Right atrial rupture caused by primary cardiac angiosarcoma: A case report

Primary cardiac angiosarcoma is a rare malignant neoplasm of the heart. Clinical manifestations typically occur at an advanced stage, rendering early diagnosis challenging. Herein, we present the case of a young female patient with cardiac angiosarcoma complicated by atrial rupture.

The patient was a young woman who was admitted to the hospital after a sudden episode of syncope with loss of consciousness. Transthoracic echocardiography revealed a solid mass located in the anterolateral wall of the right atrium, accompanied by a large amount of pericardial effusion. Computed tomography and magnetic resonance imaging findings were suggestive of cardiac angiosarcoma. Consequently, the patient underwent resection of the malignant cardiac tumor and repair of cardiac rupture. Histopathological examination demonstrated tumor cells with abundant eosinophilic cytoplasm. Immunohistochemical analysis showed that the tumor cells were positive for CD31 and ERG.

Based on the clinical presentation, imaging findings, and immunophenotypic evidence, the patient was diagnosed with primary cardiac angiosarcoma.

The patient received regular postoperative chemotherapy.

After regular follow-up for 8 months, the patient was transferred to continue chemotherapy and died due to multiple metastatic tumors.

Primary cardiac angiosarcoma is a rare malignant cardiac tumor. Because clinical manifestations usually occur at an advanced stage, early diagnosis remains challenging. The comprehensive use of multiple imaging modalities is beneficial for accurate lesion identification, tumor staging, and thorough disease evaluation.