic approach to date. We present the case report of the 66-year old female endangered by a large primary leiomyosarcoma expanding in the right-sided heart chambers with imminent risk of acute obstruction of blood flow. The patient was managed by urgent surgical resection. After the histological confirmation of incomplete R1 resection, the treatment was supplemented by adjuvant CT-targeted radiotherapy, resulting in extraordinary survival with complete remission over a 24-month follow-up period. Our case report aims to demonstrate a favorable result of an individually suited complex surgical and oncological treatment to support the multidisciplinary therapeutic approach to these patients. The article is supplemented by a detailed literature review providing a theoretical background and an overview of the acquired knowledge and possible strategies.
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Alotaibi MS, Shah SH, Khan MS, Almalki ST, Alfaifi SA. Low Grade Primary Leiomyosarcoma of the Right Atrium: Promising Survival with Complete Surgical Resection. J Saudi Heart Assoc 2020; 32:476-478. [PMID: 33537195 PMCID: PMC7849844 DOI: 10.37616/2212-5043.1149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 11/01/2020] [Accepted: 11/02/2020] [Indexed: 11/20/2022] Open
Abstract
Primary cardiac leiomyosarcoma has an extremely low incidence with overall median survival of approximately 6 months. Here, We report the case of a 60-year-old man who underwent complete surgical excision of right atrial mass. Histologic examination revealed leiomyosarcoma. The patient made a full recovery with no evidence of recurrence at 24 months. To the best of our knowledge, this is the first reported case or primary cardiac leiomyosarcoma in the Middle East.
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Affiliation(s)
- Meshaal Saud Alotaibi
- Cardiac Surgery Department, King Salman Heart Center, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Shabir Hussain Shah
- Cardiac Surgery Department, King Salman Heart Center, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Mohammad Shahbaaz Khan
- Cardiac Surgery Department, King Salman Heart Center, King Fahad Medical City, Riyadh, Saudi Arabia
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Abstract
The patient was a 39-year-old man hospitalized due to the presence of a cardiac mass and heart failure. Emergency tumor resection and mitral valve replacement were performed. The pathological findings of the tumor led to a diagnosis of cardiac leiomyosarcoma. After the operation, multiple metastases were found. The patient underwent three courses of chemotherapies: adriamycin, ifosfamide, dacarbazine, and mesna (MAID therapy), gemcitabine plus docetaxel, and sunitinib. During MAID therapy, the patient underwent resection of gastrointestinal metastases twice due to gastrointestinal hemorrhaging. Although he died 27 months after the initial treatment, use of multimodal therapy was effective in achieving a longer survival for the patient.
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Affiliation(s)
- Koji Nakashima
- First Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Japan
| | - Haruhiko Inatsu
- First Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Japan
| | - Kazuo Kitamura
- First Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Japan
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Hassan M, Khattak M, Abdullah HMA, Nasib B. Primary cardiac leiomyosarcoma presenting as haemoptysis in a 22-year-old patient: an unusual presentation of a rare condition. BMJ Case Rep 2017; 2017:bcr-2017-219416. [PMID: 28705841 DOI: 10.1136/bcr-2017-219416] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Primary cardiac sarcomas are rare malignant tumours and among them, leiomyosarcoma is extremely rare. They are especially rare in a young age group. We present a case of a 22-year-old male patient with primary leiomyosarcoma of the left atrium involving the pulmonary veins who presented with haemoptysis and shortness of breath. He underwent surgical excision of the tumour along with mitral valve replacement followed by adjuvant chemotherapy. No recurrence was reported on his second 6 monthly follow-ups.
