Right ventricular failure due to primary right ventricle osteosarcoma

A 68-year-old woman with symptoms of dyspnea and peripheral edema was referred to our hospital. Chest computed tomography (CT) scans revealed a huge mass occupying the pulmonary trunk and invading the right main pulmonary artery, with metastatic nodules in the left main and left lower pulmonary artery. She was given a diagnosis of pulmonary thromboembolism and was anticoagulated to no effect, which suggested a neoplasm. Palliative resection of the tumor was carried out even though she was in serious condition with right ventricular failure, liver congestion, renal dysfunction, and coagulopathy disorder. The histopathology, postoperative systemic CT scan, and bone scintigram provided a definitive diagnosis of a primary right ventricle osteosarcoma. Primary cardiac osteosarcoma has a poor prognosis, and this patient was at an advanced stage with pulmonary metastases. Surgical intervention should offer these patients significant palliation to relieve the clinical symptoms due to obstruction.