Primary Angiosarcoma—A Rare Cause of Right Ventricular Outflow Tract Obstruction: Case Report and Literature Review

Omair, Mohammad; Calafiore, Paul; Lim, Ruth; McGiffin, David C.; Farouque, Omar; Jones, E.

doi:10.1016/j.case.2019.08.003

Cited by 3 publications

(6 citation statements)

References 12 publications

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“…It had this type of infiltration in another reported case [ 3 ]. It was reported in other locations, including the right atrium [ 6 , 7 ], the left atrium [ 4 ], the pericardium [ 7 ], the aorta [ 8 ], the ventricular outflow tract (RVOT) and main pulmonary artery (MPA) [ 5 ]. Angiosarcomas arising from saphenous vein femoropopliteal bypass grafts have also been reported [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

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Resection of primary cardiac angiosarcoma infiltrating the right atrioventricular junction and tricuspid valve: a case report

Bakr

AlKhalaf

Takriti

2021

J Cardiothorac Surg

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Background Primary cardiac tumours are extremely rare. Most of them are benign. Sarcomas account for 95% of the malignant tumours. Prognosis of primary cardiac angiosarcoma remains poor. Complete surgical resection is oftentimes hampered when there is extensive tumour involvement into important cardiac apparatus. We report a case of cardiac angiosarcoma of the right atrium and ventricle, infiltrating the right atrioventricular junction and tricuspid valve. Case presentation Initially, a 22-year-old man presented with dyspnoea. One year later, he had recurrent pericardial effusion. Afterwards, echocardiography revealed a large mass in the right atrium, expanding from the roof of the right atrium to the tricuspid valve. The mass was causing compression on the tricuspid valve, and another mass was seen in the right ventricle. Complete resection of the tumour was impossible. The mass was resected with the biggest possible margins. The right atrium was reconstructed using heterologous pericardium. The patient’s postoperative course was uneventful. Postoperative echocardiography showed a small mass remaining in the right side of the heart. Histopathology and immunohistochemistry confirmed the diagnosis of angiosarcoma. The patient underwent adjuvant chemotherapy and radiotherapy later on. He survived for 1 year and 5 days after the surgery. After a diagnosis of lung and brain metastases, he ended up on mechanical ventilation for 48 h and died. Conclusions Surgical resection combined with postoperative chemotherapy and radiotherapy is feasible even in patients with an advanced stage of cardiac angiosarcoma when it is impossible to perform complete surgical resection.

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Section: Discussionmentioning

confidence: 99%

“…Angiosarcomas arising from saphenous vein femoropopliteal bypass grafts have also been reported [ 9 ]. Primary angiosarcoma can be a rare cause of RVOT obstruction [ 5 ]. However, this was not seen in our case.…”

Section: Discussionmentioning

confidence: 99%

Resection of primary cardiac angiosarcoma infiltrating the right atrioventricular junction and tricuspid valve: a case report

Bakr

AlKhalaf

Takriti

2021

J Cardiothorac Surg

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“…Nearly 25% of primary cardiac tumors are malignant [ 54 ], with Cardiac Hemangiosarcoma being the most prevalent among them [ 55 ]. This malignancy predominantly affects the right heart and frequently invades the atrioventricular wall and valves [ 55 ].…”

Section: Echocardiography For the Evaluation Of Patients With Tumorsmentioning

confidence: 99%

Progress in the Use of Echocardiography in Patients with Tumors

Feng,

Guo,

et al. 2024

Rev. Cardiovasc. Med.

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Advances in cancer treatment have increased patient survival rates, shifting clinical focus towards minimizing treatment-related morbidity, including cardiovascular issues. Since echocardiography allows for a comprehensive non-invasive assessment at all cancer stages, it is well suited to monitor cardiovascular disease secondary to oncology treatment. This has earned it significant attention in the study of cardiac tumors and treatment-induced cardiac alterations. Ultrasound methods—ranging from transthoracic and transesophageal echocardiography to ultrasound diagnostic techniques including myocardial strain imaging, myocardial work indices, three-dimensional cardiac imaging—offer a holistic view of both the tumor and its treatment impact cardiac function. Stress echocardiography, myocardial contrast echocardiography, and myocardial acoustic angiography further augment this capability. Together, these echocardiographic techniques provide clinicians with early detection opportunities for cardiac damage, enabling timely interventions. As such, echocardiography continues to be instrumental in monitoring and managing the cardiovascular health of oncology patients, complementing efforts to optimize their overall treatment and survival outcomes.

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“…Angiosarcomas involving the RVOT are associated with an extremely poor prognosis due to their aggressive nature. 14 , 15 Because angiosarcomas can involve the right side of the heart or RVOT, presenting symptoms commonly include dyspnea and chest discomfort. 16 At the time of diagnosis, metastases are typically present and often involve the lung.…”

Section: Casementioning

confidence: 99%

“… 16 At the time of diagnosis, metastases are typically present and often involve the lung. 14 , 16 Angiosarcomas rapidly progress and culminate in death within weeks to months because of hemodynamic compromise (e.g., valvular obstruction), local invasion, or metastatic spread. Thus, early diagnosis is essential.…”

Section: Casementioning

confidence: 99%