Key result
Urgent palliative surgery for primary cardiac sarcoma causing obstructive shock provides ~3 months of survival.
Case Report (n=1)
This case highlights the critical role of multimodality imaging in identifying the mechanism of obstructive shock and guiding urgent therapeutic decision-making in rare primary cardiac sarcomas.
Dismal 3-month survival despite urgent palliation in obstructive cardiac UPS; leaves open optimal imaging and therapeutic strategies for this rare entity.
BACKGROUND: Primary cardiac undifferentiated pleomorphic sarcoma is a rare and highly aggressive malignancy. Obstructive shock is an uncommon presentation requiring prompt diagnosis and management. CASE SUMMARY: A 39-year-old woman presented with progressive heart failure that evolved to obstructive shock. Multimodality imaging identified multiple left-sided intracardiac masses involving the left atrium and left ventricle, causing intracardiac obstruction without extracardiac disease. Given refractory hemodynamic compromise, the heart team recommended urgent palliative cytoreductive surgery. Histopathology established the diagnosis of primary cardiac undifferentiated pleomorphic sarcoma. The patient declined adjuvant oncologic therapy and died 3 months after diagnosis. DISCUSSION: This case highlights how multimodality imaging identified the mechanism of obstructive shock and guided urgent therapeutic decision-making. TAKE-HOME MESSAGES: Primary cardiac sarcomas may present with obstructive shock caused by multilevel intracardiac mechanical obstruction. Multimodality imaging clarifies the mechanism of hemodynamic compromise and guides urgent management.
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Davila-Flores et al. (2026) conducted a case report in Primary cardiac undifferentiated pleomorphic sarcoma (n=1). Urgent palliative cytoreductive surgery was evaluated. Urgent palliative cytoreductive surgery was performed for a 39-year-old woman with primary cardiac undifferentiated pleomorphic sarcoma causing obstructive shock, who died 3 months after diagnosis.
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