Primary cardiac angiosarcoma: in a patient with a dacron aortic prosthesis
Nathan J Almeida1, Priscilla Hoang, Paul Biddle
1The Cardiac Center of Creighton University, Creighton University Medical Center, Omaha, Nebraska 68131, USA. nathan.almeida@cardiac.creighton.edu
Insights
This report details a rare primary cardiac angiosarcoma linked to a Dacron graft used for aortic dissection repair. Despite treatment options, the prognosis for this rare cancer remains poor.
Area of Science:
- Cardiovascular Pathology
- Surgical Oncology
- Medical Oncology
Background:
- Primary cardiac angiosarcomas are rare and aggressive tumors.
- Dacron prostheses are rarely associated with secondary neoplasia.
- Aortic dissection repair often involves synthetic grafts like Dacron.
Observation:
- A patient with a history of aortic dissection repair using a Dacron graft developed a primary cardiac angiosarcoma.
- The patient presented with extensive metastatic disease.
- This represents a potential, though rare, long-term complication of Dacron graft implantation.
Findings:
- This is the first reported case of primary cardiac angiosarcoma associated with a Dacron graft.
- The angiosarcoma likely arose in proximity to the Dacron prosthesis.
- Metastatic spread significantly impacts patient outcomes.
Implications:
- Highlights a rare but serious potential complication of synthetic vascular grafts.
- Suggests vigilance for neoplastic changes in patients with cardiovascular prostheses.
- Emphasizes the poor prognosis of advanced cardiac angiosarcoma, despite multimodal treatment including surgery, chemotherapy, radiotherapy, and transplantation.
Abstract:
This is a report of a primary cardiac angiosarcoma in a woman who, several years earlier, had undergone repair of an aortic dissection with a Dacron graft prosthesis. Dacron prostheses have rarely been associated with neoplasia, and this, to our knowledge, is the first reported case of primary cardiac angiosarcoma in association with Dacron. Our patient presented with extensive metastases. If tumors are localized, they can be treated successfully with a combination of surgical resection, chemotherapy, and radiotherapy. Cardiac transplantation can also be beneficial, but the overall prognosis remains poor.
