[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-457202-105":59,"doc-detail-457202-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","primary-cardiac-myxofibrosarcoma-a-case-description-and-literature-review-of-a-highly-rare-entity","Primary cardiac myxofibrosarcoma: a case description and literature review of a highly rare entity","","Primary cardiac myxofibrosarcoma is an exceptionally rare cardiac sarcoma with aggressive local invasion, frequent distant metastasis, and poor prognosis. A retrospective clinical report describes a 50-year-old woman whose progressive cough and pink frothy sputum led to imaging findings of a left atrial mass with pulmonary involvement. Despite echocardiographic and CT features, the tumor initially mimicked cardiac myxoma, causing misdiagnosis. Surgical resection and histology with immunohistochemistry supported malignant myxofibrosarcoma (FNCLCC grade 2) and highlighted key clinical, imaging, and management considerations.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/primary-cardiac-myxofibrosarcoma-a-case-description-and-literature-review-of-a-highly-rare-entity/457202/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/primary-cardiac-myxofibrosarcoma-a-case-description-and-literature-review-of-a-highly-rare-entity/457202.png","ImageObject",300,407,{"name":92,"@type":93},"วิน","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-31","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":52},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Why is primary cardiac myxofibrosarcoma clinically challenging to diagnose?","Question",{"text":112,"@type":113},"Its presentation often mimics cardiac myxoma, which can lead to misdiagnosis and delays in appropriate management.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What imaging and clinical findings were described in the reported case?",{"text":117,"@type":113},"The patient had a left atrial hypodense lesion on CT and a dilated left atrium with a large, irregular tumor on echocardiography, along with concurrent bilateral pulmonary involvement suggestive of pulmonary edema.",{"name":119,"@type":110,"acceptedAnswer":120},"How was the diagnosis confirmed after resection?",{"text":121,"@type":113},"Histopathology showed spindle-shaped tumor cells with a mucoid matrix and branched blood vessels, and immunohistochemistry supported malignant myxofibrosarcoma with FNCLCC grade 2 features.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},457202,1790924590,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":52,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":44,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144,"preview_page_count":4},2336475104736,"https://ap-avatar.wpscdn.com/avatar/22000c4c5e0e5b17e70?x-image-process=image/resize,m_fixed,w_180,h_180&k=1786591360781797222","Letter to the Editor  \nPrimary cardiac myxofibrosarcoma: a case description and literature review of a highly rare entity  \nShan Wu1, Jiwei Wang1, Liangyun Guo1, Yanyan Ye1, Tao Huang2, Chen Liu1, Xi Li1  \n1Department of Ultrasound, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China; 2Department of Pathology, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China  \nCorrespondence to: Xi Li, MD. Department of Ultrasound, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, No. 1  \nMinde Road, Donghu District, Nanchang 330006, China. Email: [1181879765@qq.com](1181879765@qq.com).  \nSubmitted Jun 29, 2025. Accepted for publication Nov 11, 2025. Published online Dec 31, 2025.  \ndoi: 10.21037/qims-2025-1464  \nView this article at: [https://dx.doi.org/10.21037/qims-2025-1464](https://dx.doi.org/10.21037/qims-2025-1464)  \nIntroduction  \nPrimary cardiac tumors are rare (incidence of 0.0017– 0.33% in autopsy studies) and mostly benign (75%) (1) . Myxomas are the most common benign subtype, while sarcomas are the most frequent malignant type (2,3) . Primary cardiac myxofibrosarcoma is one of the rarest types of cardiac sarcoma and has only been described in a few isolated case reports (4) . Myxofibrosarcoma is marked by its aggressive local invasion and pronounced tendency for distant metastasis, resulting in a poor prognosis (5) . Several reports indicate that primary cardiac myxofibrosarcoma can metastasize to the brain, thoracic cavity, liver, and bones (6-9) . To our knowledge, we present the first report of a case in which primary cardiac myxofibrosarcoma metastasized to the adrenal glands. The clinical and imaging presentation of primary cardiac myxofibrosarcoma often mimics that of cardiac myxoma, frequently resulting in misdiagnosis and subsequent delays in appropriate management. In this report, we describe a case of primary cardiac myxofibrosarcoma being misdiagnosed as myxoma and describe its clinical characteristics, imaging features, histological features, and clinical management, aiming to enhance clinicians and radiologists understanding of this rare condition.  \nCase presentation  \nAll procedures described in this retrospective study were performed in accordance with the ethical standards of the relevant institutional and/or national research committee(s)  \nand with the Declaration of Helsinki and its subsequent amendments. The requirement for informed consent for the publication of this study and associated images was waived by the Ethics Management Committee of The Second Affiliated Hospital of Nanchang University. A 50-year-old woman presented with a 10-day history of progressive cough and sputum production of unknown etiology. Symptoms worsened to include pink frothy sputum during exacerbations, accompanied by chest tightness, palpitations, and fatigue. Since the onset of the disease, there was no fever, nausea, vomiting, or syncope. The patient had been in good physical condition and denied having a family history of cardiac tumors. Physical examination revealed a regular heart rhythm and a diastolic rumbling murmur in the apical region of the heart, bilateral coarse breath sounds, no crackles, and no pericardial fricative rub. The electrocardiogram (ECG) suggested sinus rhythm and prolonged QT interval. The N-terminal B-type natriuretic peptide precursor level was 1,497.00 pg/mL (normal range, 0–125 pg/mL) . Computed tomography (CT) plain scan imaging demonstrated a hypodense lesion within the left atrium, measuring up to 3.6 cm in maximum transverse diameter. Concurrent bilateral pulmonary involvement was observed with extensive patchy opacities, indicative of pulmonary edema. Echocardiography indicated that the left atrial cavity was dilated and had a slightly lower echogenic tumor measuring 6.6 cm × 3.7 cm. The tumor had a clear boundary, irregular shape, and uneven internal echogenicity. It prolapsed into ","cbCaimG0nPkDoGyV","https://ap.wps.com/l/cbCaimG0nPkDoGyV","pdf",3185989,"English","# Introduction\n# Case presentation","[{\"question\":\"Why is primary cardiac myxofibrosarcoma clinically challenging to diagnose?\",\"answer\":\"Its presentation often mimics cardiac myxoma, which can lead to misdiagnosis and delays in appropriate management.\"},{\"question\":\"What imaging and clinical findings were described in the reported case?\",\"answer\":\"The patient had a left atrial hypodense lesion on CT and a dilated left atrium with a large, irregular tumor on echocardiography, along with concurrent bilateral pulmonary involvement suggestive of pulmonary edema.\"},{\"question\":\"How was the diagnosis confirmed after resection?\",\"answer\":\"Histopathology showed spindle-shaped tumor cells with a mucoid matrix and branched blood vessels, and immunohistochemistry supported malignant myxofibrosarcoma with FNCLCC grade 2 features.\"}]","Primary cardiac myxofibrosarcoma: a case description and literature review of a highly rare entity | PDF",1790748601,23]