Key result
A 15-year-old girl initially treated for a histiocytic cerebral sarcoma was found two years later to have a primary high-grade pleomorphic cardiac sarcoma from which the brain lesion likely metastasized.
Case Report (n=1)
This case highlights an extremely rare presentation of a primary cardiac sarcoma initially manifesting as a cerebral metastasis, emphasizing the utility of cardiac MRI and PET imaging when unusual primary tumors are suspected.
Supports considering cardiac imaging in atypical cerebral sarcomas; leaves open need for larger series on primary cardiac tumors.
To date, there have been less than a 100 confirmed case reports of primary cardiac malignant fibrous histiocytomas, a rare form of sarcoma. In this report, we discuss the case of a 15-year-old girl who initially presented with a histiocytic cerebral sarcoma that was treated with aggressive resection and chemotherapy. Three years later, the same patient developed increasing shortness of breath and was found to have a high-grade pleomorphic undifferentiated cardiac sarcoma that likely represents the primary tumour from which the cerebral lesion metastasised. This represents an extremely unique case; in 2010, a research group in Germany claimed the very first description of a true cardiac sarcoma with brain metastasis [1]. However, even as far back as 1960, there were three case reports [2] and more extensive sarcoma studies recently have revealed further cases [3]. Nevertheless, there have probably been less than 10 cases in the literature up until this point.
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Wilson et al. (2016) conducted a case report in High-grade pleomorphic cardiac sarcoma with cerebral metastasis (n=1). Surgical resection and chemotherapy was evaluated. A 15-year-old girl initially treated for a histiocytic cerebral sarcoma was found two years later to have a primary high-grade pleomorphic cardiac sarcoma from which the brain lesion likely metastasized.
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