Primary Soft Tissue Sarcoma of the Heart: An Emerging Chapter in Cardio-Oncology

Figures

• 

  Figure 1. Classification of the primary soft tissue sarcoma of the heart. The figure gathers the combination of the surgical and histologic approach to the classification of these neoplasms. Cardiac sarcomas are differentiated according to the site of origin into cardiac chambers and great arteries/veins; then, sarcomas are identified in agreement with their own histologic nature.

• 

  Figure 2. Cardiac magnetic resonance imaging of a cardiac sarcoma of the left atrium (arrow). The images revealed the presence of a cardiac sarcoma of the left atrium, which encroached upon the cardiac chamber with its sessile branch (dimensions: 4 × 4 cm). The origin of the mass rose up from the posterior wall of the atrium and extended into the left pulmonary veins, with no detectable cleavage planes to aortic and esophageal walls. The lesion demonstrated late and not homogeneous enhancement. LA: left atrium; LV: left ventricle; RA: right atrium; RV: right ventricle.

• 

  Figure 3. Three-dimensional transthoracic echocardiography in apical three-chamber view (A) and parasternal short-axis view (B) showing intracardiac sarcoma attached to left ventricular apex. The arrows (red and yellow) indicate the cancer mass. AoV: aortic valve; LV: left ventricle; MV: mitral valve; RV: right ventricle.

• 

  Figure 4. Three-dimensional transoesophageal echocardiography in long-axis view (A) and en-face view (B) showing intracardiac sarcoma involving the atrial side of the posterior leaflet (P1 and P2 scallops) of the mitral valve. The arrows (red) indicate the cancer mass.AO: aorta; AoV: aortic valve; LA: left atrium; LV: left ventricle; LVOT: left ventricular outflow tract; MV: mitral valve.