Abstract
Cardiac angiosarcomas are rare malignant tumors, predominantly affecting the right heart with poor survival outcomes. The current mainstay of treatment consists of surgery with or without chemotherapy, but often yields limited results with local relapse or metastatic recurrence. This case report describes 2 patients with primary angiosarcoma located in the right atrium. One patient received neo-adjuvant and adjuvant chemotherapy; both were scheduled for surgical resection. The course of disease is described followed by a comprehensive review of the literature.
Highlights
Primary cardiac tumors are extremely rare and are more frequently benign than malignant. [1] When malignant, the majority of them are lymphomas or sarcomas. [2] The Armed Forces Institute of Pathology Files reported 1 sarcoma among 533 primary cardiac tumors [3] and Burke et al [4] illustrated that of the 75 sarcomas diagnosed, 26 were angiosarcomas (35%)
This case report describes 2 patients with primary angiosarcoma located in the right atrium
Abdominal ultrasound confirmed the presence of ascites, without apparent signs of liver disease. It demonstrated an intracardiac mass which, on transoesophageal echocardiography (TOE), revealed to be a floating multilocular mass originating from the lateral wall of the right atrium responsible for a vena cava syndrome with obstruction of the tricuspid valve (Figure 1A)
Summary
Abdominal ultrasound confirmed the presence of ascites, without apparent signs of liver disease It demonstrated an intracardiac mass which, on transoesophageal echocardiography (TOE), revealed to be a floating multilocular mass originating from the lateral wall of the right atrium responsible for a vena cava syndrome with obstruction of the tricuspid valve (Figure 1A). An 88-year old Caucasian man with a past history of mitral valve annuloplasty (Carpentier-Edwards Physio II ring) was admitted with complaints of general discomfort, anorexia and dyspnea He had been treated with antibiotics for a bronchial infection, though without any clinical improvement. Histological examination of the fluid didn’t show atypical or malignant cells, nor signs of tumor recurrence Despite these reassuring findings relapsing pleural effusions occurred, treated by a thoracoscopic pleurodesis. Considering the advanced age, frailty and expected prognosis, he was referred for palliative care
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