# A Rare Manifestation of Cardiac Myeloid Sarcoma

## TL;DR

This case report describes a rare cardiac tumor in a patient with a history of blood cancer, highlighting a new method for diagnosis.

## Contribution

The paper presents a novel use of the TLAB device for intracardiac biopsy in diagnosing cardiac myeloid sarcoma.

## Key findings

- A right atrial mass consistent with cardiac myeloid sarcoma was diagnosed using multimodal imaging and biopsy.
- The TLAB device enabled successful intracardiac biopsy for tissue diagnosis.
- The case highlights the importance of accurate diagnosis in managing this rare malignancy.

## Abstract

Cardiac myeloid sarcoma is a rare hematologic malignancy characterized by myeloid blasts invading cardiac tissue.

A 68-year-old man with myelodysplastic syndrome status post-allogeneic hematopoietic stem cell transplant presented with worsening dyspnea. He was hypoxic but remained hemodynamically stable. Computed tomography angiography chest revealed a large pericardial effusion, and transthoracic echocardiogram confirmed tamponade physiology. The patient underwent an emergent pericardial window, followed by further work-up, including computed tomography, transthoracic echocardiogram, cardiac magnetic resonance, and intracardiac biopsy with novel use of the TLAB device, which identified a right atrial mass consistent with cardiac myeloid sarcoma extending along the interventricular groove with superior vena cava stenosis.

Cardiac myeloid sarcoma is a rare primary cardiac malignancy with no established treatment guidelines, but multimodal imaging and accurate tissue diagnosis can help tailor therapy.

This case report illustrates a rare case of cardiac myeloid sarcoma and demonstrates feasibility of intracardiac biopsy with novel use of a TLAB device.