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Right coronary artery-right atrium fistula in primary angiosarcoma of the heart
J Delgado Jiménez1, J Tascón Pérez, A Albarrán González
1Servicio de Cardiologia Hospital, 12 de Octubre, Universidad Complutense, Madrid, Spain.
Insights
A rare cardiac angiosarcoma presented as a continuous heart murmur. This unique case involved a paracardiac mass with coronary artery-to-right atrium fistulas, a presentation not previously documented.
Area of Science:
- Cardiovascular Pathology
- Surgical Oncology
- Diagnostic Imaging
Background:
- Cardiac tumors are rare, with angiosarcoma being an aggressive malignancy.
- Vascular malformations and fistulas in the heart are uncommon presentations.
Observation:
- A continuous murmur prompted investigation in a patient with a cardiac mass.
- Right coronary arteriography revealed a paracardiac mass with direct fistulous connections from a coronary artery to the right atrium.
Findings:
- Histological examination confirmed the diagnosis of angiosarcoma with a sinusoidal pattern.
- This represents the first reported instance of cardiac angiosarcoma presenting with coronary artery-to-right atrium fistulas.
Implications:
- Highlights the diverse and unusual clinical manifestations of cardiac angiosarcoma.
- Emphasizes the importance of advanced imaging in diagnosing rare cardiac masses and vascular anomalies.
- Suggests considering angiosarcoma in the differential diagnosis of cardiac murmurs associated with vascular fistulas.
Abstract:
We report a case of angiosarcoma of the heart, manifested as a continuous murmur. Right coronary arteriography disclosed a paracardiac mass with fistulas from the coronary vessel to the right atrium. Histologic study revealed this to be an angiosarcoma with sinusoidal pattern. To our knowledge, this is the first case of this kind of cardiac tumor presenting as a fistula from a coronary artery to the right atrium.