Rapidly growing angiosarcoma of the pericardium presenting as hemorrhagic pericardial effusion

Primary angiosarcoma of the heart is exceptionally rare. Angiosarcoma of the heart often go undetected until late in the course of the disease as symptoms are insidious and available non-invasive imaging modalities lack specificity. Recently, we experienced an angiosarcoma of the pericardium that presented hemorrhagic pericardial effusion initially, but progressed rapidly during short period. Our case showed that, when initial diagnosis is not clear, early aggressive diagnostic modality such as surgical exploration or more frequent follow-up examination is needed for earlier detection and chance of targeted therapy. Of particular, unexplained bloody pericardial effusion as observed in our patient should prompt the clinician to continue to search for a malignant etiology for improving survival in this fatal cancer.