PMC6476112_01
EKG on presentation demonstrating atrial fibrillation with rapid ventricular response.
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Electrocardiogram (EKG) showed supraventricular tachycardia and subsequently atrial fibrillation (Figure 1); there was no old EKG to compare.
Computed tomography of the chest demonstrating the mass in the left atrium.
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A Computed Tomography Pulmonary angiography study was negative for pulmonary emboli but revealed a left atrial mass (Figure 2).
Transesophageal echocardiogram (intraoperative) demonstrating the mass in the left atrium invading the interatrial septum.
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Transesophageal echocardiogram (Figure 3) in the OR demonstrated similar mass with multiple lobes and a broad base attached to the septum, encroaching into the right atrium, aortic root wall, base of the anterior mitral leaflet flowing to the mitral orifice in diastole also obstructing the right pulmonary vein seen in.
This histopathology illustrates multiple pleomorphic cells (tumor cells) from the partial resection of the left intimal sarcoma.
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Pathology (Figure 4) revealed intimal sarcoma evidenced by markers positive for MDM2, CDK4 gene, and KIT and PDGFRA amplification.