Mesh : Actins / genetics Aged Aged, 80 and over Biomarkers, Tumor / genetics Bone Neoplasms / diagnosis diagnostic imaging genetics secondary Brain Neoplasms / diagnosis diagnostic imaging genetics secondary Female Heart Atria / diagnostic imaging metabolism pathology Heart Neoplasms / diagnosis diagnostic imaging genetics pathology Humans Immunohistochemistry Liver Neoplasms / diagnosis diagnostic imaging genetics secondary Male Middle Aged Myocardium / metabolism pathology Neoplasms, Connective and Soft Tissue / diagnosis diagnostic imaging genetics secondary Pericytes / diagnostic imaging metabolism pathology Radiography Young Adult

来  源:   DOI:10.1097/PAI.0b013e3182598554   PDF(Sci-hub)

Abstract:
We report a case of malignant myopericytoma arising in the left atrium with brain, skeletal, and liver metastases, which, to our knowledge, is the first report of this rare entity in this anatomic location. A 52-year-old man presented with progressive blackening of his left field of vision. Magnetic resonance imaging and a computed tomography scan of the brain and thorax showed a heterogeneous mass in the right occipital lobe and a large left atrial floor mass. Excision of the atrial mass showed a circumscribed but unencapsulated malignant spindled neoplasm with a perivascular concentric cellular arrangement punctuated by sheets of tumor necrosis. The cells were round to spindled with eosinophilic cytoplasm and indistinct borders. Focally, the tumor infiltrated cardiac muscle. By immunohistochemistry, the cells were positive for smooth muscle actin and negative for desmin, H-Caldesmon, S-100, HMB-45, and Melan-A. The features were prototypic for malignant myopericytoma. Eight months after initial presentation, the patient is alive with metastatic disease.
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