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Published on: July 17, 2013
[Cardiac angiosarcoma with diagnostic difficulty]
1Department of Thoracic Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Insights
This case study details a rare cardiac angiosarcoma in a young woman presenting with chest pain. Diagnostic imaging and the CA125 tumor marker aided in identifying and monitoring this right atrial malignancy.
Area of Science:
- Cardiology
- Oncology
- Pathology
Background:
- Cardiac angiosarcoma is a rare and aggressive malignancy.
- Early diagnosis is crucial for patient outcomes.
Observation:
- A 20-year-old woman presented with severe chest pain and dyspnea.
- Diagnostic imaging (CT, echocardiography, cinecardiography) revealed a right atrial tumor.
- Elevated CA125 tumor marker levels (293 U/ml) were noted.
Findings:
- A CT-guided transthoracic needle biopsy confirmed the diagnosis of cardiac angiosarcoma.
- Contrast-enhanced imaging improved visualization of tumor margins and cardiac structures.
- CA125 levels served as a valuable indicator of therapeutic response.
Implications:
- This case highlights the importance of a multidisciplinary approach in diagnosing rare cardiac tumors.
- CT-guided biopsy is a safe and effective method for definitive diagnosis.
- Monitoring CA125 may be beneficial for assessing treatment efficacy in cardiac angiosarcoma.
Abstract:
We report a case of cardiac angiosarcoma of the right atrium. A 20-year-old woman was admitted to the Kyoto Prefectural University of Medicine with severe chest pain and dyspnea. A cardiac tumor was diagnosed by computed tomography (CT), echocardiography, and cinecardiography. The tumor marker CA125 was 293 U/ml (normal : <35 U/ml). Therefore a CT-guided transthoracic needle biopsy under CT fluoroscopic guidance for definitive diagnosis was performed after obtaining the patient's informed consent. Pathohistologically, the tumor was diagnosed as a cardiac angiosarcoma. The use of an intravenous infusion of contrast material contributed greatly to clear visualization of the tumor margin and cardiac lumen and assisted in easily and correctly advancing the needle toward the tumor. Moreover, tumor marker CA125 was a good indicator of therapeutic efficacy.
