From dyspnea to diagnosis, unmasking undifferentiated cardiac sarcoma: a case report.

Mauricio Guerra-Raygada, Alee Jonhson Saavedra-Sanchez, Diego Hidalgo-Avendaño, Milagros F Bermudez-Pelaez, David Guevara-Lazo, Natalia Nombera-Aznaran
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Abstract

Background: Sarcomas are the most common type of cardiac malignancy, but they are extremely rare. Within this group, angiosarcomas have the highest frequency, followed by undifferentiated sarcomas. This type of tumor has a poor prognosis and a high recurrence rate. Information about these tumors is limited, relying mainly on case reports and autopsy series. The purpose of this case report is to detail the multifaceted approach to diagnosing and managing an undifferentiated cardiac sarcoma and contribute to the literature.

Case presentation: A 28-year-old man presented with dyspnea and chest pain, which had developed progressively over several weeks. Physical examination revealed low blood pressure, elevated heart rate, and diminished heart sounds. Imaging, including a CT scan, identified a hypodense mass in the right ventricle. Further evaluation through echocardiograms and contrast angiotomography confirmed a mass causing right ventricular obstruction. Part of the tumor was surgically removed and diagnosed  as cardiac sarcoma.  Histopathological analysis of the mass showed an undifferentiated cardiac sarcoma.

Conclusion: This case underscores the significance of including cardiac tumors as a potential cause when diagnosing cardiac masses. It also demonstrates the poor prognosis and tendency for recurrence, while revealing the absence of established management guidelines.

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从呼吸困难到确诊,揭开未分化心脏肉瘤的面纱:病例报告。
背景:肉瘤是心脏恶性肿瘤中最常见的类型,但却极为罕见。其中,血管肉瘤的发病率最高,其次是未分化肉瘤。这类肿瘤预后差,复发率高。有关这类肿瘤的信息非常有限,主要依靠病例报告和尸检系列。本病例报告旨在详细介绍诊断和治疗未分化型心脏肉瘤的多方面方法,并为相关文献做出贡献:一名 28 岁男子因呼吸困难和胸痛前来就诊,症状在数周内逐渐加重。体格检查显示血压偏低、心率增快、心音减弱。包括 CT 扫描在内的影像学检查发现右心室有一个低密度肿块。通过超声心动图和造影剂血管造影进一步评估,证实肿块导致右心室梗阻。手术切除了部分肿瘤,诊断为心脏肉瘤。 肿块的组织病理分析显示为未分化的心脏肉瘤:本病例强调了在诊断心脏肿块时将心脏肿瘤作为潜在病因的重要性。结论:该病例强调了在诊断心脏肿块时将心脏肿瘤作为潜在病因的重要性,同时也表明了该病预后差、易复发的特点,同时也揭示了缺乏既定管理指南的问题。
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