Cor Vasa 2016, 58(5):e458-e465 | DOI: 10.1016/j.crvasa.2015.07.003

Inferior vena cava leiomyosarcoma with right atrium tumorous mass presenting as heart failure in a 70-year-old man: A case report

Pavel Kukla^a,*, Leoš Pleva^a,b, Martin Porzer^a,b, Radim Brát^c,b, Petr Handlos^d,b, Petr Buzrla^e,b, Jiří Plášek^a,b, Jan Mrozek^a,b, Miroslav Homza^a,b

^a Kardiovaskulární oddělení, Fakultní nemocnice Ostrava, Ostrava, Česká republika

^b Lékařská fakulta Ostravské univerzity v Ostravě, Ostrava, Česká republika

^c Kardiovaskulární centrum, Fakultní nemocnice Ostrava, Ostrava, Česká republika

^d Ústav soudního lékařství, Fakultní nemocnice Ostrava, Ostrava, Česká republika

^e Ústav patologie, Fakultní nemocnice Ostrava, Ostrava, Česká republika

Primary tumors of the heart and the inferior vena cava are relatively rare. The incidence of the former is 0.001-0.030%, while the frequency of metastatic tumors is 20-40 times higher. Out of the total number of primary cardiac tumors recorded, only about 10% are malignant, and a similar statement can be made about the inferior vena cava, i.e. most of these tumors are of secondary origin.
This paper reports the case of a Caucasian male, aged 70, with a recent history of visiting equatorial Africa, who was originally admitted for dyspnea due to cardiac failure, and was subsequently diagnosed with expansion in the region of the inferior vena cava and the right atrium. Due to a presumed thrombus, anticoagulative treatment was initiated. As the hemodynamic condition of the patient deteriorated further, predominantly in terms of right-sided heart failure, a surgical excision of the tumorous mass had to be performed. Despite the surgery, the patient died as a result of refractory right-sided heart failure.
The discussion herein contains an analysis of the incidence of and current treatment options for primary tumors of the inferior vena cava and the heart, including prognosis, based on up-to-date literature.

Keywords: Inferior vena cava; Primary cardiac tumors; Right atrium leiomyosarcoma; Surgical resection

Received: June 28, 2015; Revised: July 24, 2015; Accepted: July 26, 2015; Published: October 1, 2016  Show citation