Primary chondroblastic osteosarcoma of the mitral valve without metastasis
Abstract: Primary osteosarcomas of the heart are extremely rare entities, with common subtypes including osteoblastic, chondroblastic and fibroblastic subtypes. We describe a case of a 53-year-old female with history of treated breast cancer who presented with progressive dyspnea on exertion. A pulm...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2022-04-01
|
| Series: | Radiology Case Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1930043322000309 |
| _version_ | 1818987648282263552 |
|---|---|
| author | Muhammad Umair, MD Stefan L. Zimmerman, MD Elliot K. Fishman, MD |
| author_facet | Muhammad Umair, MD Stefan L. Zimmerman, MD Elliot K. Fishman, MD |
| author_sort | Muhammad Umair, MD |
| collection | DOAJ |
| description | Abstract: Primary osteosarcomas of the heart are extremely rare entities, with common subtypes including osteoblastic, chondroblastic and fibroblastic subtypes. We describe a case of a 53-year-old female with history of treated breast cancer who presented with progressive dyspnea on exertion. A pulmonary artery protocol CTA demonstrated an anterior mitral leaflet lobulated mass without an osteoid or chondroid matrix. Additional cross-sectional imaging demonstrated no evidence of distant metastasis. The mass was surgically excised with pathology demonstrating a malignant neoplasm with spindle cells, bone, cartilage and rare osteoid, most consistent with a high grade chondroblastic osteosarcoma. After the expected postsurgical recovery, the patient was initiated on adjuvant therapy consisting of ifosfamide and etoposide and is currently disease free for 9 years now. Review of literature demonstrates that cardiac primary osteosarcomas typically involve the left atrium. Imaging usually shows a lobulated or irregular mass with heterogenous attenuation/enhancement and, counterintuitively, a lack of a calcified matrix. Complete surgical excision is challenging leading to poor prognosis, even in cases undergoing post-surgical chemotherapy. Median survival has been reported as about 20 months. |
| first_indexed | 2024-12-20T19:10:02Z |
| format | Article |
| id | doaj.art-fe522c27f673463ba6c37507ccad9c55 |
| institution | Directory Open Access Journal |
| issn | 1930-0433 |
| language | English |
| last_indexed | 2024-12-20T19:10:02Z |
| publishDate | 2022-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Radiology Case Reports |
| spelling | doaj.art-fe522c27f673463ba6c37507ccad9c552022-12-21T19:29:14ZengElsevierRadiology Case Reports1930-04332022-04-0117410411043Primary chondroblastic osteosarcoma of the mitral valve without metastasisMuhammad Umair, MD0Stefan L. Zimmerman, MD1Elliot K. Fishman, MD2Northwestern University, Feinberg School of Medicine, Department of Radiology, 676 N St Clair St, Chicago, IL 60611, USA; Corresponding author.Johns Hopkins Hospital, Russell H. Morgan Department of Radiology and Radiological Science, Baltimore, MD, USAJohns Hopkins Hospital, Russell H. Morgan Department of Radiology and Radiological Science, Baltimore, MD, USAAbstract: Primary osteosarcomas of the heart are extremely rare entities, with common subtypes including osteoblastic, chondroblastic and fibroblastic subtypes. We describe a case of a 53-year-old female with history of treated breast cancer who presented with progressive dyspnea on exertion. A pulmonary artery protocol CTA demonstrated an anterior mitral leaflet lobulated mass without an osteoid or chondroid matrix. Additional cross-sectional imaging demonstrated no evidence of distant metastasis. The mass was surgically excised with pathology demonstrating a malignant neoplasm with spindle cells, bone, cartilage and rare osteoid, most consistent with a high grade chondroblastic osteosarcoma. After the expected postsurgical recovery, the patient was initiated on adjuvant therapy consisting of ifosfamide and etoposide and is currently disease free for 9 years now. Review of literature demonstrates that cardiac primary osteosarcomas typically involve the left atrium. Imaging usually shows a lobulated or irregular mass with heterogenous attenuation/enhancement and, counterintuitively, a lack of a calcified matrix. Complete surgical excision is challenging leading to poor prognosis, even in cases undergoing post-surgical chemotherapy. Median survival has been reported as about 20 months.http://www.sciencedirect.com/science/article/pii/S1930043322000309Primary chondroblastic osteosarcomaMitral valveExtraosseous primary osteosarcoma |
| spellingShingle | Muhammad Umair, MD Stefan L. Zimmerman, MD Elliot K. Fishman, MD Primary chondroblastic osteosarcoma of the mitral valve without metastasis Radiology Case Reports Primary chondroblastic osteosarcoma Mitral valve Extraosseous primary osteosarcoma |
| title | Primary chondroblastic osteosarcoma of the mitral valve without metastasis |
| title_full | Primary chondroblastic osteosarcoma of the mitral valve without metastasis |
| title_fullStr | Primary chondroblastic osteosarcoma of the mitral valve without metastasis |
| title_full_unstemmed | Primary chondroblastic osteosarcoma of the mitral valve without metastasis |
| title_short | Primary chondroblastic osteosarcoma of the mitral valve without metastasis |
| title_sort | primary chondroblastic osteosarcoma of the mitral valve without metastasis |
| topic | Primary chondroblastic osteosarcoma Mitral valve Extraosseous primary osteosarcoma |
| url | http://www.sciencedirect.com/science/article/pii/S1930043322000309 |
| work_keys_str_mv | AT muhammadumairmd primarychondroblasticosteosarcomaofthemitralvalvewithoutmetastasis AT stefanlzimmermanmd primarychondroblasticosteosarcomaofthemitralvalvewithoutmetastasis AT elliotkfishmanmd primarychondroblasticosteosarcomaofthemitralvalvewithoutmetastasis |