Pathology:
Histopathological examination of resected mass showed malignant
mesenchymal neoplasm composed of sheets and individual tumoral cells
embedded in a desmoplastic and collagenized stroma. These cells are
charactherized by enlarged, pleomorphic hyperchromatic and vesicular
nuclei with frequent mitotic figures and visible nucleoli. Necrosis and
hemorrhage are also present. Immunohistochemistry staining were negative
for S100 and CD34 but positive for vimentin, desmin, smooth muscle actin
(SMA), MNF116. In addition, about 15-20% with Ki67 also positive in
osteoclast like giant cells with CD68. (Figure 7) All this data shows
malignant mesenchymal neoplasm compatible with undifferentiated
pleomorphic sarcoma.
The patient referred to oncologist for chemotherapy. Just the day before
initiation of chemotherapy, TTE was done and recurrence of tumoral mass
(1.5*1.5 cm) was seen in distal part of RVOT just beneath PV. Patient
admitted in hospital for receiving Chemotherapy protocol with
carboplatin and taxotere (docetaxel) with close monitoring of cardiac
condition and hemodynamic. Unfortunately, after one course of
chemotherapy patient was died in hospital with cardiogenic shock because
of severe right sided heart failure.