Cardiac Angiosarcoma in the Right Atrium Treated by Surgical Resection
Milica Dragicevic-Antonic1, Ljiljana Rankovic-Nicic1,2, Gordana Stamenkovic1
1Institute for Cardiovascular Diseases "Dedinje", 11000 Belgrade, Serbia.
Insights
This case study details a rare intracardiac angiosarcoma in a 49-year-old female. Early surgical intervention and vigilant monitoring are crucial for managing this aggressive cardiac tumor.
Area of Science:
- Cardiology
- Oncology
- Pathology
Background:
- Primary intracardiac angiosarcoma is a rare and aggressive malignancy.
- Early diagnosis and intervention are critical for patient outcomes.
Observation:
- A 49-year-old female presented with chest tightness, fatigue, and palpitations.
- Echocardiography revealed a right atrial mass, confirmed as high-grade angiosarcoma post-surgery.
- Recurrence with superimposed thrombus and Takotsubo cardiomyopathy were noted postoperatively.
Findings:
- Surgical excision and adjuvant chemotherapy with Paclitaxel were administered.
- Anticoagulation with Warfarin was initiated due to recurrent thrombus and cardiomyopathy.
- Cardiac MRI confirmed recurrent angiosarcoma with thrombus.
Implications:
- This case underscores the challenges in diagnosing and treating intracardiac angiosarcoma.
- Advanced imaging and meticulous postoperative surveillance are essential.
- Multidisciplinary management is key for optimizing care in complex cardiac tumor cases.
Abstract:
We present the case of a 49-year-old female of Caucasian European descent with chest tightness, fatigue, and palpitations, ultimately diagnosed with primary intracardiac angiosarcoma. Initial echocardiography revealed a significant mass within the right atrium, infiltrating the free wall. Surgical intervention included tumor excision and partial resection of the superior vena cava. Histopathological examination confirmed a high-grade angiosarcoma. Postoperative imaging identified a recurrent mass in the right atrium, suggestive of thrombus, alongside Takotsubo cardiomyopathy. Considering the elevated surgical risks and the presence of cardiomyopathy, management included anticoagulation therapy with Warfarin and adjuvant chemotherapy with Paclitaxel. Follow-up cardiac magnetic resonance imaging demonstrated a recurrent angiosarcoma with superimposed thrombus. This case presents the complex diagnostic and therapeutic landscape of angiosarcoma, highlighting the critical importance of early surgical intervention, advanced imaging techniques, and vigilant postoperative monitoring.
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