Abstract
The authors report a case of a 16-year-old man who presented progressive dyspnea. At that time the diagnosis of rheumatic fever with mitral valve involvement was performed. The bidimensional echocardiogram showed presence of mobile mass inside the left atrium. The tumor presented lobules, projecting into the left ventricle during the diastole and provoking turbulence. The patient underwent surgical resection with postoperative course needing re-operation for mitral valve replacement. Histopathology has proven that such tumor was a primary cardiac rhabdomyosarcoma and the early clinical diagnosis of rheumatic mitral valve disease was very difficult.
Highlights
The incidence of primary tumors of the heart in autopsy series ranges from 0.0017 to 0.28 per cent and about onefourth of all cardiac tumors exhibit typically malignant histological characteristics and invasive behavior [1]
Rhabdomyosarcoma is a malignant tumor of mesenchymal origin which often diffusely infiltrates the myocardium but which may on occasion, form a polypoid extension into the cardiac chambers and have been clinically mistaken for myxoma
Sarcomas are more frequently located on the right-hand side of the heart and their incidence ranges from 2% to 5% of all malignant tumors [8]
Summary
Resumo Os autores reportam caso de jovem de 16 anos, o qual apresentou dispnéia progressiva. No momento do atendimento foi feito diagnóstico de febre reumática com comprometimento da valva mitral. Ecocardiograma bidimensional demonstrou a presença de massa móvel dentro do átrio esquerdo. O tumor apresentava lobos, se projetando para o interior do ventrículo esquerdo durante a diástole, provocando turbulência. O paciente foi submetido a ressecção cirúrgica, complicada com reoperação e troca valvar mitral. A histopatologia demonstrou tratar-se de rabdomiosarcoma primário e o diagnóstico clínico diferencial com febre reumática e doença valvar mitral foi muito difícil desde o seu início.
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