Intracardiac Echocardiography-Guided Biopsy for a Giant Cardiac Angiosarcoma with Extensive Invasion

Area of Science:

• Cardiology
• Oncology
• Medical Imaging

Background:

• Cardiac angiosarcoma is a rare, aggressive malignancy with poor prognosis.
• Early pathological diagnosis is crucial for effective treatment.
• The utility of intracardiac echocardiography (ICE)-guided biopsy for cardiac masses remains unclear.

Purpose of the Study:

• To describe the successful diagnosis of a giant cardiac angiosarcoma using ICE-guided biopsy.
• To evaluate the safety and efficacy of ICE-guided biopsy in a complex cardiac tumor case.

Main Methods:

• A 52-year-old male patient presented with a giant, hypervascular right atrial tumor with extensive invasion.
• Intracardiac echocardiography (ICE)-guided biopsy was performed using a steerable sheath due to high bleeding risk with other biopsy methods.
• Contrast-enhanced computed tomography (CT) was used for initial tumor characterization.

Main Results:

• The ICE-guided biopsy was performed without complications, yielding a diagnosis of angiosarcoma.
• Surgical resection confirmed a primary cardiac angiosarcoma confined to the pericardium.
• The patient is alive 7 months post-surgery after receiving chemotherapy and radiotherapy.

Conclusions:

• Intracardiac echocardiography (ICE)-guided biopsy with a steerable sheath is a safe and effective diagnostic tool for cardiac masses.
• This technique is particularly valuable for malignant cardiac tumors with extensive invasion, where other biopsy methods pose higher risks.