A primary cardiac sarcoma presenting with superior vena cava obstruction

• Published in: The American journal of emergency medicine Vol. 30; no. 1; pp. 264.e3 - 264.e5
• Main Authors: Thakker, Manish, Keteepe-Arachi, Tracey, Abbas, Ausami, Barker, Graham, Ruparelia, Neil, Kingston, Gearoid T., Parke, Timothy J.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 2012; Elsevier Limited
• Subjects: Airway management; Anesthesia; Blood pressure; Chemotherapy; Emergency; Emergency medical care; Family medical history; Fatal Outcome; Heart Neoplasms - complications; Heart Neoplasms - diagnostic imaging; Heart Neoplasms - pathology; Heart rate; Humans; Lung cancer; Lymphoma; Male; Middle Aged; Mortality; Myocardium - pathology; Sarcoma; Sarcoma - complications; Sarcoma - diagnostic imaging; Sarcoma - pathology; Superior Vena Cava Syndrome - diagnosis; Superior Vena Cava Syndrome - diagnostic imaging; Superior Vena Cava Syndrome - etiology; Surgery; Tomography, X-Ray Computed
• ISSN: 0735-6757; 1532-8171; 1532-8171
• DOI: 10.1016/j.ajem.2010.11.030

Superior vena cava (SVC) obstruction leads to a constellation of symptoms and signs that encompass the SVC syndrome. Today, malignancy accounts for 65% of all cases. The most common neoplastic causes are non–small cell lung cancer (50%), small cell lung cancer (25%), lymphoma, and metastasis. Primary cardiac tumors are an extremely rare cause of SVC obstruction. We describe the case of a 48-year-old man who presented with dyspnea, confusion, and facial swelling with cyanosis. The patient developed life-threatening airway obstruction after administration of anxiolytic. The diagnosis of SVC obstruction secondary to a primary cardiac sarcoma was established based on clinical, radiologic, and post-mortem findings. This is one of very few reported cases of a primary cardiac sarcoma causing SVC obstruction.