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Affiliation(s)
- Masroor Hassan
- Department of Histo-Pathology, Rehman Medical Institute, Peshawar, Pakistan
| | - Maria Khattak
- Department of Histo-Pathology, Rehman Medical Institute, Peshawar, Pakistan
| | | | - Bushra Nasib
- Department of Histo-Pathology, Rehman Medical Institute, Peshawar, Pakistan
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Blachman-Braun R, Aboitiz-Rivera CM, Aranda-Fraustro A, Ransom-Rodríguez A, Baltazares-Lipp ME, Catrip-Torres JM, Martínez-Reding JO. Immunohistochemical Diagnosis of Primary Cardiac Leiomyosarcoma in a Latin American Patient. Rare Tumors 2017; 9:6669. [PMID: 28435644 PMCID: PMC5379229 DOI: 10.4081/rt.2017.6669] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 08/27/2016] [Accepted: 10/20/2016] [Indexed: 11/26/2022] Open
Abstract
Primary cardiac malignancies are rare entities. Although sarcomas enclosed the main group of malignant heart neoplasms, primary cardiac leiomyosarcomas are extremely rare and constitutes less than 8% of cardiac tumors. Leiomyosarcoma usually originates from the pulmonary veins and have a worm-like shaped structure. In this article, we present a case of a 40-year-old Hispanic man diagnosed with a cardiac tumor who underwent surgical resection, during pathological examination the tissue samples were consistent with a malignancy of mesenchymal origin that contained irregular bundles of spindle cells. Subsequent immunohistochemical study categorized the mass as a primary heart leiomyosarcoma with positive smooth muscle actin and muscle specific actin. As usual in this type of malignancy, patient’s clinical status declined overtime, recurrence was diagnosed two months after surgery, and four months after the procedure the patient was discharge for palliative care.
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Affiliation(s)
- Ruben Blachman-Braun
- Centro de Investigación en Ciencias de la Salud, Facultad de Ciencias de la Salud, Universidad Anáhuac México Norte, Tlalpan, Mexico City
| | - Carlos Manuel Aboitiz-Rivera
- Echocardiography and Hemodynamics Service, Instituto Nacional de Enfermedades Respiratorias, Tlalpan, Mexico City
| | | | - Adrián Ransom-Rodríguez
- Department of Hepatopancreatobiliary Surgery, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City
| | | | - Jorge Manuel Catrip-Torres
- Department of Cardiovascular Surgery, Instituto Nacional de Cardiología Ignacio Chavez, Mexico City, Mexico
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Behi K, Ayadi M, Mezni E, Meddeb K, Mokrani A, Yahyaoui Y, Ksontini F, Rais H, Chrait N, Mezlini A. Two years survival of primary cardiac leiomyosarcoma managed by surgical and adjuvant therapy. Clin Sarcoma Res 2017; 7:5. [PMID: 28286642 PMCID: PMC5343408 DOI: 10.1186/s13569-017-0069-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Accepted: 02/09/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cardiac tumors are a very rare entity. Leiomyosarcoma represents less than 1% of cases. CASE PRESENTATION a 51-year-old woman diagnosed with primary left atrium leiomyosarcoma. She was treated by optimal surgery and adjuvant chemotherapy. She is still alive after a follow-up of 24 months without evidence of local or distant recurrence. CONCLUSIONS Cardiac leiomyosarcoma is a rare tumor with a dismal prognosis. Surgery is the mainstay of treatment. Adjuvant treatment is still controversial.
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Affiliation(s)
- K Behi
- Medical Oncology Department, Salah Azaeiz Institute, Tunis, Tunisia
| | - M Ayadi
- Medical Oncology Department, Salah Azaeiz Institute, Tunis, Tunisia
| | - E Mezni
- Medical Oncology Department, Salah Azaeiz Institute, Tunis, Tunisia
| | - K Meddeb
- Medical Oncology Department, Salah Azaeiz Institute, Tunis, Tunisia
| | - A Mokrani
- Medical Oncology Department, Salah Azaeiz Institute, Tunis, Tunisia
| | - Y Yahyaoui
- Medical Oncology Department, Salah Azaeiz Institute, Tunis, Tunisia
| | - F Ksontini
- Medical Oncology Department, Salah Azaeiz Institute, Tunis, Tunisia
| | - H Rais
- Medical Oncology Department, Salah Azaeiz Institute, Tunis, Tunisia
| | - N Chrait
- Medical Oncology Department, Salah Azaeiz Institute, Tunis, Tunisia
| | - A Mezlini
- Medical Oncology Department, Salah Azaeiz Institute, Tunis, Tunisia
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Muthukumar L, Jan MF, Taylor R, Crouch J, Neitzel G, Tajik AJ. Biatrial High-Grade Leiomyosarcoma With Nine-Year Post-Surgical Survival. Ann Thorac Surg 2017; 103:e43-e45. [DOI: 10.1016/j.athoracsur.2016.06.063] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 05/26/2016] [Accepted: 06/13/2016] [Indexed: 10/20/2022]
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