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Successful treatment of primary cardiac angiosarcoma with docetaxel and radiotherapy
Miki Nakamura-Horigome1, Jun Koyama, Takayuki Eizawa
1Division of Cardiovascular Medicine, Shinshu University School of Medicine. mikihori@hsp.md.shinshu-u.ac.jp
Insights
A primary cardiac angiosarcoma case highlights the effectiveness of combined docetaxel and radiotherapy. This treatment showed tumor regression and reduced metabolic activity, with no progression observed at 12 months.
Area of Science:
- Cardiology
- Oncology
- Nuclear Medicine
Background:
- Primary cardiac angiosarcoma is a rare and aggressive malignancy.
- Cardiac tamponade is a life-threatening complication requiring prompt management.
Observation:
- A 49-year-old male presented with primary cardiac angiosarcoma causing cardiac tamponade.
- Imaging revealed a right atrial mass, right ventricular thickening, and increased mediastinal/cardiac FDG uptake on PET scans.
Findings:
- Combination therapy with docetaxel and radiotherapy achieved minimal tumor regression and reduced FDG uptake on PET scans.
- The patient experienced radiation esophagitis but tolerated treatment well.
- No evidence of disease progression or metastasis was noted at 12 months post-diagnosis.
Implications:
- This case suggests that combination therapy may be a viable treatment option for primary cardiac angiosarcoma.
- FDG-PET imaging can be useful for monitoring treatment response in cardiac tumors.
- Further research is warranted to establish optimal treatment protocols for this rare condition.
Abstract:
A 49-year-old man was admitted for primary cardiac angiosarcoma with a cardiac tamponade. Transthoracic echocardiography and contrast-enhanced computed tomography scan demonstrated a large mass in the right atrium and thickening of the right ventricular wall. 18F-labeled deoxyglucose (FDG) positron emission tomography (PET) scan showed increased FDG uptake in the mediastinum and over the heart. The patient responded to combination therapy with docetaxel and radiotherapy and tolerated the treatment well, except for radiation esophagitis, which required a soft diet and resolved 1 month after treatment. This combination therapy resulted in a minimal response with slight regression in the tumor size, but FDG-PET initially showed an increase in FDG uptake by the tumor that was no longer seen after combination therapy. There is no evidence of progression or metastasis even at 12 months after diagnosis.
