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[Diagnosis of a cardiac mass--a case report]
A Galrinho1, D Ferreira, J Loureiro
1Serviço de Cardiologia, Hospital Fernando Fonseca.
Insights
A rare cardiac angiosarcoma presented as a filamentous mass causing recurrent pericardial effusion. Diagnosis required a percutaneous biopsy after imaging failed to identify the cause.
Area of Science:
- Cardiology
- Oncology
- Pathology
Background:
- Recurrent pericardial effusion can be caused by various conditions, including cardiac tumors.
- Cardiac angiosarcomas are rare but aggressive malignancies originating from the heart lining.
Observation:
- A patient presented with recurrent pericardial effusion linked to an unusual, filamentous mass in the right atrium and surrounding the superior vena cava.
- Standard diagnostic imaging, including transesophageal echocardiography and magnetic resonance imaging, did not yield a definitive etiological diagnosis.
Findings:
- A percutaneous biopsy guided by transesophageal echocardiography was performed to obtain a tissue diagnosis.
- Histopathological examination confirmed the mass to be an angiosarcoma of the right atrium.
Implications:
- This case highlights the diagnostic challenges posed by rare cardiac tumors.
- Early and accurate diagnosis of cardiac angiosarcoma is crucial for appropriate management and improved patient outcomes.
- Further research into the optimal diagnostic and therapeutic strategies for cardiac angiosarcoma is warranted.
Abstract:
The authors describe a case of a recidivant pericardial effusion associated to a mass with an unusual, filamentous aspect that involved the upper part of right atrium and surrounded the upper vena cava. Despite the diagnostic techniques employed--transesophageal echocardiography and magnetic resonance imaging, the etiologic diagnosis could not be done, so a biopsy of the mass was made by percutaneous approach using transesophageal echocardiography to control the procedure. The histopathological result was an angiosarcoma of the right atrium. The authors make a brief review of the literature about this rare condition.