Primary Malignant Fibrous Histiocytoma of the Right Ventricle

Abstract

Primary cardiac tumors are very rare tumors, and cardiac sarcomas are uncommon tumors. We report the case of a 22-year-old previously healthy woman with notable medical history who presented with 4 days of light-headedness, nausea, and vomiting, 1 day of loss of awareness in orthostatism, and severe right ventricular failure. Two-dimensional transthoracic echocardiography revealed a hypoechoic homogeneous tumor measuring 50 mm on the long axis in the right ventricle and occupying the entire cavity of the right ventricle. Computed tomography (CT) confirmed the mass, with no other visible pathologic masses. Postsurgical histopathologic results showed malignant fibrous histiocytoma (MFH; undifferentiated pleomorphic sarcoma). Six follow-up monthly cardiac and abdominal sonographic examinations revealed no tumor recidivism, mild tricuspid insufficiency, normal liver aspects, no fluid in the pericardium, pleura, or peritoneum, and no images of additional tumors. To our knowledge, a case of primary MFH of the right ventricle in Romania has not been reported previously, and this is the fourth reported case in the world. Our case was especially unusual because of the primary location in the right ventricle (the usual site for metastasis), lack of symptoms until the development of severe right cardiac failure, and the young age of the patient.