Unveiling the Unknown: A Case Report of Undifferentiated Pleomorphic Sarcoma in the Heart

Figures

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  Figure 1.. Preoperative transthoracic echocardiogram. Echo images showing a definite medium-size (2.7 cm × 2.7 cm), broad based, spherical, mobile tumor in the atrial cavity (red arrow), attached to the inter-atrial septum very near to the base of the anterior mitral leaflet.

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  Figure 2.. MRI images T1,T2-weighted sequences. Showing dilated left atrium with an oblong to broad-based lobulated lesion (red arrow) within the left atrial cavity with mild lobulation and attached to the interatrial septum near the base and abutting the mitral valve leaflet orifice, it measures around 4.6 cm × 2 cm in its maximum dimension. The mass has isointense signal intensity on the T1-weighted sequences, iso to mildly hyperintense on the T2-weighted sequence, the perfusion images shows no vascularity.

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  Figure 3.. Fused PET/CT images of the thorax and whole body. Fused axial (left) and coronal (right) PET/CT images demonstrating a hypermetabolic left atrial mass with high FDG uptake. No evidence of distant metastases was observed on whole-body screening.

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  Figure 4.. Coronary angiogram demonstrating tumor vascular supply. Selective coronary angiogram revealing a branch from the circumflex artery supplying the hypervascular mass located in the posterior left atrium (red arrow).

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  Figure 5.. Gross tumor specimen following surgical resection. Figure shows gross surgical specimen of the undifferentiated pleomorphic sarcoma (UPS) involving the left atrium, demonstrating a large, lobulated, tan-pink mass with heterogeneous consistency and multiple nodular extensions. The tumor was resected en bloc in several fragments, the largest of which displays a glistening, myxoid surface. This appearance mimicked benign myxoma macroscopically, which is a common diagnostic pitfall in cardiac UPS.