Author + information
- Received December 17, 2010
- Accepted January 5, 2011
- Published online October 11, 2011.
A 38-year-old woman with a history of acute myeloid leukemia (AML) treated with chemotherapy and allogenic transplantation presented with recent onset of recurrent orthostatic syncope (∼20 episodes within the last month) and 4 subcutaneous nodular lesions. (A) Transthoracic echocardiography revealed an infiltrative mass involving the right ventricle (RV) and atrium (Online Video 1). (B) Cardiac magnetic resonance imaging showed massive infiltration of the RV free wall with obstruction of the RV inflow tract (Online Video 2). (C) Histopathologic assessment of a subcutaneous lesion established the diagnosis of extramedullary AML-granulocytic sarcoma. Salvage chemotherapy induced regression of the infiltrative lesions after 2 weeks and disappearance of symptoms. (D) Transthoracic echocardiography after 6 months shows no further infiltrative lesions (Online Video 3). Our case illustrates a rare localization of granulocytic sarcoma and an unusual clinical presentation with orthostatic syncopal episodes. LV = left ventricle.
- Received December 17, 2010.
- Accepted January 5, 2011.
- American College of Cardiology Foundation