Left Atrial Spindle Cell Sarcoma in a 34-Year-Old Woman

Figures

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  Figure 1. Electrocardiography reveals sinus tachycardia and a short PR interval with no evidence of preexcitation with prominent rightward forces.

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  Figure 2. Computed tomography of the chest: a large mass (A) (red arrow), near complete obliteration of the left atrium with impingement of the pulmonary veins (B) (white arrow).

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  Figure 3. Computed tomography of the abdomen: bilateral adrenal metastases (red arrows).

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  Figure 4. MRI of the lumbar spine: sagittal T1 precontrast on the left (white arrow), on the right (red arrow) postcontrast enhancement of L1, L4, and L5, consistent with metastatic disease.

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  Figure 5. Two-dimensional echocardiography: parasternal long-axis view and measurement of the left atrial mass (A) (red arrow) and still image of mitral regurgitation circumferential to mass by color Doppler (B).

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  Figure 6. Short-axis view and mass migrating across the annular plane (red arrow).

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  Figure 7. Transesophageal echocardiography: four-chamber view with mass mostly posterior and lateral (red arrow) with an area of nonmobile mass attached to the anterior leaflet (white arrow) (A) and color Doppler circumferential to the mass (B).

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  Figure 8. Adrenal biopsy: dense proliferation of atypical cells with myxomatous background.

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  Figure 9. Cardiac MRI: T2 hyperintense image of the mass (red arrow) with evidence of metastases (white arrow).