What is the clinical evidence from this study?

Study design: Case Report. Population: Primary undifferentiated high-grade pleomorphic cardiac sarcoma (n=1). Intervention: Mitral valve replacement and surgical resection.

What does this research mean for the field?

Primary undifferentiated high-grade cardiac sarcoma can present atypically with systemic symptoms and carries a poor prognosis characterized by rapid postoperative recurrence. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To describe the diagnostic workup, multimodal imaging, and clinical trajectory of a primary undifferentiated high-grade pleomorphic cardiac sarcoma presenting with atypical systemic symptoms.

January 1, 2023BMJ Case ReportsOpen Access

Primary undifferentiated high-grade pleomorphic cardiac sarcoma in the left atrium with atypical presentation

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Key result

Mitral valve replacement and resection for left atrial sarcoma yields symptom recurrence at 2 months.

Key Points

To describe the diagnostic workup, multimodal imaging, and clinical trajectory of a primary undifferentiated high-grade pleomorphic cardiac sarcoma presenting with atypical systemic symptoms.
Evaluated a female patient in her 60s presenting with heart failure, constitutional symptoms, and clubbing using multimodal imaging, including transthoracic echocardiography, transesophageal echocardiography, CT, cardiac MRI, and PET.
Conducted surgical resection of the left atrial mass alongside mitral valve replacement, followed by histopathologic classification and multidisciplinary oncology referral.
Diagnostic imaging identified a 2×2.8 cm hypermetabolic, circular mass in the left atrium with vegetations on the mitral valve.
Histopathology confirmed a grade 3 primary undifferentiated pleomorphic cardiac sarcoma.
Symptom recurrence occurred two months postoperatively, demonstrating rapid disease progression despite complete initial surgical excision.

Study Design

Type

Case Report (n=1)

Structured PICO

Population

A woman in her 60s presenting with malaise, fatigue, dyspnoea, night sweats, and grade 3 clubbing diagnosed with grade 3 undifferentiated cardiac sarcoma.

Intervention

Multimodal imaging (transthoracic echocardiogram, transoesophageal echocardiogram, CT, PET, and cardiac MRI) followed by mitral valve replacement and surgical resection.

Outcome

Diagnosis and clinical course

This case highlights the atypical presentation, utility of multimodal imaging for diagnosis, and poor prognosis of primary undifferentiated high-grade pleomorphic cardiac sarcoma.

Authors

STSue Fen TanNottingham University Hospitals NHS Trust SASherif Osama Ahmed AbbasNottingham University Hospitals NHS Trust NMNithiananthan MayooranUniversity of Cambridge

Discussion

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Implication

Rapid recurrence after resection warrants close surveillance; leaves open optimal adjuvant strategies for rare high-grade cardiac sarcomas.

Cite This Study

Tan et al. (2023) conducted a case report in Primary undifferentiated high-grade pleomorphic cardiac sarcoma (n=1). Mitral valve replacement and surgical resection was evaluated. Mitral valve replacement and surgical resection of a left atrial mass confirmed grade 3 undifferentiated cardiac sarcoma, with symptom recurrence 2 months postoperatively.

synapsesocial.com/papers/6aa5069468dd06f3d4aa2911 https://doi.org/10.1136/bcr-2022-252198

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Implication

Rapid recurrence after resection warrants close surveillance; leaves open optimal adjuvant strategies for rare high-grade cardiac sarcomas.

Primary undifferentiated high-grade pleomorphic cardiac sarcoma in the left atrium with atypical presentation

Key Points

Study Design

Structured PICO

Discussion

Implication

Cite This Study

Primary undifferentiated high-grade pleomorphic cardiac sarcoma in the left atrium with atypical presentation

Key Points

Study Design

Structured PICO

Discussion

Implication

Cite This Study

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