A yo–yo in the heart: a rare presentation of primary cardiac sarcoma as a serpiginous mobile left atrioventricular mass

Excerpt

We describe a rare case of primary undifferentiated cardiac sarcoma presenting as a mobile left atrioventricular cardiac mass. In a 60-year-old woman, a cardiac mass caused new onset of palpitations, fatigue, and prominent systolic click. Transthoracic echocardiography, transesophageal echocardiography, and 3-Dimensional (3D) echocardiography showed extensive thickening of up to 0.6 cm in the anterior, posterior, medial, and lateral left atrial walls, extending to the mitral intravalvular fibrosa (Fig. 1a and 1b). A serpiginous mass prolapsed through the mitral valve, nearly reaching the left ventricular apex during diastole (Fig. 1a). Moderate mitral valve regurgitation with restricted motion of the posterior leaflet was observed, the left ventricular ejection fraction was 63 %, and there were no regional wall motion abnormalities. No pathologic changes were noted on chest, abdomen, and pelvis computed tomography or on head magnetic resonance imaging. Differential diagnoses included myxoma, thrombus, metastatic tumor, or malignant primary tumor.

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