A Pleomorphic Rhabdomyosarcoma in the Left Atrium / 日本心臓血管外科学会雑誌

ABSTRACT

A 47-year-old man was referred to our hospital with acute congestive heart failure. Echocardiography and computed tomography revealed a left atrial tumor obstructing blood flow. An emergency operation was performed to relieve the obstruction. The tumor deeply invaded the posterior wall of the left atrium. We did not completely resect the tumor. The patient was discharged 10 days after surgery without complications. The tumor was diagnosed as pleomorphic rhabdomyosarcoma histopathologically. Adjuvant chemotherapy (cyclophosphamide, vincristine, adriamycin and dacarbazine) was started 23 days after surgery. Although partial remission was achieved, the tumor started to grow after chemotherapy was discontinued because of severe adverse effects. The patient died 11 months after surgery. In this patient, even though complete resection was not done, emergency palliative surgery was effective to treat acute heart failure and to establish a pathologic diagnosis of the tumor. We report this rare case and discuss the therapeutic strategy for primary cardiac sarcomas.