Multimodality imaging in cardiac myxofibrosarcoma
A 55-year-old male patient presented with chest discomfort, cough, and dyspnoea which had worsened in the prior 5 days. He had no significant medical history. He had elevated serum biomarkers including CEA-125 (119 U/mL), CK (1855 U/L), CK-MB (124.2 µg/L), cTnI (25.4 µg/L), and NT-proBNP (1408 pg/mL). His ECG was a normal sinus rhythm with a normal rate. His echo showed a cardiac mass with small pericardial effusion. CT angiography imaging revealed a large space-occupying mass in the pericardium encasing the pulmonary trunk without the ability to further characterize the tissue composition of the mass. The patient underwent tumour resection and atrial reconstruction. Postoperative pathology and immunohistochemistry confirmed cardiac myxofibrosarcoma. HE staining showed the spindle tumour cells arranged in fascicular, whorled, and storiform pattern, with mild cytologic atypia and myxoid stroma.