Primary chondroblastic osteosarcoma of the mitral valve without metastasis

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Abstract

Primary osteosarcomas of the heart are extremely rare entities, with common subtypes including osteoblastic, chondroblastic and fibroblastic subtypes. We describe a case of a 53-year-old female with history of treated breast cancer who presented with progressive dyspnea on exertion. A pulmonary artery protocol CTA demonstrated an anterior mitral leaflet lobulated mass without an osteoid or chondroid matrix. Additional cross-sectional imaging demonstrated no evidence of distant metastasis. The mass was surgically excised with pathology demonstrating a malignant neoplasm with spindle cells, bone, cartilage and rare osteoid, most consistent with a high grade chondroblastic osteosarcoma. After the expected postsurgical recovery, the patient was initiated on adjuvant therapy consisting of ifosfamide and etoposide and is currently disease free for 9 years now. Review of literature demonstrates that cardiac primary osteosarcomas typically involve the left atrium. Imaging usually shows a lobulated or irregular mass with heterogenous attenuation/enhancement and, counterintuitively, a lack of a calcified matrix. Complete surgical excision is challenging leading to poor prognosis, even in cases undergoing post-surgical chemotherapy. Median survival has been reported as about 20 months.

Original languageEnglish (US)
Pages (from-to)1041-1043
Number of pages3
JournalRadiology Case Reports
Volume17
Issue number4
DOIs
StatePublished - Apr 2022

Keywords

  • Extraosseous primary osteosarcoma
  • Mitral valve
  • Primary chondroblastic osteosarcoma

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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