ANGIOSARCOMA OF THE HEART – CLINICAL CASE

Primary angiosarcoma of the heart, constituting 33% of primary heart malignancies in adults, refers to rare diseases with a difficult diagnosis. The article describes the case of primary angiosarcoma of the right atrium, diagnosed posthumously in a patient of 45 years old. The disease debuted in a previously healthy woman 45 years, 2 months before her death. There were episodes of sudden decrease in blood pressure with pain in the chest and short-term loss of consciousness, as well as moderate manifestations of heart failure (hydrothorax, small ascites, hydropericardium, hepatomegaly, leg shunting). The patient died suddenly, a pathologic study revealed an angiosarcoma of the right atrium with invasive growth, accompanied by inferior vena cava stenosis. Angiosarcoma of the heart should be included in a differential diagnosis of patient with pericardial effusion of unspecified genesis, syndromes of vena cava obstruction, unexplained right ventricular failure, syncope with a fall in blood pressure, especially in middle-aged patients.

1. Urba W., Longo D. Primary solid tumors of the heart. In: Kapoor A, editor. Cancer of the heart. New York, NY: Springer Verlag; 1986.

2. Lam K.Y., Dickens P., Chan A.C. Tumors of the heart. A 20-year experience with a review of 12,485 consecutive autopsies. Arch Pathol Lab Med. 1993;117:1027-31.

3. Isobe S., Murohara T. Cardiac tumors: Histopathological aspects and assessments with cardiac noninvasive imaging. J Cardiol Cases. 2015;12:37-8.

4. Castillo J.G., Silvay G., Boateng P. Characterization of surgical cardiac tumors. Bratisl Lek Listy. 2016;117(1):3-10.

5. Burke A., Tavora F. The 2015 WHO Classification of Tumors of the Heart and Pericardium. J Thorac Oncol. 2015;11(4):441-52.

6. Reynen K. Frequency of primary tumors of the heart. Am J Cardiol. 1996;77:107.

7. Shapiro L. Cardiac tumors: diagnosis and management. Heart. 2001;85:218-22.

8. Burke A., Virmani R. Tumor of the heart and great vessels. In: Atlas of tumor pathology. Washington, DC: Armed Force Institute of Pathology; 1996.

9. Chiles C., Woodard P.K., Gutierrez F.R., Link K.M. Metastatic involvement of the heart and pericardium: CT and MR imaging. Radiographics. 2001;21:439-49.

10. Bussani R., De-Giorgio F., Abbate A., Silvestri F. Cardiac metastases. Clin J Pathol. 2007;67:27-34.

11. Abraham K.P., Reddy V., Gattuso P. Neoplasms metastatic to the heart: review of 3314 consecutive autopsies. Am J Cardiovasc Pathol. 1990;3:195-8. 1

12. Kodali D., Seetharaman K. Primary Cardiac Angiosarcoma. Sarcoma 2006;2006:39130.

13. Randhawa K. Magnetic resonance imaging of cardiac tumors: Part 2. Malignant tumors and tumorlike conditions. Curr Probl Diagn Radiol. 2011;40:169-79.

14. Janigan D.T., Husain A., Robinson N.A. Cardiac angiosarcomas. A review and a case report. Cancer. 1986;57:852-9.

15. Bocklage T., Leslie K., Yousem S., Colby T. Extracutaneous angiosarcomas metastatic to the lungs: clinical and pathologic features of twenty-one cases. Mod Pathol. 2001;14(12):1216-25. 1

16. Kontogiorgi M., Exarchos D., Charitos C., et al. Primary right atrium angiosarcoma mimicking pericarditis. World J SurgOncol. 2007;5:120.

17. Strohl K.P. Angiosarcoma of the heart. A case study. Arch Intern Med. 1976;136:928-9.

18. Brandt R.R., Arnold R., Bohle R.M., et al. Cardiac angiosarcoma: Case report and review of the literature. Z Kardiol. 2005;94:824-8. 1

19. Kurian K.C., Weisshaar D., Parekh H., et al. Primary cardiac angiosarcoma: case report and review of the literature. Cardiovasc Pathol. 2006;15(2):110-2.