560 a Rare Case of Pericardial Sarcoma

Abstract

A 47 years old man, with no previous medical history, presented to the emergency department for dyspnea increased over the prior weeks. The echocardiographic evaluation revealed a severe pericardial effusion. Moreover, a round-shaped, indeterminate mass was detected into the pericardium, partially enhanced after injection SonoVue R contrast. After the pericardiocentesis, to exclude a severe dilatation of the coronary sinus, the patient underwent to a coronary angiography that showed a diffuse vascularization of the region of the mass. A CT-scan were then performed, and confirmed the presence of a well-defined mass placed near to the left atrial-ventricular junction into the pericardium. The magnetic resonance revealed a limited area of infiltration of the lesion into the myocardium. Finally the patient underwent surgical asportation, and the biopsy showed an high-grade sarcoma. Primary cardiac tumors are rare diseases and in the majority of the cases are of benign nature. Among malignant tumor of the heart sarcoma is the most common. Despite their rarity, malignant heart cancers are associated with high mortality and the prognosis is mostly influenced by the localization of the tumor, its biological aggressiveness, and the difficulty in obtaining surgical radicality. Cardiac sarcomas are most likely to arise from the right atrium followed by right ventricle and less often from the epicardium. In these cases, the asportation of the mass can be challenging, and the risk of myocardial narrowing can affect the area of resection. We reported a rare case of primary cardiac sarcoma mainly localized into the pericardium. Due to its position, the surgical asportation of the tumor was considered complete and our patient was discharge from the hospital without further complication and with a program of chemotherapy. At six months follow-up no recurrence of disease was observed.