title: Primary cardiac undifferentiated sarcoma: role of intraoperative imprint cytology and frozen section of two cases.
abstract: Primary cardiac tumors are very rare, and a vast majority of such malignant tumors are sarcomas. Associated symptoms are usually vague and nonspecific resulting in a late diagnosis and poorer prognosis. Most cardiac sarcomas have been reported in autopsy series. Although echocardiography may help make a diagnosis of a cardiac sarcoma, histopathological confirmation is quintessential. Presented here are two cases of patients who underwent successful surgery for the removal of a cardiac tumor, along with echocardiographic, cytological, and histopathological findings as well as a compact literature review. In both patients, the masses were on the surface of the mitral valve, and intraoperative evaluation of frozen sections and imprint cytology were indicative of a "probably malignant" mesenchymal tumor prompting more extensive surgical resection. Immunohistochemical staining of the resected material in both cases was only positive for vimentin, leading to a diagnosis of undifferentiated sarcoma. One of the patients died 3 months after surgery, while the other who received adjuvant chemotherapy was still alive after 4 months. Surgery remains the most definite treatment for cardiac sarcomas. The use of intraoperative frozen section and imprint cytology plays an important role in the decision to extend surgical resection.
authors.affiliation: Department of Pathology, Turkiye Yuksek Ihtisas Teaching and Research Hospital, Sihhiye, Ankara, Turkey. nesrinturhan@hotmail.com
authors.forename: Nesrin
authors.initials: N
authors.lastname: Turhan
authors.forename: Zişan
authors.initials: Z
authors.lastname: Ozgüler
authors.forename: Kumral
authors.initials: K
authors.lastname: Cağlı
authors.forename: Kerim
authors.initials: K
authors.lastname: Cağlı
authors.forename: Zehra
authors.initials: Z
authors.lastname: Gölbaşı
mesh_terms: D003581:Cytodiagnosis; D005260:Female; D005629:Frozen Sections; D006338:Heart Neoplasms / Q000175:diagnosis / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D006801:Humans; D007150:Immunohistochemistry; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000473:pathology; D012509:Sarcoma / Q000175:diagnosis / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D014746:Vimentin / Q000378:metabolism
chemical_list: D014746:Vimentin