Qiu Jingping, Tang Lingrong, Han Yang, Wang Chun, Gu Tianxiang, Li Guang
Department of Radiation Oncology Department of Pathology Department of Cardiac Surgery, the First Hospital, China Medical University, Shenyang, China.
Medicine (Baltimore). 2017 Dec;96(49):e8930. doi: 10.1097/MD.0000000000008930.
Fibromyxosarcoma is common in head and neck, vessel, omentum, and reproductive system, with low-grade malignant behavior. However, primary atrial fibromyxosarcoma with highly malignant behavior is extremely rare.
A 34-year-old female presented with oppression in the chest, short breath, and onset of headache as initial symptoms. The preoperative echocardiogram showed a medium-size echogenic mass close to the posterior leaflet of the mitral valve in the left atrium.
Primary atrial fibromyxosarcoma with multiple-system metastases.
The patient underwent surgery, and the tumor was removed completely. The diagnosis of left atrium fibromyxosarcoma was confirmed through postoperative histopathological examination. Positron emission tomography/computed tomography scan was performed, which revealed multiple metastases to left adnexa, bilateral adrenal glands, left iliacus, right lateral ventricle, and skeletal system.
The patient died of cerebral hernia caused by hemorrhage from the metastatic brain tumor, 30 days after the surgery, without receiving chemotherapy or radiotherapy.
Cardiac fibromyxosarcoma is a rare primary malignant cardiac neoplasm, probably with systemic metastases. The possibility of malignancy should be considered as differential diagnosis for cardiac mass.
纤维黏液肉瘤常见于头颈部、血管、大网膜及生殖系统，恶性程度较低。然而，具有高度恶性行为的原发性心房纤维黏液肉瘤极为罕见。
一名34岁女性最初出现胸部压迫感、呼吸急促及头痛症状。术前超声心动图显示左心房靠近二尖瓣后叶有一个中等大小的回声团块。
原发性心房纤维黏液肉瘤伴多系统转移。
患者接受了手术，肿瘤被完全切除。术后组织病理学检查确诊为左心房纤维黏液肉瘤。进行了正电子发射断层扫描/计算机断层扫描，结果显示左附件、双侧肾上腺、左髂肌、右侧脑室及骨骼系统有多处转移。
患者术后30天因转移性脑肿瘤出血导致脑疝死亡，未接受化疗或放疗。
心脏纤维黏液肉瘤是一种罕见的原发性恶性心脏肿瘤，可能发生全身转移。对于心脏肿物，应考虑恶性的可能性以进行鉴别诊断。
