A case report of primary cardiac myxofibrosarcoma presenting with severe congestive heart failure
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CASE REPORT
Open Access
A case report of primary cardiac myxofibrosarcoma presenting with severe congestive heart failure Kosuke Ujihira1* , Akira Yamada1, Naritomo Nishioka1, Yutaka Iba1, Ryushi Maruyama1, Katsuhiko Nakanishi1, Ai Shimizu2, Kanako C. Hatanaka2, Tomoko Mitsuhashi2, Toshiya Shinohara3 and Hatsue Ishibashi Ueda4
Abstract Background: Primary cardiac sarcomas are extremely rare. Furthermore, the myxofibrosarcomas are one of the rarest forms of cardiac sarcomas, and its prognosis is known to be quite poor. Case presentation: This is a case of a 23-year-old man who presented with acute severe congestive heart failure caused by almost complete obstruction of the mitral valve due to a large left atrial tumor. The patient required endotracheal intubation before his arrival to the hospital, and underwent an emergent surgical excision of the tumor. The tumor had a complex shape and originated from the orifice of the right upper pulmonary vein. Because the tumor seemed to extend over most of the surface of the left atrium, it seemed impossible to reconstruct the left atrium had we done a complete transmural resection. Instead, we carefully peeled the tumor leaving the outer layer of the left atrial wall. We applied cryoablation to the attached site, in order to prevent a recurrence of the tumor. The pathology report revealed that the tumor was a myxofibrosarcoma, and it seemed to originate from the heart. The patient received radiation therapy after the surgery and continues to be alive and well after 1-year, without apparent recurrence. Conclusions: Cardiac myxofibrosarcoma can cause acute, severe left-sided heart failure. Non-transmural atrial wall resection with cryoablation might be effective for patients with cardiac myxofibrosarcomas with extensive atrial attachment. Keywords: Cardiac tumor, Myxofibrosarcoma, Heart failure, Cryoablation
Background The majority of cardiac tumors are benign, and approximately half of them are myxomas [1]. Primary cardiac sarcomas are rare malignant primary tumors of the heart, accounting for about 20 % of all primary cardiac tumors [2]. Myxofibrosarcomas are reported as one of the rarest forms of cardiac sarcomas [1]. The clinical presentation depends on the site of the tumor and it varies from symptoms of congestive heart failure to thromboembolism and arrhythmias [3–6]. In this report, we present a 23-year-old man who presented with symptoms and signs of acute severe left-sided heart failure, requiring an emergent * Correspondence: [email protected] 1 Department of Cardiovascular Surgery, Teine Keijinkai Hospital, 1-12 Maeda Teine-ku, Sapporo 006-0811, Japan Full list of author information is available at the end of the article
endotracheal intubation followed by cardiac surgery, caused by a primary cardiac myxofibrosarcoma in the left atrium.
Case presentation A 23-year-old man called for an ambulance due to a sudden onset of severe dyspnea. He had 1-year history of general malaise without a major change in his weight or other health problems. At ag
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