Rapid Development of Primary Right Atrial Angiosarcoma

TL;DR

This paper reports a rare case of primary right atrial angiosarcoma in a 58-year-old male, highlighting the challenges in diagnosis and the importance of immunohistochemistry for confirmation.

Contribution

The paper presents a novel case study emphasizing the need for frequent malignancy screening in pericardial and pleural fluid analysis.

Findings

A 58-year-old male was diagnosed with a primary right atrial angiosarcoma after surgical resection and immunohistochemistry.

The tumor was heavily vascularized by the right coronary artery and left circumflex.

Exudative fluid analysis may help in early detection of malignancy when combined with patient history and symptoms.

Abstract

Cardiac angiosarcomas are rare and generally followed by a high level of metastasis with poor median survival outcomes. Echocardiograms, CT scans, and MRIs are the standard methods for finding sites of cardiac tumors; however, immunohistochemical confirmation is necessary for a definitive diagnosis of angiosarcoma. A 58-year-old male presented to the emergency room with one week of dyspnea on moderate exertion accompanied by chest pain and alleviated with rest. A workup done to evaluate mass found a single 5 x 3.5 x 4.8 cm mass heavily vascularized by the right coronary artery and left circumflex involving the free wall of the right atrium with no extension to the tricuspid valve. Surgical resection was performed, and immunohistochemistry was consistent with a primary cardiac angiosarcoma. An exudative fluid analysis on pericardial and pleural fluid analysis may warrant screening for malignancy more frequently in concurrence with a patient’s history and presentation. Although the time from onset of symptoms to diagnosis of cardiac angiosarcoma is not well established, further investigation of such correlation may offer insight into survival post-treatment.

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