Primary Cardiac Angiosarcoma: A Rare and Fatal Diagnosis

Gonçalves, Inês Corrêa; Nunes, C. R. F.; Vieira, Catarina; Freitas, Diana; Pinto, Luísa Serpa

doi:10.7759/cureus.20816

Cited by 5 publications

(6 citation statements)

References 17 publications

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“…Other sites of metastasis include the liver, adrenal glands, spleen and bones, while metastases to the brain are exceptionally rare. [2,3,8] Regarding the patient's initial presentation, she initially sought care at the neurology department of an external hospital due to dizziness, along with accompanying nausea and vomiting. Brain magnetic resonance imaging (MRI) revealed no abnormal density within the brain parenchyma.…”

Section: Discussionmentioning

confidence: 99%

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The diagnosis and treatment for primary cardiac angiosarcoma with N-ras gene mutation and MSI-L: A case report and review of the literature

Sun,

Wei,

Sun

et al. 2023

Medicine

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Rationale: Primary cardiac angiosarcomas (PCA) is a rare malignancy with a poor prognosis. Currently, there is no standard treatment protocol for the PCA. We report a case of PCA in a 51-year-old woman. Patient concerns: A 51-year-old woman initially presented with unexplained palpitations and chest tightness accompanied by nausea and vomiting, which worsened after activity and improved after rest. After symptomatic treatment, the symptoms improved, and the above symptoms recurred 8 months later. Diagnoses: Positron emission tomography-computed tomography revealed multiple lung nodules of varying sizes, some of which exhibited increased glucose metabolism. Furthermore, a soft tissue mass protruding into the pericardial cavity and involving the adjacent right atrium was observed in the right pericardium. The mass exhibited increased glucose metabolism, suggestive of a pericardial tumor with multiple lung metastases. Finally, histopathologic diagnosis of metastatic angiosarcoma was done by computed tomography-guided percutaneous lung and mediastinal biopsy. Interventions: The patient was treated with palliative chemotherapy for the primary cardiac angiosarcomas and hematogenous lung metastasis. One cycle later, the result of Next-Generation Sequencing showed that the microsatellite instability status was determined to be low-level. Based on this result, tislelizumab was added to the original chemotherapy regimen. Outcomes: Unfortunately, the patient with PCA passed away after only 2 cycles of chemotherapy, and the cause of death remained unknown. Lessons: This case report well demonstrates typical imaging findings of a rare cardiac angiosarcomas and emphasizes importance of early investigation for accurate diagnosis and proper management of the cardiac angiosarcomas.

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Section: Discussionmentioning

confidence: 99%

“…Other sites of metastasis include the liver, adrenal glands, spleen and bones, while metastases to the brain are exceptionally rare. [ 2 , 3 , 8 ]…”

Section: Discussionmentioning

confidence: 99%

The diagnosis and treatment for primary cardiac angiosarcoma with N-ras gene mutation and MSI-L: A case report and review of the literature

Sun,

Wei,

Sun

et al. 2023

Medicine

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“…Diagnosing cardiac neoplasms can be challenging due to the non-specific clinical manifestations and low index of suspicion (due to its low incidence). Transthoracic echocardiography (TTE) and transoesophageal echocardiography (TEE) are the main diagnostic tools, with TEE being more sensitive (98%) than TTE (75%) 14. These imaging techniques allow for the evaluation of tumour size, degree of infiltration and extent.…”

Section: Discussionmentioning

confidence: 99%

“…Cardiac MRI with contrast is the primary imaging modality for characterising cardiac masses, allowing for the assessment of the extension and vascularisation 3 14. CT and PET/CT (positron emission tomography) scans are also valuable in identifying potential metastases 15…”

Section: Discussionmentioning

confidence: 99%

Primary cardiac angiosarcoma presenting with haemoptysis

Tolentino-de la Mora,

Verdugo-Carrión,

Vázquez-Castro

et al. 2023

BMJ Case Rep

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A male patient in his 30s presented to the emergency room with a 1-week history of dyspnoea that progressed to haemoptysis, having coughed up approximately 200 mL of blood on two occasions. On diagnostic investigation, a mediastinal tumour infiltrating the free wall of the right atrium and multiple pulmonary nodules were discovered. The first suspicion was a neoplasm of pulmonary origin, and a bronchoscopy was performed, histology reported a probable cardiac origin for the neoplasm. A subsequent biopsy confirmed the presence of a primary cardiac angiosarcoma. An extension CT scan revealed brain metastases. The patient received chemotherapy treatment, resulting in a partial response to date. This case is one of the few reported instances of cardiac neoplasm presenting with respiratory symptoms.

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“…A dispneia persistente e o desconforto torácico sem origem específica em pacientes jovens podem nos levar ao diagnóstico de tumor. 19 No entanto, tumores cardíacos também devem ser considerados em pacientes idosos. Linfeng et al, 20 descreveram um homem de 65 anos com quadro de dispneia indeterminada, desconforto torácico, tontura e fraqueza em membros inferiores, finalmente diagnosticado como angiossarcoma.…”

Section: Discussionunclassified