High-grade spindle cell sarcoma of the heart: a case report and review of literature

Primary cardiac spindle cell sarcomas are extremely rare and have poor prognosis. Complete surgical resection represents the only treatment option proven to work. We report a case of a 28-year-old man who was referred to our cardiothoracic unit with a right ventricular mass extending to the main pulmonary artery with a provisional diagnosis of a thrombus or a right ventricular myxoma. He sought medical attention after experiencing shortness of breath, cough, chest pain, abdominal pain and bilateral leg swelling for about 6 weeks. Two dimensional transthoracic echocardiogram showed a mass arising from the right ventricle and extending into the main pulmonary artery; findings that were confirmed with contrast chest CT scan. He underwent extensive resection of the mass and had uneventful postoperative period with immediate symptomatic relieve. He is on adjuvant chemotherapy using vincristine, adriamycin and cyclophosphamide (VAC). Right ventricular sarcoma is a very rare cause of right sided heart failure, a very aggressive tumour whose only chance of successful treatment is complete surgical excision.