MRI combined with percutaneous pericardial biopsy is a useful approach for the difficult premortem diagnosis of primary cardiac leiomyosarcoma.
May facilitate premortem diagnosis of rare cardiac leiomyosarcoma; leaves open survival impact pending larger prospective validation.
A 53-year-old male was hospitalized with complaints of cough, fever and backache. Two-dimensional echo-cardiography showed a pericardial echo-free space and a mass in the right atrium. Based on the MRI findings showing a pericardial mass originating from the atrial tumor, the final diagnosis of leiomyosarcoma was made by a percutaneous pericardial biopsy. Despite various therapies, the patient died after 3 wk. Because of its rareness (to date only 25 case reports), a premortem diagnosis of primary cardiac leiomyosarcoma is generally difficult. However, we feel that MRI and a subsequent biopsy is quite useful for making an early diagnosis of this disease.
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Takamizawa et al. (1992) studied this question.
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