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Metastatic osteosarcoma and heart: a rare involvement in an unusual cardiac location
  1. Majid Maleki1,
  2. Kambiz Mozaffari2,
  3. Nader Givtaj3,
  4. Alireza Tatina4,
  5. Behdad Bahadorian4
  1. 1Department of Echocardiography, Shahid Rajaei Cardiovascular Medical Center, Tehran, Iran
  2. 2Department of Pathology, Shahid Rajaei Cardiovascular Medical Center, Tehran university of medical sciences, Tehran, Iran
  3. 3Department of Surgery, Shahid Rajaei Cardiovascular Medical Center, Tehran university of medical sciences, Tehran, Iran
  4. 4Department of Cardiology, Shahid Rajaei Cardiovascular Medical Center, Tehran university of medical sciences, Tehran, Iran
  1. Correspondence to Dr Majid Maleki, Department of echocardiography, shahid rajaei cardiovascular medical cener, Elaheieh Ghorbansaeidi, No13, Tehran, 1964947519, Iran; Majid33{at}yahoo.com

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Introduction

Metastatic sarcomas to the heart involve the myocardium more often than the pericardium. All types of sarcomas metastasise to this organ and this occurs via the haematogenous route. Bilateral or diffuse involvement is seen in 30–35% of cases. Only in 5% of cases may endocardium or chamber cavities be involved, as was the case in our patient. The clinical signs and symptoms of metastatic cardiac neoplasms include dyspnoea, cough, chest pain, palpitations, superior vena cava syndrome, right ventricular outflow tract obstruction and pericardial effusion. Only 25 antemortem cases of metastatic osteogenic sarcoma to the heart have been diagnosed over the past 50 years.

Case report

A 38-year-old man presented with a history of osteosarcoma in the left femur 5 years prior to his recent admission. Four courses of chemotherapy had been carried out over a period of 3 years. However, on account of the poor response to therapy resulting in local recurrence, he underwent left hip disarticulation 2 years before his recent admission.

The patient had no further complaints until 5 months before his referral to us when he developed diffuse ischaemic lesions …

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