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A bleeding heart: case report and review of pericardial angiosarcoma
Ujjwal Madan1, Himil Mahadevia1, Parth Sharma1
1University of Missouri Kansas City, Division of Internal Medicine, Kansas City, MO, USA.
Autopsy & Case Reports
|May 28, 2024
Summary
Primary cardiac sarcomas, rare but aggressive tumors, present diagnostic challenges. Early detection and multimodal treatment, including imaging and therapy, are crucial for improving survival in patients with these rare heart tumors.
Area of Science:
- Cardiology
- Oncology
- Radiology
Background:
- Primary cardiac tumors are rare, with sarcomas being the most common malignant type.
- Cardiac sarcomas have a poor prognosis, with a median survival of approximately 25 months.
- Clinical presentations often include dyspnea, arrhythmias, and heart failure, mimicking other conditions.
Observation:
- A 30-year-old male with COVID-19 developed recurrent hemorrhagic pericardial effusions unresponsive to standard treatment.
- Diagnosis was confirmed as pericardial angiosarcoma via biopsy.
- Positron Emission Tomography-Computed Tomography with Fluorodeoxyglucose (PET-CT-FDG) scan was used for staging.
Findings:
- The case highlights the diagnostic difficulty of cardiac sarcomas, especially with atypical presentations.
- Recurrent hemorrhagic pericardial effusions, even with inflammatory cytology, warrant consideration of malignancy.
- Advanced imaging like cardiac CT and MRI are vital for diagnosis, staging, and treatment planning.
Implications:
- Early consideration of malignant etiology is critical for patients with unexplained or refractory symptoms.
- Multimodal treatment (surgery, chemotherapy, radiotherapy) offers improved outcomes compared to single-modality approaches.
- Timely diagnosis and intervention can potentially prolong survival for patients with cardiac sarcomas.
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