Why the study?
Primary cardiac undifferentiated pleomorphic sarcomas are rare with variable presentations, and multiorgan embolism carries significant morbidity and mortality without early recognition and timely intervention.
Highlights the severe risk of multiorgan embolism and catastrophic hemorrhagic stroke associated with therapeutic anticoagulation in patients with primary cardiac undifferentiated pleomorphic sarcoma.
Primary cardiac undifferentiated pleomorphic sarcomas (UPS) are very rare entities with a myriad of potential presentations. Multiorgan embolism can result in significant morbidity and mortality in the absence of early recognition and timely intervention. This case report describes a patient who received treatment for the abovementioned pathology and a literature review of available evidence on primary cardiac neoplasms was performed. This case is a 62-year-old female with cardioembolic stroke due to a left atrial mass. On hospital day 10 prior to operative intervention, the patient developed renovisceral and bilateral common iliac artery thromboemboli leading to acute limb ischemia and underwent bilateral femoral cutdown with aortoiliac thromboembolectomy. There was no mesenteric ischemia. Histopathological assessment of the emboli revealed primary cardiac undifferentiated pleomorphic sarcoma. She developed a catastrophic hemorrhagic stroke while on therapeutic anticoagulation which led to withdrawal of care. The literature review and case report demonstrate the need for timely intervention, judicial use of anticoagulation and histological assessment of emboli in cases of cardioembolic phenomena from an underlying cardiac neoplasm.
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Soon et al. (2022) studied this question.
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