Yonsei Med J.  2007 Feb;48(1):131-134. 10.3349/ymj.2007.48.1.131.

Primary Undifferentiated Pleomorphic Sarcoma of the Left Atrium that Presented as Acute Pulmonary Edema

• Suh SH
• Park TH
• Yoo JN
• Cha KS
• Kim MH
• Kim YD
• Wu JS
• Roh MS

• KMID: 1093535
• DOI: http://doi.org/10.3349/ymj.2007.48.1.131

Abstract

A 37-year-old woman was admitted to Dong-A University Hospital for rapidly progressive congestive heart failure. Transthoracic echocardiography demonstrated a large mass with a stalk that appeared to be a myxoma on the posterior wall of the left atrium. However, the histological diagnosis was undifferentiated pleomorphic sarcoma. We report a case of primary undifferentiated pleomorphic sarcoma of the left atrium with acute pulmonary edema caused by mitral inflow obstruction.

Keyword

Undifferentiated pleomorphic sarcoma; echocardiography; acute pulmonary edema

Figure

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  Fig. 1 Chest radiograph showing bilateral pulmonary edema.

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  Fig. 2 Transthoracic echocardiogram in apical 4 chamber view. A large mobile mass attached on posterior wall of left atrium was observed.

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  Fig. 3 Doppler echocardiogram in apical 4 chamber view. Continuous-wave Doppler showed a severe mitral stenosis with a maximal velocity of 3.1 m/s and a mean pressure gradient of 20 mmHg through the mitral valve.

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  Fig. 4 Photographs of the resected tumors. The main mass (right side) observed in echocardiogram was resected from the posterior wall of the left atrium, measuring 4 × 3.5 × 3.5 cm. The second mass (left side) was not detected in echocardiogram and was found at the interatrial septum and posterior mitral leaflet, measuring 5.5 × 3 × 1.5 cm.

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  Fig. 5 Microscopic examination of undifferentiated pleomorphic sarcoma showed prominent nuclear pleomorphism, hyperchromicity and frequent mitoses of spindled or epithelioid tumor cells (H&E, × 200).

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