Pericardial Angiosarcoma: An Elusive Diagnosis

Ashley Silakoski Felecia Jinwala

doi:10.4172/2155-9880.1000390

Abstract

The diagnosis of pericardial angiosarcoma is rare. We present a 33 year-old man with recurrent hemorrhagic pericardial effusions ultimately diagnosed with pericardial angiosarcoma by surgical biopsy. This case report highlights the challenges in diagnosing primary pericardial malignancy.

Highlights

Primary cardiac tumors are exceedingly rare, with reports of primary pericardial tumors even more limited
Fewer than 30 case reports exist in the literature
Most patients had at least a mild pericardial effusion, though most were large and hemorrhagic

Summary

Introduction

Primary cardiac tumors are exceedingly rare, with reports of primary pericardial tumors even more limited. The diagnosis of pericardial angiosarcoma is difficult to make, since the presentation is generally non-specific and imaging modalities, such as echocardiography and computer tomography (CT) scan, are nonspecific. The most common presenting symptom is dyspnea caused by tamponade due to pericardial effusion or direct compression from the mass. The patient was readmitted for progressive dyspnea. Two days after his admission, the patient’s symptoms worsened and a repeat echocardiogram showed a thickened pericardium and a loculated effusion, which failed percutaneous drainage. A CT angiogram of the chest demonstrated markedly thickened pericardium and pericardial effusion (Figures 1A and 1B). He was taken to the operating room on hospital day four for re-do sternotomy and pericardiectomy.

Case Presentation

Discussion