Case reportPrimary cardiac leiomyosarcoma: imaging with 2-D echocardiography, electron beam CT and 1.5-Tesla MR
Introduction
Primary cardiac sarcomas are extremely rare [1]. There are only a few case reports concerning the sonography, computed tomography (CT) and magnetic resonance imaging (MRI) appearance of cardiac leiomyosarcoma 2, 3, 4, 5. In a review of the literature reported by Nguyen et al., only 27 cases (including his own patient) of primary leiomyosarcoma of the heart had been reported [2]. Leiomyosarcoma is a highly aggressive and local invasive tumor with mean survival of 6 months from the time of diagnosis, if the patient was not treated [3]. We present a case of pathologically proved left atrium leiomyosarcoma who received 2-dimensional (2-D) echocardiography, electron beam CT (EBCT) scan and cardiac MRI.
Section snippets
Case report
A 28-year-old lady was admitted in September, 1995 via the emergency room with the chief complaint of intermittent fever for about 2 months. She also had body weight loss, poor appetite and anemia. The patient had no past history of hypertension, tuberculosis, hepatitis or previous surgery. There was no exertional dyspnea, no night sweating, no cough and no chest tightness.
Physical examination on admission revealed anemic conjunctiva and clubbing fingers on both hands. A grade II diastolic
Discussion
Malignant primary cardiac tumors are extremely rare, approximately 16–40 times less common than secondary cardiac tumors. Most of the primary cardiac malignancies are sarcomas and the leiomyosarcomas are among the rarest ones 1, 2, 3, 6, 7. The estimated incidence of primary cardiac leiomyosarcoma is less than 0.25% of all cardiac tumors and 1% of all primary cardiac malignant lesions 3, 6. Many cardiac sarcomas arise from the right atrium 1, 5, 7, 8. According to Nguyen et al., 27 cases of
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2011, Current Problems in Diagnostic RadiologyCitation Excerpt :Rarely, leiomyosarcoma can arise from the inferior vena cava and produce symptoms suggestive of right heart failure. CMRI findings are relatively nonspecific, with intermediate signal onT1-weighted and mildly increased signal intensity on T2-weighted black-blood images having been reported (Fig 2).19 These lesions originate within the left atrium in around 50% of cases, within either ventricle in 30% and from the pericardium in 20%.17
Cardiac Tumors
2008, Seminars in RoentgenologyCitation Excerpt :The imaging characteristics at MR imaging are nonspecific. Lesions of intermediate signal intensity on T1-weighted images and increased signal on T2-weighted images have been reported.17 Leiomyosarcoma is the most frequent histological type of intimal sarcoma of the pulmonary artery.18
MR Imaging of Cardiac Masses
2008, Magnetic Resonance Imaging Clinics of North AmericaCitation Excerpt :Limited MR imaging descriptions of leiomyosarcoma exist in the literature. Generally, these tumors appear as isointense on T1-weighted images and hyperintense on T2-weighted images77,78 and demonstrate enhancement after contrast administration.79 Cardiac fibrosarcomas are rare malignant tumors that are primarily fibroblastic in origin.
Primary cardiac leiomyosarcoma: An analysis of clinical characteristics and outcome patterns
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