RESUMO
Abstract We are going to present a case of malignant fibrous histiocytoma in the right atrium, which is a very rare entity. The patient had a right atrial mass, which prolapsed through the tricuspid valve into the right ventricle, causing functional tricuspid valve stenosis. The tumor was completely resected and the patient had an uneventful postoperative period. Histopathological examination reported malignant fibrous histiocytoma. The patient presented to the emergency department five weeks after discharge with dyspnea and palpitation. Echocardiography and magnetic resonance imaging revealed recurrent right atrial tumor mass. His clinical status has worsened, with syncope and acute renal failure. On the repeated echocardiography, suspected tumor recurrence was observed in left atrium, which probably caused systemic embolization. Considering the aggressive nature of the tumor and systemic involvement, our Heart Council decided to provide palliative treatment by nonsurgical management. His status deteriorated for the next few days and the patient succumbed to a cardiac arrest on the 4th day.
Assuntos
Humanos , Masculino , Histiocitoma Fibroso Maligno/patologia , Neoplasias Cardíacas/patologia , Imageamento por Ressonância Magnética , Ecocardiografia , Tomografia Computadorizada por Raios X , Prolapso da Valva Tricúspide/patologia , Prolapso da Valva Tricúspide/diagnóstico por imagem , Angiografia Coronária , Evolução Fatal , Doenças Raras , Histiocitoma Fibroso Maligno/diagnóstico por imagem , Átrios do Coração/patologia , Átrios do Coração/diagnóstico por imagem , Neoplasias Cardíacas/diagnóstico por imagem , Recidiva Local de NeoplasiaAssuntos
Humanos , Feminino , Pessoa de Meia-Idade , Sarcoma/diagnóstico por imagem , Neoplasias dos Seios Paranasais/diagnóstico por imagem , Histiocitoma Fibroso Maligno/diagnóstico por imagem , Seio Etmoidal/diagnóstico por imagem , Sarcoma/cirurgia , Sarcoma/patologia , Neoplasias dos Seios Paranasais/cirurgia , Neoplasias dos Seios Paranasais/patologia , Imageamento por Ressonância Magnética , Tomografia Computadorizada por Raios X , Diagnóstico Diferencial , Histiocitoma Fibroso Maligno/cirurgia , Histiocitoma Fibroso Maligno/patologia , Seio Etmoidal/cirurgia , Seio Etmoidal/patologiaRESUMO
Summary Malignant fibrous histiocytoma is a rare tumor. It is most commonly seen in individuals between the fifth and seventh decades of life, in extremities, and less frequently in the retroperitoneum. Although its etiology is not clearly known, radiotherapy, chemical agents, previous history of surgery, trauma and fracture, and Hodgkin lymphoma have been blamed. Leiomyosarcoma, liposarcoma and rhabdomyosarcoma should be taken into account in differential diagnosis. It is seen on computed tomography as a mass lesion with irregular borders and density similar to that of the surrounding muscle tissue. Necrotic and hemorrhagic components in the mass are characterized as heterogeneous low density areas. Fluid-fluid levels can be detected by computed tomography and magnetic resonance imaging.