Recently a 23 years old Iraqi boy was referred to Metro Heart Institute with Multispecialty Faridabad with the diagnosis of Right Atrial Myxomas. Myxomas are benign tumors of atria, upper chamber of heart and do well after excision of tumor and carries good prognosis.
In this patient investigation suggests that there was a large blood collection around the heart & no clear cut site of origin of tumor could be established. Pericardium is a sac around the heart. These finding were not usual for myxoma so after thorough investigation & fitness, patient was taken up for surgery on 9th April 2018 by cardiothoracic team headed by Dr. (Brig) Sudeep Singh Sidhu. On opening the pericardium sac approximately 200 ml blood stains fluid was removed. After removal of fluid a large tumor appeared which was covering majority of the right atrium (heart upper right chamber). On visual examination there were deep invasion of tumor into wall of right atrium extending in right ventricle also. At one place the tumor had invaded entire thickness of atrial wall approaching pericardial sac leading to bleeding & collection of blood in the sac.
Invasion into the surrounding areas were so extensive & vascular that any attempt to remove tumor would have resulted in massive bleeding and possible loss of patient’s life.
So a part of it was taken as biopsy for Histopathological examination to establish the diagnosis as it was not looking simple myxoma.
Histopathological examination revealed that it was “Angiosarcoma” which is a rare cellular vascular tumor. It is a rare soft tissue sarcoma which originates from endothelium in the wall of capillaries (very tiny blood vessels). With the current scenario of extensive involvement of the vital structure by tumor and highly vascular nature of tumor it was decided in consultation with medical oncologist that radiotherapy or chemotherapy is the most appropriate and safe modality of treatment for this patient. However, part of the tumor blocking the flow of blood was removed which was most essential for his survival.
This was very unusual and challenging case for cardiothoracic team & one of the example where operative team took quick decision on finding this rare tumor said Dr. S.S Bansal, MD & Sr. Interventional cardiologist.
Text Box: We are very happy to have renowned heart surgeon, Dr. S.S Sidhu who was head of heart surgery in Army Hospital. He has already done many heart surgeries in Metro Hospital, Faridabad with 100% success rate.
Wrong decision could have been resulted in disastrous outcome so he appreciated timely interventions of operative team and their decision to partially remove it to save the patient and achieve a confirmatory diagnosis.