JACC. Case reports · 2026
Multimodality Cardiac Imaging and Multidisciplinary Collaboration in Monitoring Intracardiac Sarcoma Response to Immunotherapy.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Kocx Christopher, Geraghty Lucy, Rolfe Zara, McColl Hayden, Holloway Cameron, Bhadri Vivek, Karve Sameer, Liu Jia, Hunyor Imre
Аннотация
BACKGROUND: Intracardiac metastases causing right ventricular outflow tract obstruction are rare and carry a dismal prognosis. Immune checkpoint inhibitor (ICI) therapy risks immune-mediated pseudoprogression that could worsen hemodynamic obstruction.
CASE SUMMARY: A 40-year-old man with metastatic alveolar soft part sarcoma presented with dyspnea, pericardial effusion, and intracardiac masses causing significant right ventricular outflow tract obstruction. Cardiac magnetic resonance tissue characterization established a noninvasive diagnosis without endomyocardial biopsy. ICI therapy was delivered as an inpatient in a coronary care unit with continuous cardiology monitoring. Serial echocardiography demonstrated progressive reduction in mass size with relief of obstruction, and Cardiac magnetic resonance confirmed treatment response. More than 2 years later, he achieved complete metabolic response on positron emission tomography-computed tomography and remains well in active surveillance.
DISCUSSION: Multimodality imaging provides complementary hemodynamic, tissue-level, and metabolic surveillance essential for detecting pseudoprogression and confirming true treatment response in hemodynamically significant intracardiac tumors.
TAKE-HOME MESSAGE: Multidisciplinary cardio-oncology collaboration can enable safe ICI delivery and durable complete response in hemodynamically significant intracardiac metastatic disease.
CASE SUMMARY: A 40-year-old man with metastatic alveolar soft part sarcoma presented with dyspnea, pericardial effusion, and intracardiac masses causing significant right ventricular outflow tract obstruction. Cardiac magnetic resonance tissue characterization established a noninvasive diagnosis without endomyocardial biopsy. ICI therapy was delivered as an inpatient in a coronary care unit with continuous cardiology monitoring. Serial echocardiography demonstrated progressive reduction in mass size with relief of obstruction, and Cardiac magnetic resonance confirmed treatment response. More than 2 years later, he achieved complete metabolic response on positron emission tomography-computed tomography and remains well in active surveillance.
DISCUSSION: Multimodality imaging provides complementary hemodynamic, tissue-level, and metabolic surveillance essential for detecting pseudoprogression and confirming true treatment response in hemodynamically significant intracardiac tumors.
TAKE-HOME MESSAGE: Multidisciplinary cardio-oncology collaboration can enable safe ICI delivery and durable complete response in hemodynamically significant intracardiac metastatic disease.