Eur J Cardiothorac Surg 2004;25:650
© 2004 Elsevier Science NL
Images in cardio-thoracic surgery |
Osteoblastic chondrosarcoma with cardiac and pulmonary arterial extension
Jacques Kpodonu,
Malek G. Massad*,
Adriana Anderson,
Tapas K. Das Gupta
Division of Cardiothoracic Surgery, Department of Surgery, The University of Illinois at Chicago, MC 958, CSB Suite #417, 840 S. Wood St., Chicago, IL 60612, USA
Received 25 November 2003;
received in revised form 9 January 2004;
accepted 14 January 2004.
* Corresponding author. Tel.: +1-312-996-6215; fax: +1-312-996-2013
e-mail: mmassad{at}uic.edu
Key Words: Chondrosarcoma • Pelvis • Metastatic • Vena cava • Heart • Pulmonary artery
A 23-year-old woman with pelvic mass and leg edema was diagnosed with chondrosarcoma. CT scan demonstrated tumor extension into the right atrium and ventricle and pulmonary artery (Fig. 1)
. The tumor was removed on cardiopulmonary bypass through two incisions in the right atrium and main PA (Fig. 2)
.
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Fig. 1. CT scan of the chest with contrast demonstrates the radiolucent right atrial (a) and pulmonary arterial extensions (b) of the tumor (black arrows).
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Fig. 2. (a) Right atrial exposure of the tumor (white arrow) showing its direct attachment to the IVC. (b) Another intraoperative view shows the right atrial and the pulmonary arterial extensions of the tumor (white arrows). The pulmonary arterial extension was removed through a longitudinal pulmonary arteriotomy after obtaining distal control of the right and left pulmonary arteries to avoid distal dislodgment while cannulating the IVC. The tumor was mobile and not adherent to the cardiac chambers or the pulmonary artery. The pulmonary and tricuspid valves were preserved. Grossly, the tumor was multi-lobulated with firm glistening white cartilaginous consistency.
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