Primary Cardiac Osteosarcoma

Wang, Jigang; Liu, Bing; Gao, Han; Li, Yujun; Zhao, Peng; Liu, Xiuping

doi:10.1016/j.hlc.2016.01.006

Cited by 19 publications

(34 citation statements)

References 62 publications

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“…Because of its invasion, size, site, and attachment, complete resection is impossible for most cases. 14) Although receiving resection, patients cannot look forward to long-term survival, and the necessity for surgery becomes questionable, if a pre-operative diagnosis can be firmly established.…”

Section: Resultsmentioning

confidence: 99%

Primary Left Atrial Osteosarcoma

2017

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SummaryPrimary cardiac osteosarcomas are rare entities, mostly arising from the left atrium. Because of their rarity, few reports have described this uncommon lesion. We herein report a case of primary cardiac osteosarcoma originating from the left atrium in a 34-year-old woman, who underwent tumor debulking surgery and died 3 months after being diagnosed.(Int Heart J 2017; 58: 1024-1027) Key words: Left atrium, Cardiac tumor P rimary cardiac tumors are extremely rare with a prevalence ranging from 0.001% to 0.030% in autopsy series.1) The majority of cardiac tumors are metastatic, accounting for 20-40 times more cases than primary tumors.2) Only approximately 25% of primary cardiac tumors are malignant, and less than 10% of primary cardiac malignant tumors are osteosarcoma.3,4) Primary cardiac osteosarcomas, as one subtype of sarcomas, are much rarer than other primary sarcomas, such as angiosarcoma, leiomyosarcoma, and undifferentiated sarcoma. 5)As far as it is known, there have been fewer than 40 cases reported over the last 40 years from the first case described by McConnel et al. in 1970. 6,7) Case ReportA 34-year-old woman was admitted to our department presenting with a 3-month history of progressive dyspnea and frequent expectoration. At the onset of dyspnea and expectoration episodes, she visited a regional hospital but simply received symptomatic treatment. Nevertheless, her symptoms were not alleviated. On admission, a transthoracic echocardiogram revealed a well-defined mass (57 × 32 × 28 mm) with a broad base attached to the lateral wall of the left atrium and very close to the left atrial appendage ( Figure 1A-C). Transesophageal echocardiogram detected the mass, the tip of which prolapsed into the left ventricle at the mitral valve level, causing a mild functional mitral valve stenosis ( Figure 1D). Threedimensional echocardiogram reconstructed the spatial geometric shape of the mass. It was uneven and nonlobulated, suspended from the free wall of the left atrium ( Figure 1E, F). Without further assessment of morphology, in combination with our prior experience, we diagnosed this mass as a cardiac myxoma, which in hindsight was a rushed conclusion, and therefore a surgical resection was scheduled.After induction of anesthesia, median sternotomy, cardiopulmonary bypass, and aortic and bicaval cannulation, as a set of routine procedures, were performed. Intraoperatively, the findings were beyond our expectations. The mass was not shaped like a cardiac myxoma but looked more like "fish-flesh" matter. The patient underwent a tumor debulking surgery other than complete resection due to the finding that the tumor had invaded into the ventricle, which made complete resection impossible.The tumor was detached into pieces with sharp and blunt dissection and removed from the atrium. These pieces had a smooth and irregular surface, an elastic and firm consistency, and a tannish-yellow color. Scattered hemorrhagic foci were seen in the cut sections (Supplemental Figure A).Histopathology with hematoxylin-e...

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Section: Resultsmentioning

confidence: 99%

Primary Left Atrial Osteosarcoma

2017

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“…Primary cardiac osteosarcomas and chondrosarcoma are rare malignant entities (Table 1) that mostly occur in young/middle-aged individuals (20-60-year-old) [37]. The literature provides poor data about these two pathological, infiltrative, and aggressive entities, except for some case reports [37][38][39][40]. The left atrium is the preferred site of origin, thus explaining the symptoms generated by this neoplasm [19,28].…”

Section: Osteosarcoma and Chondrosarcomamentioning

confidence: 99%

“…Osteoblastic, chondroblastic, or fibroblastic types of cells are detectable at the histological analysis of the specimens. The cancer is composed of spindle cells with areas of osteoid, sometimes with undifferentiated elements or giant cells [19,37,38].…”

Section: Osteosarcoma and Chondrosarcomamentioning

confidence: 99%

Primary Soft Tissue Sarcoma of the Heart: An Emerging Chapter in Cardio-Oncology

Scicchitano¹,

Sergi

Cameli

et al. 2021

Biomedicines

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Primary malignant cardiac tumors are rare, with a prevalence of about 0.01% among all cancer histotypes. At least 60% of them are primary soft tissue sarcomas of the heart (pSTS-h) that represent almost 1% of all STSs. The cardiac site of origin is the best way to classify pSTS-h as it is directly linked to the surgical approach for cancer removal. Indeed, histological differentiation should integrate the classification to provide insights into prognosis and survival expectancy of the patients. The prognosis of pSTS-h is severe and mostly influenced by the primary localization of the tumor, the difficulty in achieving complete surgical and pharmacological eradication, and the aggressive biological features of malignant cells. This review aims to provide a detailed literature overview of the most relevant issues on primary soft tissue sarcoma of the heart and highlight potential diagnostic and therapeutic future perspectives.

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“…Benign cardiac tumors such as myxomas are usually treated with surgical excision followed by clinical surveillance with imaging studies. Cardiac sarcomas have a poor prognosis as reported in many case studies, with a median survival of 6-25 months [10][11][12]. Radiotherapy is avoided in left and right heart tumors given the risk of myocardial toxicity, however, it can be used in the treatment of pulmonary artery sarcoma [11].…”

Section: Table 1: Primary Cardiac Malignant Tumor Characteristicsmentioning

confidence: 99%

The Rarest of the Rare: A Case of Primary Cardiac Osteosarcoma With a Review of the Literature

Mhadgut¹,

Manthri²,

Youssef³

et al. 2021

Cureus

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A 54-year-old female presented with shortness of breath and cyanosis. Work up with chest X-ray and subsequent echocardiogram revealed an intracardiac bi-atrial mass leading to emergent cardiothoracic resection. Pathology was consistent with a primary cardiac high-grade osteosarcoma. Post-resection staging positron emission tomography-computed tomography (PET-CT) showed hypermetabolic mixed lytic and sclerotic lesion of T10 concerning for metastasis. She received five cycles of adriamycin and ifosfamide chemotherapy before discontinuation due to systolic dysfunction. Nine months later, she developed a high tumor burden with progressive disease and was treated with second-line gemcitabine/docetaxel with disappointing results. She is currently on treatment with cyclophosphamide and topotecan as third-line treatment with an excellent clinico-radiographic response. Osteosarcomas are aggressive with a high incidence of recurrence and metastasis. Fewer than 50 cases of primary cardiac osteosarcomas have been reported in the literature. Even though complete resection can be achieved in some cases, long-term results are usually poor. No standard therapy has been established.

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Primary Cardiac Osteosarcoma

Cited by 19 publications

References 62 publications

Primary Left Atrial Osteosarcoma

Primary Left Atrial Osteosarcoma

Primary Soft Tissue Sarcoma of the Heart: An Emerging Chapter in Cardio-Oncology

The Rarest of the Rare: A Case of Primary Cardiac Osteosarcoma With a Review of the Literature

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