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Myxofibrosarcoma is one of the most rare tumors of the heart. Surgical resection is the principal method of treatment; however, in some cases, radical removal of the tumor is not possible. Here, we present a case of heart transplant in a patient who experienced recurrent myxofibrosarcoma of the left atrium and examine the morphological features of this tumor. A 40-year-old female patient presented for treatment for heart failure of a high functional class. An examination revealed a tumor in the left atrial cavity, which was subsequently surgically removed. Morphological examination revealed an inflammatory myofibroblastic tumor. After 2 years, the patient's tumor recurred. The tumor was removed, and a morphological study again diagnosed myxofibrosarcoma of the heart. A year later, recurrence was again diagnosed. Instrumental examination determined that the tumor had incurred into the mitral valve and possibly spread to the myocardium. Tumor resection was not possible, and the need to perform a heart transplant was determined. The given case contributes to the practical conclusion that heart transplant contributes to an increase in the life expectancy for patients with inoperable cases of cardiac sarcoma.

Myxofibrosarcoma is a rare type of highly malignant sarcoma which easily occur lung metastasis. We report a rare metastatic myxofibrosarcoma which generated from the upper and middle lobe of the lung, invading the right superior pulmonary vein, extending to the left atrium. A single imaging examination may lead to misdiagnosis, so the combination of computed tomography imaging, magnetic resonance imaging, as well as positron emission tomographic scan are necessary for perioperative diagnosis and surgical planning., (© 2018 Wiley Periodicals, Inc.)

Primary cardiac myxofibrosarcoma (MFS) is a very rare cardiac tumor with no more than 22 cases reported in the literature, including our case. We report an MFS arising in the left atrium in a 65-year-old woman who presented with pneumonia and cardiac failure. The 9.5-cm mass was diagnosed by echocardiogram. Histopathology examination showed an intermediate-grade MFS with osseous metaplasia, a feature that has not been reported before., (Copyright © 2014 Elsevier Inc. All rights reserved.)

Primary cardiac sarcomas are extremely rare tumors. In this case report, we presented the condition of a 37-year-old male patient diagnosed with myxofibrosarcoma after histopathologic evaluation of the left atrium mass excision. FDG PET/CT was performed and showed recurrent hypermetabolic lesions in the left atrial wall and right anterior mediastinal region.

Primary cardiac tumors are rare with a reported prevalence of 0.01-0.02% based on pooled autopsy series. Although most mobile cardiac tumors arising from the interatrial septum and extending into the atria are thought to be benign myxomas, this may often not be true. Myxoid fibrosarcomas which in contrast to myxomas are malignant cardiac tumors often mimic the clinical and echocardiographic picture of atrial myxomas. We describe a rare entity of biatrial low-grade myxoid fibrosarcoma presenting in an adult patient as a butterfly shaped mass, with progressive shortness of breath and prolonged PR interval on the ECG that was pre-operatively thought to be a cardiac myxoma. The distinguishing echocardiographic features of the two entities are discussed., (Copyright © 2013. Published by Elsevier B.V.)

Aims and Background: Primary myxofibrosarcoma of the heart is a rare malignancy. To the best of our knowledge, no more than 17 cases have been reported since 1963., Methods and Study Design: We report the case of a 42-year-old man who presented with dyspnea and palpitation of one month's duration. Echocardiography and enhanced computed tomography revealed a large tumor in the left atrium., Results: The patient underwent palliative excision of the tumor and histopathological analysis revealed it to be a low-grade myxofibrosarcoma. The patient developed a bone metastasis two years later and is still alive 26 months after the cardiac surgery., Conclusions: Primary cardiac myxofibrosarcoma involves predominantly the left atrium and the most common symptom induced by the tumor is dyspnea. Disease outcome is often disappointing despite aggressive postoperative radiotherapy and chemotherapy.

Malignant primary cardiac tumors are exceptionally rare, and the most common of these are sarcomas. We present a case of a patient who was found to have a large mass in the left atrium causing obstruction of mitral inflow. Only selected views on a transthoracic echocardiogram reveal the mass and its hemodynamic effect. Although the mass was sizeable, it could be easily overlooked on cursory review of the echocardiogram. After surgical resection, the mass was proven to be a myxofibrosarcoma. We review the etiologies and possible solutions for the imperfect sensitivity of transthoracic echocardiography for cardiac masses.

An elderly female with refractory cardiovascular symptoms due to functional mitral stenosis secondary to a primary left atrial fibrosarcoma is described. The symptoms are often nonspecific and most of the patients present first time with hemodynamic compromise. A high index of suspicion is essential for the early diagnosis of these highly malignant cardiac tumors because of their rarity, a wide spectrum of nonspecific symptoms and poor survival.

