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Rare Case of Grade 3 Undifferentiated Pleomorphic Sarcoma in Left Atrium, Mitral Valve, and Papillary Muscle

Title: Rare Case of Grade 3 Undifferentiated Pleomorphic Sarcoma in Left Atrium, Mitral Valve, and Papillary Muscle
Authors: Silvia Preda; Kishore K. Gangangari; Robert Tiganasu; Andreea Liciu; Claudia Nica; Alexandra Voicu; Vlad Ichim; Horatiu Moldovan
Source: Journal of Clinical Medicine ; Volume 14 ; Issue 9 ; Pages: 3053
Publisher Information: Multidisciplinary Digital Publishing Institute
Publication Year: 2025
Collection: MDPI Open Access Publishing
Subject Terms: intracardiac tumor; undifferentiated pleomorphic sarcoma; rapid deep cooling; cerebral embolism
Description: Background: Primary intracardiac tumors may be diagnosed incidentally, sometimes in the case of complications. Case Report: This case report presents a 64-year-old woman who was admitted to the emergency department with cardiac complications, including heart palpitations and shortness of breath. Initial investigations revealed the presence of ground glass opacity in the left lung and significant mediastinal adenopathy. Transthoracic echocardiography (TTE) indicated severe mitral stenosis caused by a mass attached to the mitral valve, and the transesophageal echocardiography (TEE) confirmed the presence of a tumor, raising concerns about a myxoma with a high risk of embolism. The patient experienced transitory neurological dysfunction, and subsequent imaging uncovered a thrombus occluding the left internal carotid artery. An emergency surgical procedure was performed, including extracorporeal circulation and rapid deep cooling, to facilitate safe mass excision and carotid embolectomy. Histopathological analysis of the extracted tissue revealed undifferentiated pleomorphic sarcoma (FNCLCC Grade 3). Following the surgery, the patient needed extended mechanical ventilation and subsequently underwent a tracheostomy because of her ongoing respiratory support requirements. Conclusions: Despite the complexity of the surgical intervention, the prognosis remained poor due to the aggressive nature of the tumor and neurologic complications. This case underscores the rarity of primary cardiac sarcomas, the challenges in diagnosis, and the need for prompt surgical intervention to mitigate risks associated with embolic events.
Document Type: text
File Description: application/pdf
Language: English
Relation: Cardiovascular Medicine; https://dx.doi.org/10.3390/jcm14093053
DOI: 10.3390/jcm14093053
Availability: https://doi.org/10.3390/jcm14093053
Rights: https://creativecommons.org/licenses/by/4.0/
Accession Number: edsbas.6EB78449
Database: BASE