Diagnostic Approach for the Primary Cardiac Angiosarcoma – A Case Report

Abstract

Background: We report a 25-year-old male who presented to an outside institution with progressive dyspnoea. He had increased jugular venous pressure and muffled heart sounds, suggesting a pericardial tamponade. A diagnosis of a cardiac angiosarcoma was put forward. Primary cardiac tumours are rare, and patients can present with constitutional symptoms, posing a diagnostic challenge. The objective of this report is to suggest a diagnostic standard for early recognition of these fatal tumours. Case presentation: A chest radiograph demonstrated an enlarged cardiac contour and signs of pericardial tamponade. Pericardiocentesis was performed, complicated by a pneumopericardium and the pericardial fluid was haemorrhagic and exudative. Echocardiography confirmed a right atrial mass featured by heterogeneous enhancement in subsequent chest computed tomography and magnetic resonance imaging concerning a sarcoma. No metastatic lesions were found. The tumour was excised completely, and the following echocardiogram indicated normokinetic biventricular function. Histological examination of the tumour cells confirmed the presence of a cardiac angiosarcoma. Patient was scheduled for combined chemotherapy following discharge. Conclusion: Primary cardiac angiosarcomas are difficult to diagnose due to the rarity of the tumour as well as the non-specific symptoms. An early diagnosis may help improve prognosis which emphasizes the importance of establishing a standard diagnostic protocol for such tumours.