Malignant solitary fibrous tumor of the right atrium.

Cardiac solitary fibrous tumors (SFTs) are extremely rare, with only 4 cases described to date. Here, we describe the case of a 55-year-old man with a primary, malignant SFT that arose in the right atrium of his heart. His presenting complaint was of chest distress and shortness of breath. Physical examination revealed jugular venous engorgement. Computed tomography showed a tumor of 15 × 10 × 8 cm in the anterior mediastinum. The tumor was surgically resected under cardiopulmonary bypass. A grayish white neoplasm was discovered lying within the right atrium. The histological appearance of the tumor was of a hypercellular distribution of spindle cells with nuclear atypia, arranged in a storiform pattern and intermixed with collagenous stroma. Immunohistochemistry showed that the tumor was positive for CD34. Based on the aforementioned features, the diagnosis of malignant SFT was made. The patient subsequently died as a result of respiratory and circulatory failure.