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[A case of cardiac angiosarcoma with a pseudoaneurysm formed in the right coronary artery]
T Sawamura1, H Takiya, T Yamada
1Department of Thoracic Surgery, Gifu Prefectural Hospital, Japan.
Insights
A rare cardiac angiosarcoma case involved a pseudoaneurysm of the right coronary artery. Despite surgical repair, the patient experienced lung metastasis and succumbed two months post-operation.
Area of Science:
- Cardiovascular Pathology
- Surgical Oncology
Background:
- Cardiac angiosarcoma is a rare and aggressive malignancy.
- Superficial infiltration can present diagnostic challenges.
Observation:
- A 25-year-old male presented with recurrent cardiac tamponade and audible heart murmur.
- Imaging revealed a hen egg-sized pseudoaneurysm involving the proximal right coronary artery.
Findings:
- Intraoperative rupture of the pseudoaneurysm and right atrium occurred.
- Successful surgical repair included coronary bypass and equine pericardium graft.
- Pathological examination confirmed cardiac angiosarcoma.
Implications:
- This case highlights the aggressive nature of cardiac angiosarcoma.
- Early diagnosis and surgical intervention are critical, though prognosis remains poor.
- Metastasis to the lungs is a common and fatal complication.
Abstract:
A case of superficially infiltrating cardiac angiosarcoma damaging the right coronary artery and forming a pseudoaneurysm was studied. The patient was a 25-year-old male who had undergone cardiac tamponade twice in the past six months. Since heart murmur was audible in auscultation, thorough examination was performed. Cardioechography and cardiac angiography revealed a pseudoaneurysm of hen egg size involving the proximal right coronary artery. Although the pseudoaneurysm and right atrium ruptured during operation, a coronary bypass was placed and the right atrium was repaired with an equine pericardium. Angiosarcoma was identified by pathological examination of the excised specimen. The patient died two months after operation due to lung metastasis.