Diagnosis of primary cardiac leiomyosarcoma by endomyocardial biopsy

J Amory; T M Chou; R F Redberg; L M Blake; R K Vartanian

doi:10.1016/1054-8807(95)00060-7

Diagnosis of primary cardiac leiomyosarcoma by endomyocardial biopsy

Cardiovasc Pathol. 1996 Mar-Apr;5(2):113-7. doi: 10.1016/1054-8807(95)00060-7.

Authors

J Amory¹, T M Chou¹, R F Redberg¹, L M Blake¹, R K Vartanian²

Affiliations

¹ Department of Medicine University of California, San Francisco, San Francisco, California U.S.A.
² Department of Pathology, University of California, San Francisco, San Francisco, California U.S.A.

PMID: 25851363
DOI: 10.1016/1054-8807(95)00060-7

Abstract

We report a case of a primary right ventricular leiomyosarcoma in a 58-year-old woman diagnosed by endomyocardial biopsy. Clinical findings included a 5-year history of atypical chest pain and atrial fibrillation as well as a 30-lb weight loss. A ventricular mass was identified by echocardiography and magnetic resonance imaging, and an endomyocardial biopsy was performed. Biopsy was guided by right ventriculography, which revealed a mobile mass in the cavity of the right ventricle. Light microscopy revealed a fasciculated, spindle cell sarcoma, most consistent with leiomyosarcoma, and immunohistochemical staining for muscle-specific actin was strongly positive in nearly all tumor cells, confirming its myogenous differentiation. Endomyocardial biopsy provided a definitive tissue diagnosis of this rare primary malignant cardiac neoplasm without the need for a surgical procedure.