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Primary cardiac sarcoma in pregnancy: a case report.

Cho GJ, Kim HJ, Kang JS - J. Korean Med. Sci. (2006)

Bottom Line: It is also associated with poor prognoses, due to diagnostic delay, therapeutic difficulty, and high metastatic potential.Surgery is the standard treatment for cardiac tumors, and their removal should always be attempted, even in pregnant women.Although the overall survival rates of the patients are rather poor, palliative cardiac surgery allows the prolonging of pregnancy, until an acceptable fetal viability level is reached.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, College of Medicine, Korea University, Seoul, Korea.

ABSTRACT
Primary cardiac sarcoma is a rare disease in adults. It is also associated with poor prognoses, due to diagnostic delay, therapeutic difficulty, and high metastatic potential. The coincidence of pregnancy and a primary cardiac intimal sarcoma is extremely rare. We report a pregnant woman at 27(+5) weeks gestation who was admitted to the hospital with acute-onset dyspnea. A mass was found on the left atrium by transthoracic echocardiography. Subsequently, the intracardiac mass was removed, and mitral valve replacement and modified DeVega tricuspid annuloplasty were performed. The patient was diagnosed with a undifferentiated sarcoma, and gave birth to a 1,230 g living baby boy by Caesarean section from preterm contraction at 29(+5) weeks gestation. The patient then received systemic chemotherapy. However, 10 months after the initial clinical onset, the patient suddenly died. Surgery is the standard treatment for cardiac tumors, and their removal should always be attempted, even in pregnant women. Although the overall survival rates of the patients are rather poor, palliative cardiac surgery allows the prolonging of pregnancy, until an acceptable fetal viability level is reached.

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Transthoracic echocardiography shows a mass spreading from the anterior of the left atrium to the mitral leaflet and mitral annulus.
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Figure 1: Transthoracic echocardiography shows a mass spreading from the anterior of the left atrium to the mitral leaflet and mitral annulus.

Mentions: Routine blood tests and chest radiography were performed, but resulted in no peculiarity. Transthoracic echocardiography revealed a 5 cm in diameter echogenic mass spreading from the anterior of the left atrium to the mitral leaflet and mitral annulus, severe eccentric mitral regurgitation coupled with severe stenosis, and severe pulmonary hypertension (Fig. 1). The fetus was at a size consistent with IUP 27+2 weeks, according to obstetric sonography, and appeared to be normal. The patient was given intramuscular dexamethasone, 5 mg every 12 hr for 4 doses.


Primary cardiac sarcoma in pregnancy: a case report.

Cho GJ, Kim HJ, Kang JS - J. Korean Med. Sci. (2006)

Transthoracic echocardiography shows a mass spreading from the anterior of the left atrium to the mitral leaflet and mitral annulus.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2722010&req=5

Figure 1: Transthoracic echocardiography shows a mass spreading from the anterior of the left atrium to the mitral leaflet and mitral annulus.
Mentions: Routine blood tests and chest radiography were performed, but resulted in no peculiarity. Transthoracic echocardiography revealed a 5 cm in diameter echogenic mass spreading from the anterior of the left atrium to the mitral leaflet and mitral annulus, severe eccentric mitral regurgitation coupled with severe stenosis, and severe pulmonary hypertension (Fig. 1). The fetus was at a size consistent with IUP 27+2 weeks, according to obstetric sonography, and appeared to be normal. The patient was given intramuscular dexamethasone, 5 mg every 12 hr for 4 doses.

Bottom Line: It is also associated with poor prognoses, due to diagnostic delay, therapeutic difficulty, and high metastatic potential.Surgery is the standard treatment for cardiac tumors, and their removal should always be attempted, even in pregnant women.Although the overall survival rates of the patients are rather poor, palliative cardiac surgery allows the prolonging of pregnancy, until an acceptable fetal viability level is reached.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, College of Medicine, Korea University, Seoul, Korea.

ABSTRACT
Primary cardiac sarcoma is a rare disease in adults. It is also associated with poor prognoses, due to diagnostic delay, therapeutic difficulty, and high metastatic potential. The coincidence of pregnancy and a primary cardiac intimal sarcoma is extremely rare. We report a pregnant woman at 27(+5) weeks gestation who was admitted to the hospital with acute-onset dyspnea. A mass was found on the left atrium by transthoracic echocardiography. Subsequently, the intracardiac mass was removed, and mitral valve replacement and modified DeVega tricuspid annuloplasty were performed. The patient was diagnosed with a undifferentiated sarcoma, and gave birth to a 1,230 g living baby boy by Caesarean section from preterm contraction at 29(+5) weeks gestation. The patient then received systemic chemotherapy. However, 10 months after the initial clinical onset, the patient suddenly died. Surgery is the standard treatment for cardiac tumors, and their removal should always be attempted, even in pregnant women. Although the overall survival rates of the patients are rather poor, palliative cardiac surgery allows the prolonging of pregnancy, until an acceptable fetal viability level is reached.

Show MeSH
Related in: MedlinePlus