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Primary undifferentiated high-grade pleomorphic cardiac sarcoma in the left atrium with atypical presentation
  1. Sue Fen Tan,
  2. Sherif Osama Ahmed Abbas,
  3. Nithiananthan Mayooran and
  4. Surendra Kashinath Naik
  1. Cardiac surgery, Nottingham University Hospitals NHS Trust, Nottingham, UK
  1. Correspondence to Dr Sue Fen Tan; esthertan1195{at}


A woman in her 60s had 4 months of malaise, fatigue, dyspnoea, night sweats and grade 3 clubbing. She had a pansystolic murmur and signs of congestive heart failure. Multimodal imaging with a transthoracic echocardiogram, transoesophageal echocardiogram and CT was carried out to diagnose and reconstruct the mass for surgical planning. A 2×2.8 cm circular dense mass was found in the left atrium with vegetations on the mitral valve. Positron emission tomography and cardiac MRI confirmed the mass’s hypermetabolic activity and malignant features. Mitral valve replacement and surgical resection were performed. She was diagnosed with grade 3 undifferentiated cardiac sarcoma and referred to the sarcoma multidisciplinary team for further management given sarcoma’s rarity and complexity. The poor prognosis of sarcoma was evident as her symptoms recurred 2 months postoperatively.

  • Cancer - see Oncology
  • Cardiothoracic surgery

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  • Contributors The case report was written by SFT, SOAA and NM. The patient was under the care of SKN and the case report was supervised by SKN.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.