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Laks T, Kirik K, Joeste E, Lax SF, Liiver A, Samarin A, Kalinina L, Puusepp M, Sarev T. Heart Osteosarcoma Presenting as Infective Endocarditis: A Case Report of a Patient With a Cardiac Pacemaker and Triple Malignancies. J Med Cases 2019; 10:234-240. [PMID: 34434312 PMCID: PMC8383708 DOI: 10.14740/jmc3333] [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: 07/12/2019] [Accepted: 08/06/2019] [Indexed: 12/03/2022] Open
Abstract
Primary and metastatic cardiac sarcomas represent rare neoplasms with a variable clinical course. We present a rare case of an 84-year-old man with a cardiac pacemaker and heart osteosarcoma, hepatocellular and prostatic carcinoma, who was admitted with suspected symptoms of infective endocarditis. Findings of cardiac osteosarcoma in a patient with a pacemaker and three malignancies have not been reported before in the literature.
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Affiliation(s)
- Toivo Laks
- Department of Cardiology, North Estonia Medical Centre, 19 Sutiste, 13419 Tallinn, Estonia
| | - Katlin Kirik
- Department of Internal Medicine, North Estonia Medical Centre, 19 Sutiste, 13419 Tallinn, Estonia
| | - Enn Joeste
- Department of Pathology, North Estonia Medical Centre, 19 Sutiste, 13419 Tallinn, Estonia
| | - Sigurd F. Lax
- Department of Pathology, Hospital Graz II, Academic Teaching Hospital of the Medical University Graz, Goestingerstrasse 22, AT-8020 Graz, Austria
- Institute of Pathology and Molecular Pathology, Johannes Kepler University Linz, Linz, Austria
| | - Anita Liiver
- Department of Cardiology, North Estonia Medical Centre, 19 Sutiste, 13419 Tallinn, Estonia
| | - Andrei Samarin
- Department of Radiology, North Estonia Medical Centre, 19 Sutiste, Tallinn, Estonia
| | - Ljudmilla Kalinina
- Department of Internal Medicine, North Estonia Medical Centre, 19 Sutiste, 13419 Tallinn, Estonia
| | - Mai Puusepp
- Department of Radiology, North Estonia Medical Centre, 19 Sutiste, Tallinn, Estonia
| | - Toomas Sarev
- Department of Cardiology, Norfolk and Norwich University Hospital NHS Foundation Trust, Colney Lane, Norwich, NR4 7UY, Norfolk, UK
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Li Y, Ye T, Gu Q, Dong L, Chen G, Lu S. Primary, cardiac, fibroblastic osteosarcoma: A case report. Medicine (Baltimore) 2018; 97:e9543. [PMID: 29505531 PMCID: PMC5943118 DOI: 10.1097/md.0000000000009543] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2017] [Revised: 12/07/2017] [Accepted: 12/12/2017] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Primary cardiac osteosarcoma is a rare tumor. To our knowledge, only 15 cases have been reported in the literature in the past 10 years. We describe a case of primary, cardiac, fibroblastic osteosarcoma in a 42-year-old woman. PATIENT CONCERNS A 42-year-old woman with a 10-day history of chest pain. Intraoperatively, a mass was found originating from the ostium of the left inferior pulmonary vein in the left atrium, extending to the mitral orifice. Histologically, the tumor contained variable amounts of spindle cells and osseous differentiation in different areas. Primary, cardiac fibroblastic osteosarcoma had the typical appearance of interlacing hyperchromatic spindle-shaped stromal cells associated with osseous matrix. DIAGNOSES According to the clinicopathological features, diagnosis of primary, cardiac fibroblastic osteosarcoma was made. INTERVENTIONS Wide surgical excision of the mass was performed. OUTCOMES Three months after the operation, transthoracic echocardiography demonstrated a 3.2 cm × 2 cm recurrent mass in the wall of the left atrium (LA). She died shortly afterwards as a result of the local disease recurrence. LESSONS In this report, we describe a rare case of primary, cardiac fibroblastic osteosarcoma, and findings are helpful for the pathologists would like to further identify the clinicopathological features of this rare tumor.
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Affiliation(s)
- Yangyang Li
- Department of Pathology, The First Affiliated Hospital of Wenzhou Medical University
| | - Teng Ye
- Department of Dermatology, Wenzhou Hospital of Integrated Chinese and Western Medicine, Wenzhou Children's Hospital, Wenzhou, Zhejiang
| | - Qianru Gu
- Department of Pathology, The First Affiliated Hospital of Wenzhou Medical University
| | - Lei Dong
- Department of Pathology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Guorong Chen
- Department of Pathology, The First Affiliated Hospital of Wenzhou Medical University
| | - Shanshan Lu
- Department of Pathology, The First Affiliated Hospital of Wenzhou Medical University
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Wang JG, Liu B, Gao H, Li YJ, Zhao P, Liu XP. Primary Cardiac Osteosarcoma. Heart Lung Circ 2016; 25:698-704. [PMID: 26907617 DOI: 10.1016/j.hlc.2016.01.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2015] [Revised: 12/31/2015] [Accepted: 01/07/2016] [Indexed: 11/16/2022]
Abstract
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.
