Multimodality imaging of a recurrent case of right-sided cardiac leiomyosarcoma with an unusual clinical course

Abstract

Primary cardiac sarcoma is an uncommon entity and is related with poor long-term survival. Presented here is an unusual case of right atrial leiomyosarcoma which almost completely occluded both the right atrium and ventricle and destroyed the tricuspid valve. Multimodality imaging was used to characterize the mass and guide surgical management. A combination of two radical surgical excisions and both radiation and chemotherapy resulted in a better long-term outcome. The patient was one of the longest survivors.

Adjuvant chemoradiation for high‐grade cardiac leiomyosarcoma in a child: Case report and review of literature

“…11 A 40-year-old woman, treated with adjuvant chemoradiation after surgery for first recurrence (unknown dose), had disease-free survival of 42 months. 12 A 19-year-old man treated with surgery alone initially, and surgery with adjuvant radiotherapy to 60 Gy after recurrence, subsequently developed widespread metastases within 4 months of the radiation. 13 We report on a case where proton therapy allowed for safe treatment delivery with sparing of the uninvolved heart and adjacent organs at risk.…”

“…A 53‐year‐old woman, who received adjuvant radiation to 66 Gy following margin‐positive resection without recurrence after 9 years 11 . A 40‐year‐old woman, treated with adjuvant chemoradiation after surgery for first recurrence (unknown dose), had disease‐free survival of 42 months 12 . A 19‐year‐old man treated with surgery alone initially, and surgery with adjuvant radiotherapy to 60 Gy after recurrence, subsequently developed widespread metastases within 4 months of the radiation 13 .…”

Expansive intracardiac leiomyosarcoma - a combined therapeutic approach resulting in survival with complete remission. A literature review and case report

“…As follows from the mentioned above, the echocardiography should be interpreted not only by the detection of a mass, but also by its localization, mobility, consistency, base of the tumour, and hemodynamic consequences 16 . While echocardiography enables us to diagnose tumours as small as 3 mm, the CT and MRI are superior in the visualization of the complete extent of the tumour 17 . Both contrast CT and contrast MRI increase the accuracy of the malignant diagnosis, provide clear information about the anatomical relationship of the tumour and the surrounding tissues, or reveal possible pulmonary metastases.…”

Cardiac metastasis of great saphenous vein leiomyosarcoma

“…1 Traditionally, TTE has been the primary imaging modality to diagnose, differentiate, and delineate intracardiac masses. 2 Additional diagnostic imaging tools include CT and MRI that provide comprehensive data on tumor morphology, anatomic location, grade, and vascularization. [2][3][4] The mainstay of the treatment is a complete resection with adjuvant chemotherapy.…”

“…2 Additional diagnostic imaging tools include CT and MRI that provide comprehensive data on tumor morphology, anatomic location, grade, and vascularization. [2][3][4] The mainstay of the treatment is a complete resection with adjuvant chemotherapy. 5…”