Primary undifferentiated pleomorphic sarcoma of the left atrium that presented as acute pulmonary edema

Unique presentation of a primary pleomorphic sarcoma of the left atrium

This report describes an extremely rare cause of a common presentation. A 59-year-old man who presented with symptoms of progressive cardiac failure, was demonstrated to have a large left intraatrial mass on computed tomography pulmonary angiography and an echocardiogram. He proceeded to urgent surgery under cardiopulmonary bypass. Histology of the resected mass diagnosed primary pleomorphic sarcoma of the left atrium. This exceedingly rare malignancy has a poor prognosis and often presents with nonspecific symptoms. Echocardiography remains vital in diagnosis, and treatment is primarily surgical excision, with some reports of adjuvant chemotherapy.

Primary cardiac pleomorphic sarcoma presenting as back pain in an 18-year-old man

Soft-tissue sarcoma is the most prevalent primary malignant cardiac tumor. This sarcoma usually presents with cardiac manifestations secondary to local obstruction or arrhythmias; very rarely does it present with initial symptoms of distant metastasis. We discuss the unusual case of an 18-year-old man who emergently presented with acute-on-chronic back pain. Imaging revealed a lesion on the 12th thoracic vertebra and a large mass arising from the left atrium. The cardiac mass was resected, and immunohistochemical analysis revealed it to be a pleomorphic sarcoma that had metastasized to the spine. The patient died 2 years later of diffuse metastases. In addition to the patient's case, we discuss the nature and treatment of cardiac sarcoma.