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Affiliation(s)
- Ji-Gang Wang
- Department of Pathology, The Affiliated Hospital of Qingdao University, People's Republic of China; Department of Pathology, School of Basic Medical Sciences, Fudan University, People's Republic of China
| | - Bing Liu
- Department of Vascular Surgery, The Affiliated Hospital of Qingdao University, People's Republic of China
| | - Han Gao
- Department of Pathology, Qingdao Municipal Hospital, People's Republic of China
| | - Yu-Jun Li
- Department of Pathology, The Affiliated Hospital of Qingdao University, People's Republic of China
| | - Peng Zhao
- Department of Pathology, The Affiliated Hospital of Qingdao University, People's Republic of China
| | - Xiu-Ping Liu
- Department of Pathology, The Fifth Peoples' Hospital of Shanghai, Fudan University, People's Republic of China; Department of Pathology, School of Basic Medical Sciences, Fudan University, People's Republic of China.
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Trimble CR, Burke A, Kligerman S. Primary Cardiac Osteosarcoma: AIRP Best Cases in Radiologic-Pathologic Correlation. Radiographics 2015; 35:1352-7. [PMID: 26371582 DOI: 10.1148/rg.2015140265] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Christopher R Trimble
- From the Department of Diagnostic Radiology and Nuclear Medicine (C.R.T., S.K.) and Department of Pathology (A.B.), University of Maryland School of Medicine, 22 S Greene St, Room N2E23, Baltimore, MD 21201
| | - Allen Burke
- From the Department of Diagnostic Radiology and Nuclear Medicine (C.R.T., S.K.) and Department of Pathology (A.B.), University of Maryland School of Medicine, 22 S Greene St, Room N2E23, Baltimore, MD 21201
| | - Seth Kligerman
- From the Department of Diagnostic Radiology and Nuclear Medicine (C.R.T., S.K.) and Department of Pathology (A.B.), University of Maryland School of Medicine, 22 S Greene St, Room N2E23, Baltimore, MD 21201
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Bentz K, Hoferer A, Latus J, Bode-Erdmann S, Albert M, Backes M, Hehr T, Mahrholdt H, Greulich S. Unusual cause for recurrent syncope in a patient late after radiation therapy. Circulation 2014; 129:1988-91. [PMID: 24821828 DOI: 10.1161/circulationaha.113.006935] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Kerstin Bentz
- Departments of Cardiology (K.B., H.M., S.G.), Haemato-Oncology (A.H.), Nephrology (J.L.), Clinical Pathology (S.B.-E.), Cardiovascular Surgery (M.A.), and Radiology (M.B.), Robert Bosch Medical Center, Stuttgart, Germany; and Department of Radiation Oncology, Marienhospital, Stuttgart, Germany (T.H.)
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Dell'Amore A, Asadi N, Caroli G, Dolci G, Bini A, Stella F. Recurrent primary cardiac osteosarcoma: a case report and literature review. Gen Thorac Cardiovasc Surg 2013; 62:175-80. [PMID: 23526150 DOI: 10.1007/s11748-013-0236-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2013] [Accepted: 03/12/2013] [Indexed: 11/24/2022]
Abstract
Primary malignant cardiac tumors are very rare. Among malignant tumors, sarcomas occupy first place. In particular, primary cardiac osteosarcoma is extremely rare. To the best of our knowledge, only 42 cases have been reported worldwide. Cardiac malignant tumors usually require complex operations due to the difficulty in completely removing the tumor with acceptable free surgical margins and because of the proximity to vital structures. The current multimodality treatment strategies for cardiac sarcoma are still suboptimal, and surgery in particular frequently has unsatisfactory results. We report a case of recurrent primary cardiac osteosarcoma in a young male who underwent trans-sternal right pneumonectomy and a wide resection of the left and right atrium followed by reconstruction with heterologous pericardium under extracorporeal circulation. The patient died 6 months after the operation due to local and systemic disease recurrence.
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Affiliation(s)
- Andrea Dell'Amore
- Thoracic Surgery Unit, S.Orsola Malpighi Hospital, University of Bologna, Via Massarenti 9, Bologna, Italy,
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Aguilar CA, Donet JA, Galarreta CI, Yabar A. A primary cardiac osteosarcoma: Case report and review of the literature. J Cardiol Cases 2012; 7:e29-e33. [PMID: 30533114 DOI: 10.1016/j.jccase.2012.09.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2012] [Revised: 09/19/2012] [Accepted: 09/27/2012] [Indexed: 12/31/2022] Open
Abstract
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.>.
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Affiliation(s)
- Cristian A Aguilar
- Department of Pathology, Hospital Edgardo Rebagliati Martins, Lima, Peru
| | - Jean A Donet
- Department of Medicine, University of Miami - Jackson Memorial Hospital, Miami, FL, USA
| | | | - Alejandro Yabar
- Department of Pathology, Hospital Edgardo Rebagliati Martins, Lima, Peru
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