Adult-onset primary Ewing’s sarcoma of the right atrium: a case report

Abstract Background Primary cardiac tumors, which are only detected in 0.001–0.03% of autopsies, are rare. Only 25% of primary cardiac tumors are malignant, of which 95% are sarcomas. Ewing’s sarcoma, one of the Ewing’s sarcoma of family tumors, is thought to be derived from neural crest cells. Whil...

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Main Authors: Jun Ushigusa, Yosuke Mukae, Masanori Takamatsu, Eijiro Nogami, Akira Furutachi, Manabu Itoh, Junji Yunoki, Takahiro Nishida
Format: Article
Language:English
Published: Japan Surgical Society 2019-11-01
Series:Surgical Case Reports
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Online Access:http://link.springer.com/article/10.1186/s40792-019-0727-1
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author Jun Ushigusa
Yosuke Mukae
Masanori Takamatsu
Eijiro Nogami
Akira Furutachi
Manabu Itoh
Junji Yunoki
Takahiro Nishida
author_facet Jun Ushigusa
Yosuke Mukae
Masanori Takamatsu
Eijiro Nogami
Akira Furutachi
Manabu Itoh
Junji Yunoki
Takahiro Nishida
author_sort Jun Ushigusa
collection DOAJ
description Abstract Background Primary cardiac tumors, which are only detected in 0.001–0.03% of autopsies, are rare. Only 25% of primary cardiac tumors are malignant, of which 95% are sarcomas. Ewing’s sarcoma, one of the Ewing’s sarcoma of family tumors, is thought to be derived from neural crest cells. While Ewing’s sarcoma usually presents in the bone of children, Ewing’s sarcoma of cardiac origin is rare, with only a few reports described in the literature. The prognosis is unpredictable because of the scarcity and unestablished treatment. We herein report an extremely rare case of primary cardiac Ewing’s sarcoma in the right atrium of a 64-year-old man. Case presentation The patient is a 64-year-old Japanese male who was referred to our hospital to treat a floating mass of the right atrium (RA). Although the patient was asymptomatic, we performed an operation to urgently resect the floating mass on the next day of admission due to the risk of pulmonary embolism. The operation was performed under cardiopulmonary bypass and cardiac arrest. We resected the tumor with at least 1.5 cm of the RA wall as a margin. The postoperative pathological diagnosis of the mass was compatible with a primitive neuroectodermal tumor (PNET, a form of Ewing’s sarcoma). The cells were positive for CD56, CD99, and Vimentin and negative for S-100 and Desmin. Although no malignant cells were observed in the margin of the resected RA wall and the sarcoma was completely resected, he was transferred to another hospital to receive adjuvant postoperative chemotherapy to improve the prognosis by preventing subclinical micrometastasis. Conclusions We experienced an extremely rare case of primary cardiac Ewing’s sarcoma in the right atrium of a 64-year-old man, which was successfully resected under cardiac arrest. Although the sarcoma was completely resected, postoperative chemotherapy and long-term follow-up are recommended for patients with primary cardiac sarcoma because of the high rates of metastasis and recurrence.
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spelling doaj-art-9dcd492dbf844447add0774fac41db752025-08-20T03:34:53ZengJapan Surgical SocietySurgical Case Reports2198-77932019-11-01511410.1186/s40792-019-0727-1Adult-onset primary Ewing’s sarcoma of the right atrium: a case reportJun Ushigusa0Yosuke Mukae1Masanori Takamatsu2Eijiro Nogami3Akira Furutachi4Manabu Itoh5Junji Yunoki6Takahiro Nishida7Center for Graduate Medical Education Development and Research, Saga University HospitalDepartment of Thoracic and Cardiovascular Surgery, Faculty of Medicine, Saga UniversityDepartment of Thoracic and Cardiovascular Surgery, Faculty of Medicine, Saga UniversityDepartment of Thoracic and Cardiovascular Surgery, Faculty of Medicine, Saga UniversityDepartment of Thoracic and Cardiovascular Surgery, Faculty of Medicine, Saga UniversityDepartment of Thoracic and Cardiovascular Surgery, Faculty of Medicine, Saga UniversityDepartment of Thoracic and Cardiovascular Surgery, Faculty of Medicine, Saga UniversityDepartment of Thoracic and Cardiovascular Surgery, Faculty of Medicine, Saga UniversityAbstract Background Primary cardiac tumors, which are only detected in 0.001–0.03% of autopsies, are rare. Only 25% of primary cardiac tumors are malignant, of which 95% are sarcomas. Ewing’s sarcoma, one of the Ewing’s sarcoma of family tumors, is thought to be derived from neural crest cells. While Ewing’s sarcoma usually presents in the bone of children, Ewing’s sarcoma of cardiac origin is rare, with only a few reports described in the literature. The prognosis is unpredictable because of the scarcity and unestablished treatment. We herein report an extremely rare case of primary cardiac Ewing’s sarcoma in the right atrium of a 64-year-old man. Case presentation The patient is a 64-year-old Japanese male who was referred to our hospital to treat a floating mass of the right atrium (RA). Although the patient was asymptomatic, we performed an operation to urgently resect the floating mass on the next day of admission due to the risk of pulmonary embolism. The operation was performed under cardiopulmonary bypass and cardiac arrest. We resected the tumor with at least 1.5 cm of the RA wall as a margin. The postoperative pathological diagnosis of the mass was compatible with a primitive neuroectodermal tumor (PNET, a form of Ewing’s sarcoma). The cells were positive for CD56, CD99, and Vimentin and negative for S-100 and Desmin. Although no malignant cells were observed in the margin of the resected RA wall and the sarcoma was completely resected, he was transferred to another hospital to receive adjuvant postoperative chemotherapy to improve the prognosis by preventing subclinical micrometastasis. Conclusions We experienced an extremely rare case of primary cardiac Ewing’s sarcoma in the right atrium of a 64-year-old man, which was successfully resected under cardiac arrest. Although the sarcoma was completely resected, postoperative chemotherapy and long-term follow-up are recommended for patients with primary cardiac sarcoma because of the high rates of metastasis and recurrence.http://link.springer.com/article/10.1186/s40792-019-0727-1Cardiac Ewing’s sarcomaRight atriumAdult-onset
spellingShingle Jun Ushigusa
Yosuke Mukae
Masanori Takamatsu
Eijiro Nogami
Akira Furutachi
Manabu Itoh
Junji Yunoki
Takahiro Nishida
Adult-onset primary Ewing’s sarcoma of the right atrium: a case report
Surgical Case Reports
Cardiac Ewing’s sarcoma
Right atrium
Adult-onset
title Adult-onset primary Ewing’s sarcoma of the right atrium: a case report
title_full Adult-onset primary Ewing’s sarcoma of the right atrium: a case report
title_fullStr Adult-onset primary Ewing’s sarcoma of the right atrium: a case report
title_full_unstemmed Adult-onset primary Ewing’s sarcoma of the right atrium: a case report
title_short Adult-onset primary Ewing’s sarcoma of the right atrium: a case report
title_sort adult onset primary ewing s sarcoma of the right atrium a case report
topic Cardiac Ewing’s sarcoma
Right atrium
Adult-onset
url http://link.springer.com/article/10.1186/s40792-019-0727-1
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