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[Cardiac angiosarcoma resected after definitive diagnosis by thoracoscope-assisted biopsy]
Tetsuyuki Ueda1, Masami Sotokawa, Minori Tateishi
1Department of Thoracic and Cardiovascular Surgery, Toyama Prefectural Central Hospital, Toyama, Japan.
Insights
A rare cardiac angiosarcoma case highlights diagnostic challenges. Early surgical resection is crucial for improving outcomes in patients with cardiac tumors.
Area of Science:
- Cardiology
- Oncology
- Thoracic Surgery
Background:
- Cardiac angiosarcoma is a rare and aggressive primary cardiac tumor.
- Early diagnosis and treatment are critical for patient survival.
Observation:
- A 31-year-old woman presented with cardiac tamponade due to an inhomogeneously-enhanced soft tissue mass.
- Contrast-enhanced chest computed tomography (CT) identified a mass adjacent to the right atrial wall.
- Thoracoscope-assisted biopsy confirmed the diagnosis of cardiac angiosarcoma.
Findings:
- Surgical resection and equine pericardium reconstruction were performed.
- Postoperative radiation therapy was administered.
- The patient experienced tumor recurrence with malignant ascites and died 177 days post-operation.
Implications:
- Thoracoscope-assisted biopsy, while useful for superficial cardiac tumors, carries a risk of tumor cell dissemination.
- Prompt surgical resection following pathological diagnosis is recommended for cardiac angiosarcoma to prevent recurrence and improve prognosis.
Abstract:
A 31-year-old woman presented with cardiac tamponade. Contrast-enhanced chest computed tomography(CT) revealed an inhomogeneously-enhanced soft tissue mass measuring 50×35×30 mm, which was in contact with the right atrial wall. The mass was definitely diagnosed as cardiac angiosarcoma by thoracoscope-assisted biopsy. The right atrial wall, including the tumor, was extensively resected, and then reconstructed with the equine pericardium. Postoperative radiation therapy was performed, but the patient developed malignant ascites with an intra-pericardial ectopic tumor recurrence. Additional radiation therapy was performed, but she died 177 days after the operation. Although thoracoscopeassisted biopsy is considered to be a useful diagnostic method for cardiac tumors on the surface of the heart, it carries the risk of spreading tumor cells. In the present case, the tumor should have been resected immediately after the prompt pathological diagnosis.
