An Absolute Obstacle: Cardiac Metastasis of Synovial Sarcoma

Published:January 27, 2014DOI:
      Bilateral swelling of the lower extremities, a 25-lb (11.3-kg) weight gain, and abdominal distension were grim heralds for a 44-year-old man. He presented with a 2-month history of these symptoms but denied shortness of breath, orthopnea, chest pain, palpitations, or syncope. Two years earlier, the patient had been diagnosed with synovial sarcoma of the right shoulder, for which he underwent preoperative radiation, local resection, and chemotherapy. A year after the initial diagnosis, he required further chemotherapy for biopsy-proven metastatic disease to his lungs. His second course of treatment was complicated by glomerulonephritis from Henoch-Schönlein purpura and a central-catheter-related deep vein thrombosis of the upper extremity that required 6 months of anticoagulation. From that point on, he suffered from stage III chronic kidney disease and severe thrombocytopenia.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to The American Journal of Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Reynen K.
        Frequency of primary tumors of the heart.
        Am J Cardiol. 1996; 77: 107
        • Devbhandari M.P.
        • Meraj S.
        • Jones M.T.
        • Kadir I.
        • Bridgewater B.
        Primary cardiac sarcoma: reports of two cases and a review of current literature.
        J Cardiothorac Surg. 2007; 2: 34
        • Molina J.E.
        • Edwards J.E.
        • Ward H.B.
        Primary cardiac tumors: experience at the University of Minnesota. The Thoracic and cardiovascular surgeon.
        Thorac Cardiovasc Surg. 1990; 38: 183-191
        • Lam K.Y.
        • Dickens P.
        • Chan A.C.
        Tumors of the heart. A 20-year experience with a review of 12,485 consecutive autopsies.
        Arch Pathol Lab Med. 1993; 117: 1027-1031
        • Hallahan D.E.
        • Vogelzang N.J.
        • Borow K.M.
        • Bostwick D.G.
        • Simon M.A.
        Cardiac metastases from soft-tissue sarcomas.
        J Clin Oncol. 1986; 4: 1662-1669
        • Skubitz K.M.
        • D'Adamo D.R.
        Mayo Clin Proc. 2007; 82: 1409-1432
        • Eilber F.C.
        • Dry S.M.
        Diagnosis and management of synovial sarcoma.
        J Surg Oncol. 2008; 97: 314-320
        • Gulati G.
        • Sharma S.
        • Kothari S.S.
        • Juneja R.
        • Saxena A.
        • Talwar K.K.
        Comparison of echo and MRI in the imaging evaluation of intracardiac masses.
        Cardiovasc Iintervent Radiol. 2004; 27: 459-469
        • Bleiweis M.S.
        • Georgiou D.
        • Brundage B.H.
        Detection of intracardiac masses by ultrafast computed tomography.
        Am J Card Imaging. 1994; 8: 63-68
        • Rahbar K.
        • Seifarth H.
        • Schӓfers M.
        • et al.
        Differentiation of malignant and benign cardiac tumors using 18F-FDG PET/CT.
        J Nucl Med. 2012; 53: 856-863
        • Sleijfer S.
        • Ray-Coquard I.
        • Papai Z.
        • et al.
        Pazopanib, a multikinase angiogenesis inhibitor, in patients with relapsed or refractory advanced soft tissue sarcoma: a phase II study from the European Organisation for Research andTreatment of Cancer—soft tissue and bone sarcoma group (EORTC study 62043).
        J Clin Oncol. 2009; 27: 3126-3132