En-bloc resection and superior vena cava: right atrial reconstruction for chondrosarcoma infiltrating to superior vena cava and right heart

A 41-year-old lady presented with superior vena cava obstruction (SVCO) and impending right ventricular inflow tract obstruction resulted from recurrent chondrosarcoma with transvenous extension into the superior vena cava (SVC), right atrium (RA) and right ventricle (RV). She underwent en-bloc resection of the intracardiac and intravascular tumor together with right forequarter amputation, followed by SVC and RA reconstruction using autologous pericardium combined with Cormatrix (R), an acellular bioscaffold. She experienced significant symptomatic relief and good quality of life before her demise due to pneumonia 4 months after surgery. This is the first reported case of successful resection of transvenous extension of chondrosarcoma into the heart. Aggressive cardiac surgery for intra-cardiac extension of tumors is feasible to prevent imminent cardiac cause of death, provided that patient has good performance status and cardiac function, favourable anatomy and lack of other treatment options.