No abstract

The metastasis of sarcoma to the brain is very rare except for the i n v o l v e m e n t of l e u k a e m i a and l y m p h oma [1][2][3][4][5]. Cardiac m y x o f i b r o s a r c o m a is very rare and its brain metastasis is even rarer. There has been only one autopsy case report of metastatic brain m y x o f i brosarcoma from the heart [4].The authors report a case of myxofirbrosarcoma of the heart that metastasized repeatedly to the intracranial cavity. The patient was an 18-year-old female who underwent en bloc resection of a tumour in the left atrium of the heart in December, 1991. The specimen from the left atrium was a 5 • 5 • 6 cm ovoid mass with smooth surface. The cut surface was whitish yellow and partly myxoid. Microscopically, stellate or spindle cells surrounded by abundant loose stroma rich in acid mucopolysaccharides were seen. Foci of highly pleomorphic cells were present. Mitotic figures and areas of necrosis were present. The diagnosis of myxofibrosarcoma was made. She received external radiation therapy (54 Gy) and two years later underwent occipital craniotomy for the removal of an epidural mass, followed by radiotherapy (59.4 Gy). One and half years after the first craniotomy, she underwent a right suboccipital craniectomy for the removal of a right cerebellar mass (Fig. 1). Histological diagnosis of the two intracranial masses was the same as that of the cardiac mass, although the indicators of malignancy such as mitosis, cellularity, hyperchromasia, and pleomorphism were higher than those of the initial tumour. Multiple metastases to the lungs, ribs, and Vertebral bodies were noted and systemic chemotherapy with adriamycin, isophosphamide and dacarbazine was given. She lived for 50 months after the initial diagnosis and her KPS was maintained above 70 until the recurrence of the cerebellar tumour after the second craniotomy even with multiple systemic metastases.M y x o f i b r o s a r c o m a is a m a l i g n a n t t u m o u r and the final outcome is inevitably fatal [1,2], however, the *Keywords: Brain tumour; cardiac tumour; myxofibrosarcoma; metastasis.