{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T09:13:08Z","timestamp":1776417188716,"version":"3.51.2"},"reference-count":10,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T00:00:00Z","timestamp":1773964800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Primary cardiac intimal sarcoma is an exceptionally rare and aggressive malignant tumour that often mimics benign cardiac lesions, particularly atrial myxoma. Accurate diagnosis requires multimodality imaging and histopathological confirmation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case summary<\/jats:title>\n                    <jats:p>A 58-year-old woman presented with palpitations, exertional dyspnoea, and recurrent syncope. Echocardiography and CT revealed a large, polypoid left atrial mass attached to the interatrial septum, initially suggestive of atrial myxoma. Due to haemodynamic compromise, urgent surgical resection was performed. Histopathology demonstrated a high-grade intimal sarcoma with myxoid stroma and MDM2 gene amplification. Initial staging showed no metastases; however, tumour recurrence in the left atrium occurred within 2 months. Cardiac MRI confirmed recurrent disease with delayed enhancement. Despite chemotherapy and subsequent radiotherapy for brain metastases, the tumour progressed, and the patient died 7 months after diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This case highlights the diagnostic challenge of distinguishing benign from malignant cardiac tumours when echocardiography and computed tomography are used in isolation. Although echocardiography is the first-line modality for detecting cardiac masses, it provides limited tissue characterization, and CT offers limited soft-tissue contrast with non-specific enhancement patterns. In contrast, cardiac magnetic resonance imaging provides superior soft-tissue resolution and multiparametric tissue characterization, allowing identification of heterogeneous signal intensity, necrosis, and infiltrative margins that favour malignancy. In this case, CMR findings supported the diagnosis of intimal sarcoma rather than myxoma. Given the aggressive biology and poor prognosis of intimal sarcoma despite multimodal therapy, early multidisciplinary evaluation in a specialized cardio-oncology centre is essential.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytag223","type":"journal-article","created":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T12:40:05Z","timestamp":1773924005000},"source":"Crossref","is-referenced-by-count":0,"title":["Essential role of multimodality imaging in the diagnosis of a rare high-grade primary cardiac intimal sarcoma"],"prefix":"10.1093","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-3430-4278","authenticated-orcid":false,"given":"Mohamud A","family":"Mohamud","sequence":"first","affiliation":[{"name":"Inova Schar Heart and Vascular Institute, Inova Fairfax Hospital , 3300 Gallows Rd, Falls Church, VA 22042 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Axucillia","family":"Moyo","sequence":"additional","affiliation":[{"name":"Inova Schar Heart and Vascular Institute, Inova Fairfax Hospital , 3300 Gallows Rd, Falls Church, VA 22042 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kunal","family":"Kothari","sequence":"additional","affiliation":[{"name":"Inova Schar Heart and Vascular Institute, Inova Fairfax Hospital , 3300 Gallows Rd, Falls Church, VA 22042 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rui","family":"He","sequence":"additional","affiliation":[{"name":"Inova Schar Heart and Vascular Institute, Inova Fairfax Hospital , 3300 Gallows Rd, Falls Church, VA 22042 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-9780-098X","authenticated-orcid":false,"given":"Qiong","family":"Zhao","sequence":"additional","affiliation":[{"name":"Inova Schar Heart and Vascular Institute, Inova Fairfax Hospital , 3300 Gallows Rd, Falls Church, VA 22042 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2026,3,20]]},"reference":[{"key":"2026041704174532300_ytag223-B1","doi-asserted-by":"crossref","first-page":"919","DOI":"10.1007\/s00428-022-03293-9","article-title":"Myxoid type and non-myxoid type of intimal sarcoma in large vessels and heart: review of histological and genetic profiles of 20 cases","volume":"480","author":"Yamada","year":"2022","journal-title":"Virchows Arch"},{"key":"2026041704174532300_ytag223-B2","doi-asserted-by":"crossref","first-page":"2122","DOI":"10.1038\/s41379-021-00874-y","article-title":"Intimal sarcomas and undifferentiated cardiac sarcomas carry mutually exclusive MDM2, MDM4, and CDK6 amplifications and share a common DNA methylation signature","volume":"34","author":"Koelsche","year":"2021","journal-title":"Mod Pathol"},{"key":"2026041704174532300_ytag223-B3","first-page":"bcr-2018-226073","article-title":"Primary undifferentiated pleomorphic cardiac sarcoma with MDM2 amplification presenting as acute left-sided heart failure","volume":"2018","author":"Watson","year":"2018","journal-title":"Case Rep"},{"key":"2026041704174532300_ytag223-B4","author":"Travis"},{"key":"2026041704174532300_ytag223-B5","doi-asserted-by":"crossref","first-page":"925","DOI":"10.1016\/j.ejcts.2006.03.034","article-title":"Primary cardiac sarcoma","volume":"29","author":"Shanmugam","year":"2006","journal-title":"Eur J Cardiothorac Surg"},{"key":"2026041704174532300_ytag223-B6","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1016\/j.jtcvs.2019.12.109","article-title":"Survival outcomes in patients with primary cardiac sarcoma in the United States","volume":"162","author":"Yin","year":"2021","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2026041704174532300_ytag223-B7","doi-asserted-by":"crossref","first-page":"1089636","DOI":"10.3389\/fcvm.2023.1089636","article-title":"Case report: the diagnostic challenge of primary cardiac intimal sarcoma","volume":"10","author":"Ye","year":"2023","journal-title":"Front Cardiovasc Med"},{"key":"2026041704174532300_ytag223-B8","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1002\/cam4.1897","article-title":"Primary cardiac sarcomas: a multi-national retrospective review","volume":"8","author":"Chen","year":"2019","journal-title":"Cancer Med"},{"key":"2026041704174532300_ytag223-B9","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1080\/14737140.2020.1711738","article-title":"Current clinical management of primary cardiac sarcoma","volume":"20","author":"Siontis","year":"2020","journal-title":"Expert Rev Anticancer Ther"},{"key":"2026041704174532300_ytag223-B10","doi-asserted-by":"crossref","first-page":"828","DOI":"10.1016\/j.jtcvs.2021.10.070","article-title":"Primary cardiac sarcomas: treatment strategies","volume":"166","author":"Chan","year":"2023","journal-title":"J Thorac Cardiovasc Surg"}],"container-title":["European Heart Journal - 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