CASE REPORT article
Front. Oncol.
Sec. Radiation Oncology
Case Report: Adjuvant Radiation Therapy for Cardiac Intimal Sarcoma With Long-Term Disease Control
Ariel Rosa 1
John Roubil 2
Raj Singh 3
Elisabeth Weiss 2
Navid Fallahi 2
Andrew Poklepovic 2
1. Virginia Commonwealth University, Richmond, United States
2. Virginia Commonwealth University Massey Comprehensive Cancer Center, Richmond, United States
3. The Ohio State University Arthur G James Cancer Hospital and Richard J Solove Research Institute, Columbus, United States
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Abstract
Cardiac intimal sarcomas (CIS) are rare, aggressive primary cardiac malignancies with limited data guiding adjuvant treatment. We report a case of a 40-year-old woman with bi-atrial CIS who underwent bi-atrial resection and mitral valve replacement, with pathology confirming an MDM2-amplified intimal sarcoma and positive margins (R1). She received four cycles of adjuvant chemotherapy followed by adjuvant radiation therapy (RT) delivered using volumetric modulated arc therapy (VMAT), planned with four-dimensional computed tomography to account for respiratory motion, to a total dose of 60 Gy with a 6 Gy sequential boost. Treatment was well tolerated, with only grade 1–2 acute toxicities that resolved by completion of therapy. At 33 months following completion of RT and 41 months from diagnosis, the patient remains alive and disease-free without evidence of recurrence or significant late toxicity. This case supports the feasibility of incorporating adjuvant RT into a multimodal treatment approach for CIS and suggests that advanced radiation planning techniques may allow safe delivery of curative-intent doses to the heart, although further studies are needed to define its role in this rare malignancy.
Summary
Keywords
Adjuvant radiation therapy, Cardiac intimal sarcomas, CIS, VMAT, volumetric modulated arc therapy
Received
20 December 2025
Accepted
16 February 2026
Copyright
© 2026 Rosa, Roubil, Singh, Weiss, Fallahi and Poklepovic. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Ariel Rosa
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