Cardiac sarcoma attached to pacemaker lead

J Card Surg. 2020 May;35(5):1148-1151. doi: 10.1111/jocs.14541. Epub 2020 Apr 15.

Abstract

Background and aim: Cardiac sarcoma is a rare condition and may mimic atrial myxoma. We present a case report of a man with a cardiac sarcoma.

Method: Case report presentation.

Results: A 68-year-old man with a permanent pacemaker presented to us with a 4-month history of breathlessness. Echocardiography revealed a large right atrial mass adherent to the pacemaker lead and a provisional diagnosis of atrial myxoma was made based on echocardiographic appearance. A 60 x 30 x 30 mm irregular lobulated tumour was surgically resected from the right atrium. Upon histopathologic examination, the tumour was consistent with an undifferentiated pleomorphic sarcoma.

Conclusion: Cardiac sarcomas have an extremely poor prognosis and more unfortunately this man developed a surgical site infection and died of acute mediastinitis. We discuss the presentation, imaging and current surgical approaches to cardiac sarcoma. Curative treatment is currently limited for this disease.

Keywords: cardiac mass; cardiac sarcoma; cardiovascular pathology; pacemaker.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Cardiac Surgical Procedures / methods*
  • Cardiopulmonary Bypass
  • Diagnosis, Differential
  • Echocardiography
  • Echocardiography, Three-Dimensional
  • Fatal Outcome
  • Heart Atria / surgery
  • Heart Neoplasms / diagnostic imaging
  • Heart Neoplasms / pathology
  • Heart Neoplasms / surgery*
  • Humans
  • Male
  • Mediastinitis
  • Pacemaker, Artificial / adverse effects*
  • Postoperative Complications
  • Sarcoma / diagnostic imaging
  • Sarcoma / pathology
  • Sarcoma / surgery*
  • Surgical Wound Infection