Stanisław Ostrowski, Anna Marcinkiewicz, Anna Kośmider, Witold Pawłowski, Alicja Nowakowska, Ryszard Jaszewski overstatement of the concomitant mitral regurgitation [16]. Coexisting lymphadenopathy could be a neoplastic reaction [17], but also sarcoidosis cannot be excluded as a distinct clinical entity. Only the lower paratracheal lymph nodes showed increased metabolic activity in the PET examination, which could indicate the presence of cancer cells. The pericardial effusion present in our patient should be considered as a pericardial response [3]. Furthermore, it was also connected with advanced heart failure of grade 3/4. The remaining high level of inflammatory markers should be associated with both the continuing neoplastic process and cardiological disease. Documentary data have reported on the production of cytokines and their free receptors by tumour cells, which decides the systematic inflammatory signs occurrence and increase in inflammatory markers [6, 18]. Other sources, in turn, refer to the raised CRP level in the course of cardiac diseases, from heart failure to valvular defects [19-22]. It should be taken into consideration that in this case it was an inflammatory syndrome associated directly with paraneoplastic fibrohistiocytoma [23]. Pathogenesis and aetiology of MFH remain unclear. The prognosis is unfavourable, recurrences frequent, and adjuvant therapy ineffective [8]. In our patient it is difficult to identify with full certainty the origin of the tumour. Assuming that the primary lesion was located in the bone, and the diagnosis of fibrohistiocytoma was established, within the tumour tissue found in the heart an increase of the histopathological degree of sarcoma differentiation toward liposarcoma should have occurred. However, according to the histopathological diagnosis of tissue material from the heart, assuming that the primary lesion was located there, the correct diagnosis is liposarcoma, which had dediffe- rentiated to pleomorphic sarcoma, resembling MFH, and gave metastases. It is worth mentioning that diagnosed in the tissue material, excised from the heart, liposarcoma is one of the tumours most often becoming dedifferentiated. However, the pathomorphological presentation takes on the characteristics of malignant fibrous histiocytoma [24], the selection of which as a distinct nosological entity is currently questionable [25]. Taking into consideration the left-sided tumour location, one would rather suspect the primary cardiac sarcoma, because the right handed tumour location in the heart is more typical of metastases [26]. In the literature, there are only seven cases of primary cardiac sarcoma giving bone metastases [27]. In conclusion, the patient diagnosed and treated in our clinic is an example of a unique tumour localization in the heart chambers and at the base of the anterior leaflet. Previous findings do not suggest, however, considerable differences in the length of survival of patients with malignant tumours, depending on the chosen route of treatment [28, 29]. Mortality within 8 months after the surgery is estimated at 50% [3]. Semi- annual observation of our patient proves the correctness of the intraoperative decision. It shows effectiveness of the pharmacological and oncological therapy, continued after the surgical procedure. Each case manifesting unspecific symptoms should be subjected to differential diagnosis, including the now widely available tests TTE and TEE. The diagnostics should be followed by CT (MRI) in reasonable cases. R e f e r e n c e s 1. Haponiuk I, Skalski JH, Wronecki K. Guzy serca. In: Kardiochirurgia dziecięca. Skalski JH, Religa Z (eds). 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