Staged surgery for advanced cardiac intimal sarcoma involving the right
atrium and the inferior vena cava
Abstract
Intimal sarcomas simultaneously involving the right atrium and the
inferior vena cava are rare. We report an advanced cardiac intimal
sarcoma in the right atrium of a 19-year-old man that was complicated by
tumor-related inferior vena cava thrombosis. We initially performed
partial tumor resection and vena cava thrombectomy to resolve the
circulatory obstruction, because complete resection was difficult due to
the invading malignancy and an unclear margin. The patient received
adjuvant chemo- and radiotherapy along with anticoagulant therapy. After
3 months, the border of the residual sarcoma was clear, and the patient
underwent a secondary complete sarcoma excision (including that of the
right atrium) and a suprahepatic vena cava reconstruction. At the 2-year
follow-up, there was no tumor recurrence. We conclude that aggressive
treatment and a staged complete resection can lead to improved outcomes
for advanced cardiac intimal sarcoma with poor prognosis.