Key result
Surgical excision of a 2 x 2 cm right atrial low-grade fibrosarcoma and permanent pacemaker implantation resulted in stable hospital discharge on postoperative day 4 in a 19-year-old man.
Why the study?
Primary cardiac tumors are rare, may cause nonspecific symptoms and cardiac conduction disturbances, and preoperative imaging may not reliably distinguish benign from malignant cardiac masses.
Case Report (n=1)
No
This case highlights that a primary malignant right atrial fibrosarcoma can mimic a benign myxoma on preoperative imaging and present with intermittent complete atrioventricular block in a young adult, underscoring the necessity of histopathological confirmation and rhythm management.
Answers are grounded in this paper and cite their sources.
Requires histopathology to distinguish malignant right atrial masses in young adults; leaves open standardized long-term management of low-grade cardiac fibrosarcoma.
Primary cardiac tumors are rare and may be associated with nonspecific symptoms and cardiac conduction disturbances. Preoperative imaging may not reliably distinguish benign from malignant cardiac masses. A 19-year-old man presented with progressive dyspnea, fatigue, and diaphoresis. Electrocardiographic assessment identified first-degree atrioventricular (AV) block with intermittent complete AV block. Transthoracic echocardiography revealed a 2 × 2 cm right atrial mass with a left ventricular ejection fraction of 65%, and cardiac computed tomography raised suspicion of myxoma. While awaiting surgery, the patient received dopamine at 15 μg/kg/min and oxygen at 3 L/min by nasal cannula. He underwent tumor excision with cardiopulmonary bypass and permanent pacemaker implantation. Intraoperative ventricular fibrillation caused cardiac arrest, for which defibrillation and adrenaline were administered. Histopathology was reported as low-grade fibrosarcoma. After three days of intensive care, he was discharged in stable condition on postoperative day four. A right atrial tumor clinically suspected to be myxoma was associated with advanced intermittent AV conduction disease and was subsequently reported as low-grade fibrosarcoma. This case emphasizes cardiac imaging, rhythm surveillance, histopathological assessment, and careful interpretation of perioperative outcomes.
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Putra et al. (2026) conducted a case report in Right atrial low-grade fibrosarcoma mimicking myxoma with intermittent complete atrioventricular block (n=1). Surgical tumor excision with cardiopulmonary bypass and permanent pacemaker implantation was evaluated on Histopathological diagnosis and postoperative clinical recovery. Surgical excision of a 2 x 2 cm right atrial low-grade fibrosarcoma and permanent pacemaker implantation resulted in stable hospital discharge on postoperative day 4 in a 19-year-old man.
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