Primary cardiac undifferentiated sarcoma: role of intraoperative imprint cytology and frozen section of two cases.
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.
Turhan
Nesrin
N
Department of Pathology, Turkiye Yuksek Ihtisas Teaching and Research Hospital, Sihhiye, Ankara, Turkey. nesrinturhan@hotmail.com
Ozgüler
Zişan
Z
Cağlı
Kumral
K
Cağlı
Kerim
K
Gölbaşı
Zehra
Z
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
D014746:Vimentin