Primary cardiac malignancies are rare tumors that are difficult to diagnose clinically. Different primary cardiac malignancies may have different clinical, morphologic, and radiologic features and intracardiac locations. Angiosarcoma is the most common primary cardiac malignancy. It tends to occur in the right atrium and involve the pericardium. Because of its tendency to hemorrhage, angiosarcoma often demonstrates areas of increased signal intensity with T1-weighted sequences. Undifferentiated sarcomas typically occur in the left atrium and have variable epidemiologic and radiologic features. Rhabdomyosarcoma is the most common primary cardiac malignancy in children and is more likely than other primary cardiac sarcomas to involve the valves. Primary cardiac osteogenic sarcoma almost always occurs in the left atrium and frequently demonstrates calcification. Certain features (eg, broad base of attachment, origin at a site other than the atrial septum) help differentiate this tumor from left atrial myxoma. Leiomyosarcoma favors the left atrium and tends to invade the pulmonary veins and mitral valve. Fibrosarcoma also tends to occur in the left atrium and is often necrotic. Liposarcoma is very rare and usually manifests as a large, infiltrating mass. Foci of macroscopic fat are occasionally seen. Primary cardiac lymphoma occurs more commonly in immunocompromised patients, frequently involves the pericardium, and, unlike other primary cardiac malignancies, may respond to chemotherapy. The advent of cross-sectional imaging has allowed earlier detection of primary cardiac malignancies as well as more accurate diagnosis and characterization.

This is a case report of a six-year-old female White Alpine sheep with a cardiac fibrosarcoma in the right atrium. Clinically, the sheep had right-sided cardiac insufficiency with tachycardia, engorgement of the jugular veins, brisket edema, and ascites. Chronic congestion of the liver resulted in increased hepatic enzyme activity. Based on clinical findings, a tentative diagnosis of endocarditis or pericarditis was made. Radiography of the thorax revealed hydrothorax. An echogenic mass was observed in the right atrium via echocardiography; it was interpreted as a tumor or thrombus. Ultrasonography of the abdomen revealed severe ascites and chronic congestion of the liver attributable to right-sided cardiac insufficiency. The clinical and sonographic findings were verified at post mortem. The mass in the right atrium was a pedunculated fibrosarcoma.

A 31-year-old woman presented with general malaise, back pain, and edema of the lower extremities. A chest X-ray film showed an enlarged cardiac shadow and clear lung fields. A pericardial lesion with decreased activity on blood pool imaging and increased uptake on gallium citrate imaging displaced the heart upwards and to the left. The pericardial mass showed an inhomogeneous signal intensity on MRI and was large enough to obstruct the venous return by compressing the heart. At operation, the mass was found to originate from the pericardium and was histologically identified as a malignant fibrosarcoma. Twelve years previously, the patient had undergone an operation for the removal of a pericardial tumor which was histologically identified as a benign hemangioma. In view of the rarity of pericardial tumors, the present tumor is suspected to have undergone a transformation from benign hemangioma to malignant fibrosarcoma.

Four patients with cardiac tumours were investigated by gated cardiac blood pool radionuclide imaging and echocardiography. Contrast angiocardiography was performed in three of the cases. Two left atrial tumours were detected by all three techniques. In one of these cases echocardiography alone showed additional mitral valve stenosis, but isotope imaging indicated tumour size more accurately. A large septal mass was detected by all three methods. In this patient echocardiography showed evidence of left ventricular outflow obstruction, confirmed at cardiac catheterisation, but gated isotope imaging provided a more detailed assessment of the abnormal cardiac anatomy. In the fourth case gated isotope imaging detected a large right ventricular tumour which had not been identified by echocardiography. Gated cardiac blood pool isotope imaging is a complementary technique to echocardiography for the non-invasive detection and assessment of cardiac tumours.

Cardiac imaging by means of CT requires administration of intravenous contrast medium which can be applied by infusion or by rapid bolus injection. Contrast infusion is easier in performance and yields opacification of all cardiac cavities. Using bolus technique selective enhancement of cardiac chambers can be obtained which provides increased image quality and better resolution of cardiac structures. Both techniques are described and the results of 221 examinations are analysed with special respect to image quality, technical amount and contrast media side effects.

Right atrial hypertension and pericardial effusion developed 2 years after mastectomy for fibrosarcoma. Clinical and echocardiographic features suggested right ventricular tumour. At catheterization the right ventricular cavity was almost obliterated, with an infundibular gradient of 13 mmHg, and biopsy of the mass was attempted. Post-mortem revealed extensive infiltrating and intracavitary right ventricular fibrosarcoma without extracardiac tumour.

A case of malignant fibrosarcoma originated from pericardium was reported. A 31 year-old female who complained of general fatigue and back pain showed dilated cardiac shadow in chest X-ray. Cardiac blood pool scan with 99mTc-RBC revealed avascular mass in pericardial cavity which push the heart up and left side. It was suspected to be malignant, since the mass had increased 67Ga uptake. CT and MRI also demonstrated that the tissue characterization of the pericardial mass was irregular, and the mass compressed venous return. The large mass originated from pericardium caused the right sided cardiac failure. In 12 years ago, she had a history of operation which resected benign hemangioma in the same space (pericardium). We could suspect the malignant transformation between the two rare pericardial tumors; benign hemangioma and malignant fibrosarcoma.