209 Cardiac schwanoma: A case report

Soft tissues sarcomas are rare, and cardiac localization uncommon. We report here a case of invasive primary tumor of the heart, incompletely surgically resected and treated by postoperative radiation therapy. In January 1989, a 67 year old woman undergoes a right costal traumatism. In April 1989, a systematic chest X-ray is performed showing in the right side a diaphragmatic hernia and in the left cardiac side an opacity with an increase of the cardiac size. Clinical examination is negative. Echocardiography shows a pericardial effusion and an heterogenousmass near left ventricular cavity. Electrocardiogram is normal. The patient is operated on. A large infiltrating tumor arising from the left ventricular wall is incompletely removed The anatomopathological examination is in favour of low grade schwanoma with infiltration of the adjacent myocardium. Metastatic check-up shows no evidence of dissemination. Radiation therapy is administered to tumor bed: 45 Gy in 25 fractions, and 5 weeks using 25 MV photons. More than five years later, the patient is alive without evidence of recurrent disease or complication. Post-operative moderate doses of irradiation seem to be effective in the treatment of incompletely resected low grade cardiac schwanoma.