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Primary chondroblastic osteosarcoma of the mitral valve without metastasis

Primary osteosarcomas of the heart are extremely rare entities, with common subtypes including osteoblastic, chondroblastic and fibroblastic subtypes. We describe a case of a 53-year-old female with history of treated breast cancer who presented with progressive dyspnea on exertion. A pulmonary arte...

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Detalles Bibliográficos
Autores principales: Umair, Muhammad, Zimmerman, Stefan L., Fishman, Elliot K.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8818898/
https://www.ncbi.nlm.nih.gov/pubmed/35145566
http://dx.doi.org/10.1016/j.radcr.2022.01.030
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author Umair, Muhammad
Zimmerman, Stefan L.
Fishman, Elliot K.
author_facet Umair, Muhammad
Zimmerman, Stefan L.
Fishman, Elliot K.
author_sort Umair, Muhammad
collection PubMed
description Primary osteosarcomas of the heart are extremely rare entities, with common subtypes including osteoblastic, chondroblastic and fibroblastic subtypes. We describe a case of a 53-year-old female with history of treated breast cancer who presented with progressive dyspnea on exertion. A pulmonary artery protocol CTA demonstrated an anterior mitral leaflet lobulated mass without an osteoid or chondroid matrix. Additional cross-sectional imaging demonstrated no evidence of distant metastasis. The mass was surgically excised with pathology demonstrating a malignant neoplasm with spindle cells, bone, cartilage and rare osteoid, most consistent with a high grade chondroblastic osteosarcoma. After the expected postsurgical recovery, the patient was initiated on adjuvant therapy consisting of ifosfamide and etoposide and is currently disease free for 9 years now. Review of literature demonstrates that cardiac primary osteosarcomas typically involve the left atrium. Imaging usually shows a lobulated or irregular mass with heterogenous attenuation/enhancement and, counterintuitively, a lack of a calcified matrix. Complete surgical excision is challenging leading to poor prognosis, even in cases undergoing post-surgical chemotherapy. Median survival has been reported as about 20 months.
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spelling pubmed-88188982022-02-09 Primary chondroblastic osteosarcoma of the mitral valve without metastasis Umair, Muhammad Zimmerman, Stefan L. Fishman, Elliot K. Radiol Case Rep Case Report Primary osteosarcomas of the heart are extremely rare entities, with common subtypes including osteoblastic, chondroblastic and fibroblastic subtypes. We describe a case of a 53-year-old female with history of treated breast cancer who presented with progressive dyspnea on exertion. A pulmonary artery protocol CTA demonstrated an anterior mitral leaflet lobulated mass without an osteoid or chondroid matrix. Additional cross-sectional imaging demonstrated no evidence of distant metastasis. The mass was surgically excised with pathology demonstrating a malignant neoplasm with spindle cells, bone, cartilage and rare osteoid, most consistent with a high grade chondroblastic osteosarcoma. After the expected postsurgical recovery, the patient was initiated on adjuvant therapy consisting of ifosfamide and etoposide and is currently disease free for 9 years now. Review of literature demonstrates that cardiac primary osteosarcomas typically involve the left atrium. Imaging usually shows a lobulated or irregular mass with heterogenous attenuation/enhancement and, counterintuitively, a lack of a calcified matrix. Complete surgical excision is challenging leading to poor prognosis, even in cases undergoing post-surgical chemotherapy. Median survival has been reported as about 20 months. Elsevier 2022-02-03 /pmc/articles/PMC8818898/ /pubmed/35145566 http://dx.doi.org/10.1016/j.radcr.2022.01.030 Text en © 2022 The Authors. Published by Elsevier Inc. on behalf of University of Washington. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Umair, Muhammad
Zimmerman, Stefan L.
Fishman, Elliot K.
Primary chondroblastic osteosarcoma of the mitral valve without metastasis
title Primary chondroblastic osteosarcoma of the mitral valve without metastasis
title_full Primary chondroblastic osteosarcoma of the mitral valve without metastasis
title_fullStr Primary chondroblastic osteosarcoma of the mitral valve without metastasis
title_full_unstemmed Primary chondroblastic osteosarcoma of the mitral valve without metastasis
title_short Primary chondroblastic osteosarcoma of the mitral valve without metastasis
title_sort primary chondroblastic osteosarcoma of the mitral valve without metastasis
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8818898/
https://www.ncbi.nlm.nih.gov/pubmed/35145566
http://dx.doi.org/10.1016/j.radcr.2022.01.030
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