Cardiac Angiosarcoma: From Cardiac Tamponade to Ischaemic Stroke – A Diagnostic Challenge
  • Vanessa Meireles Chaves
    Department of Internal Medicine, Centro Hospitalar de S. João, Porto, Portugal
  • Catarina Pereira
    Department of Internal Medicine, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
  • Marta Andrade
    Department of Cardiothoracic Surgery, Centro Hospitalar de S. João, Porto, Portugal
  • Pedro von Hafe
    Department of Internal Medicine, Centro Hospitalar de S. João, Porto, Portugal
  • Jorge Almeida
    Department of Internal Medicine, Centro Hospitalar de S. João, Porto, Portugal

Keywords

Cardiac angiosarcoma, pericardial effusion, cardiac tamponade, pericardial biopsy, ischaemic stroke

Abstract

Cardiac angiosarcoma (CA) is the most common primary malignant heart tumour. Its atypical symptoms and rapidly progressive nature contribute to delayed diagnosis and poor outcome. We report the case of a 52-year-old woman admitted with a large pericardial effusion. An extensive study of the aetiology of the pericardial effusion was inconclusive. Two months later the patient returned with ischaemic stroke. An echocardiogram revealed a probable right atrium contained rupture. The patient was submitted to surgical correction but died 9 days later. Histology revealed an angiosarcoma. This case exemplifies the atypical presentation of CA and highlights the importance of a multimodal diagnostic work-up in patients with idiopathic pericardial effusion.

VIEW THE ENTIRE ARTICLE

References

  • Patel SD, Peterson A, Bartczak A, Lee S, Chojnowski S, Gajewski P, et al. Primary cardiac angiosarcoma – a review. Med Sci Monit 2014;20:103–109.

  • Look Hong NJ, Pandalai PK, Hornick JL, Shekar PS, Harmon DC, Chen YL, et al. Cardiac angiosarcoma management and outcomes: 20-year single-institution experience. Ann Surg Oncol 2012;19:2707–2715.

  • Wang M, Fu G, Jiang H, Zeng K, Hua P. Multimodality treatment for cardiac angiosarcoma. Intern Med 2014;53:1949–1953.

  • Yusuf SW, Hassan SA, Mouhayar E, Negi SI, Banchs J, O'Gara PT. Pericardial disease: a clinical review. Expert Rev Cardiovasc Ther 2016;14:525–539.

  • Adler Y, Charron P, Imazio M, Badano L, Barón-Esquivias G, Bogaert J, et al. 2015 ESC Guidelines for the diagnosis and management of pericardial diseases: The Task Force for the Diagnosis and Management of Pericardial Diseases of the European Society of Cardiology (ESC) Endorsed by: The European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J 2015;36:2921–2964.

  • Maisch B, Rupp H, Ristic A, Pankuweit S. Pericardioscopy and epi- and pericardial biopsy - a new window to the heart improving etiological diagnoses and permitting targeted intrapericardial therapy. Heart Fail Rev 2013;18:317–328.

  • Leduc C, Jenkins SM, Sukov WR, Rustin JG, Maleszewski JJ. Cardiac angiosarcoma: histopathologic, immunohistochemical, and cytogenetic analysis of 10 cases. Hum Pathol 2017;60:199–207.

    • Views: 1174
    HTML downloads: 101
    PDF downloads: 481

    Published: 2019-04-03
    Issue: Vol 6 No 4 (view)

    How to cite:
    1.
    Chaves VM, Pereira C, Andrade M, von Hafe P, Almeida J. Cardiac Angiosarcoma: From Cardiac Tamponade to Ischaemic Stroke – A Diagnostic Challenge. EJCRIM 2019;6 doi:10.12890/2019_001079.

    Most read articles by the same author(s)

    1 2 > >>