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Gepubliceerd in: Netherlands Heart Journal 5/2023

Open Access 05-04-2023 | Heart Beat

A rare presentation of a solitary fibrous tumour

Auteurs: Gonçalo N. Ferraz Costa, Fátima Franco, Rogério P. C. Teixeira

Gepubliceerd in: Netherlands Heart Journal | Uitgave 5/2023

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Extras
Video 1 Transoesophageal echocardiogram showing mass (size: 6.2 × 4.4 cm) that fills large part of left atrial volume, with irregular contour and heterogeneous echogenicity. This mass originated from left superior pulmonary vein and was suggestive of malignancy
Video 2 Transoesophageal echocardiogram showing left atrial mass that causes restrictive transmitral flow with transmitral maximal/mean gradients of 14/7 mm Hg, which indicated functional mitral stenosis
Video 3 Cardiac computed tomography angiogram with retrospective gating and multiphasic reconstruction in axial plane showing vascularised, low-density tumour mass (size: 6.5 × 4.3 cm; 60–70 HU) that occupies three-quarters of left atrial volume. This mass expanded to left atrial appendage
Video 4 Colour cardiac computed tomography angiogram with retrospective gating and multiphasic reconstruction showing vascularised mass in left atrium, with reduced mobility and heterogeneous contrast enhancement. No invasion of valves, left ventricle, right chambers, coronary arteries or aorta
Video 5 Colour cardiac computed tomography angiogram with retrospective gating and multiphasic reconstruction showing left atrial mass entering heart from left upper pulmonary vein, with associated left superior pulmonary vein thrombosis
Opmerkingen

Video online

The online version of this article contains 5 videos. The article and the videos are online available (https://​doi.​org/​10.​1007/​s12471-023-01775-2). The videos can be found in the article back matter as “Electronic Supplementary Material”.
A 67-year-old woman was referred to our centre because of an intracardiac mass. Her medical history included a retroperitoneal tumour (2015), lung metastases (2020) and bilateral breast implantation. Transthoracic echocardiography had a poor acoustic window due to the breast implants. Transoesophageal echocardiography showed a mass in the left atrium (6.2 × 4.4 cm) that occluded most of the atrium, had an uneven shape and showed heterogeneous echogenicity. Due to its size, the mass, which seemed to derive from the left pulmonary vein, restricted transmitral flow; mean transmitral gradient was 7 mm Hg (Fig. 1a, b, and see Videos 1 and 2 in Electronic Supplementary Material). Cardiac computed tomography (CT) angiography showed a vascularised cardiac mass with reduced mobility and uneven contrast enhancement; there was no cardiac infiltration. CT showed the tumour entered the heart from the left upper pulmonary vein and revealed left superior pulmonary vein thrombosis (Fig. 1c, d, and see Videos 3–5 in Electronic Supplementary Material); lung window study indicated several lung metastases (Fig. 1e). Transthoracic biopsy of one metastasis and subsequent pathological examination revealed a solitary fibrous tumour (Fig. 1f). Despite chemotherapy, the patient died. This report is an example of a slow-growing, solitary fibrous tumour turning malignant [1, 2].

Conflict of interest

G.N. F. Costa, F. Franco and R.P. C. Teixeira declare that they have no competing interests.
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://​creativecommons.​org/​licenses/​by/​4.​0/​.
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Supplementary Information

Video 1 Transoesophageal echocardiogram showing mass (size: 6.2 × 4.4 cm) that fills large part of left atrial volume, with irregular contour and heterogeneous echogenicity. This mass originated from left superior pulmonary vein and was suggestive of malignancy
Video 2 Transoesophageal echocardiogram showing left atrial mass that causes restrictive transmitral flow with transmitral maximal/mean gradients of 14/7 mm Hg, which indicated functional mitral stenosis
Video 3 Cardiac computed tomography angiogram with retrospective gating and multiphasic reconstruction in axial plane showing vascularised, low-density tumour mass (size: 6.5 × 4.3 cm; 60–70 HU) that occupies three-quarters of left atrial volume. This mass expanded to left atrial appendage
Video 4 Colour cardiac computed tomography angiogram with retrospective gating and multiphasic reconstruction showing vascularised mass in left atrium, with reduced mobility and heterogeneous contrast enhancement. No invasion of valves, left ventricle, right chambers, coronary arteries or aorta
Video 5 Colour cardiac computed tomography angiogram with retrospective gating and multiphasic reconstruction showing left atrial mass entering heart from left upper pulmonary vein, with associated left superior pulmonary vein thrombosis
Literatuur
1.
go back to reference Fain K, Parmar K, Sharma M, Horn R, Sethi P. An unusual location of solitary fibrous tumor in heart—A case report and review of literature. Cancer Rep. 2022;5:e1698. Fain K, Parmar K, Sharma M, Horn R, Sethi P. An unusual location of solitary fibrous tumor in heart—A case report and review of literature. Cancer Rep. 2022;5:e1698.
Metagegevens
Titel
A rare presentation of a solitary fibrous tumour
Auteurs
Gonçalo N. Ferraz Costa
Fátima Franco
Rogério P. C. Teixeira
Publicatiedatum
05-04-2023
Uitgeverij
Bohn Stafleu van Loghum
Gepubliceerd in
Netherlands Heart Journal / Uitgave 5/2023
Print ISSN: 1568-5888
Elektronisch ISSN: 1876-6250
DOI
https://doi.org/10.1007/s12471-023-01775-2

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