Management of device-related malignant sarcoma

Introduction With the globally increasing life expectancy and improved outcome of congenital heart disease, the number of cardiac device implantations is increasing steadily. A prolonged pacemaker (PM) therapy period is associated with potential long-term complications. Thereby battery and electrode longevity have not improved in the past decades, leading to recurrent device and electrode replacements. The combination of an increased PM indication and life expectancy possibly aggravates this effect. An increased frequency of device and electrode replacements leads to higher complication rates than de novo implantations. A rare complication after PM implantation is the development of malignant sarcomas. Previous studies demonstrated a slightly higher risk of cancer in PM recipients. In this report we present a case of an undifferentiated pleomorphic sarcoma surrounding PM electrodes during prolonged PM therapy and recurrent replacements. To our knowledge, this has not been reported so far.