Primary cardiac angiosarcoma evaluated with contrast two-dimensional and real-time three-dimensional echocardiography

Area of Science:

• Cardiology
• Oncology
• Medical Imaging

Background:

• Primary cardiac tumors are rare, with angiosarcoma being an aggressive malignancy.
• Early diagnosis is crucial for patient management and prognosis.

Observation:

• A 63-year-old female presented with syncope and atypical chest pain.
• Conventional 2D and contrast echocardiography identified a vascular mass compressing the right atrium.
• Real-time 3D echocardiography (RT3DE) provided detailed spatial and internal characteristics of the mass.
• Chest CT revealed a large cardiac mass and pulmonary nodules.

Findings:

• Histopathology confirmed primary cardiac angiosarcoma.
• The tumor was a 6 x 7 cm solid mass arising from the right atrium.
• Metastatic pulmonary nodules were also identified.

Implications:

• This is the first reported case of histology-confirmed primary cardiac angiosarcoma evaluated comprehensively with conventional 2D, contrast, and RT3DE.
• RT3DE offers valuable insights into the spatial relationships and internal heterogeneity of cardiac masses.
• Advanced imaging modalities are essential for the accurate diagnosis and characterization of rare cardiac tumors.