February 2017	The patient was referred to the electrophysiology service for management of paroxysmal atrial fibrillation.
March 2017	An attempt at pulmonary vein isolation was attempted, but the procedure was aborted due to an extremely thick septum.
June 2017	Transoesophageal echocardiogram revealed a sheet-like mass lining the left atrium, suspicious for a thrombus.
June 2018	A cardiac magnetic resonance imaging (MRI) characterized a 4.7 × 1.3 cm mass in the atrium, believed to be an atrial myxoma.
January 2019	The patient underwent radical excision of the left atrial mass. She was discharged on postoperative day #6.
April 2019	Repeat cardiac MRI revealed complete resection of the left atrial mass, believed to be an organizing thrombus.
May 2020	The patient presented with back pain secondary to T10 and L1 pathological fractures. She underwent vertebral body biopsies and vertebroplasty. Initial pathology suggested a diagnosis of metastatic leiomyosarcoma.
June 2020	Repeat MRI revealed interval increase in the spinal canal encroachment at T10 and L1 vertebral bodies. She underwent surgical decompression and instrumental fusion of the affected vertebral levels.
August 2020	Pathological review of the left atrial mass and vertebral biopsies confirmed the diagnosis of high-grade intimal sarcoma.
September 2020	The patient underwent 6 weeks of stereotactic body radiation therapy.
February 2021	The patient presented with shortness of breath secondary to a large right pleural effusion. Repeat MRI shows progression of an anterior paraspinal soft tissue mass at the T10 and L1 level.
February 2021	The patient was started on an anthracycline-based chemotherapy regimen, including Adriamycin/Ifosfamide mesna for palliation.