About this Journal Submit a Manuscript Table of Contents
Case Reports in Medicine
Volume 2013 (2013), Article ID 461815, 5 pages
http://dx.doi.org/10.1155/2013/461815
Case Report

Primary Intimal (Spindle Cell) Sarcoma of the Heart: A Case Report and Review of the Literature

1Department of Pathology, Toronto General Hospital, University Health Network, Toronto, ON, Canada M5G 2C4
2Division of Cardiology, University of Toronto, Toronto, ON, Canada M5T 2S8
3Department of Radiology, Sunnybrook Hospital and University Health Network, North York, ON, Canada M4N 3M5
4Division of Cardiac Surgery, Peter Munk Cardiac Centre, Toronto General Hospital, Toronto, ON, Canada M5G 2C4
5Faculty of Medicine, University of Toronto, Toronto, ON, Canada M5S 1A8

Received 12 October 2012; Accepted 17 December 2012

Academic Editor: Jahn M. Nesland

Copyright © 2013 A. Ibrahim et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Intimal (spindle cell) sarcomas of the left atrium are extremely rare primary cardiac tumours with three cases reported (Li et al. (2013), Cho et al. (2006), and Modi et al. (2009)). We present a 69-year-old man who first came to medical attention after experiencing abdominal discomfort. He had a 30 lb weight loss apparently due to dieting. He denied any other constitutional symptoms. His symptoms persisted despite a course of antibiotics for presumed diverticulitis. Laboratory values were within normal limits, though the haemoglobin was 131 g/L (normal: 140–180). Subsequent abdominal computed tomography (CT) scan revealed an abdominal wall mass and intracardiac lesion; the cardiac mass was further characterized by transesophageal echo (TEE), magnetic resonance imaging (MRI), and dedicated cardiac CT. TEE revealed a mass attached to the posterolateral wall of the left atrium above the mitral annulus, and the cardiac CT and MRI confirmed the TEE findings. The patient underwent extensive surgical resection and repair of the left side of the heart. Postoperatively, he developed acute renal failure requiring dialysis and reintubation for volume overload. He became acutely hypotensive, developed multiorgan failure, and succumbed to his illness. Histopathologic examination of the left atrial mass showed an intimal sarcoma.