Cardiac Angiosarcoma in the Right Atrium Treated by Surgical Resection

TL;DR

A 49-year-old woman with a rare heart tumor underwent surgery and treatment, highlighting the challenges in diagnosing and managing cardiac angiosarcoma.

Contribution

This case study contributes a detailed clinical account of surgical and therapeutic approaches to a rare cardiac angiosarcoma.

Findings

Surgical resection of a right atrial angiosarcoma was performed with partial resection of the superior vena cava.

Postoperative imaging revealed recurrence and Takotsubo cardiomyopathy, managed with anticoagulation and chemotherapy.

The case emphasizes the importance of early intervention and advanced imaging in angiosarcoma management.

Abstract

We present the case of a 49-year-old female of Caucasian European descent with chest tightness, fatigue, and palpitations, ultimately diagnosed with primary intracardiac angiosarcoma. Initial echocardiography revealed a significant mass within the right atrium, infiltrating the free wall. Surgical intervention included tumor excision and partial resection of the superior vena cava. Histopathological examination confirmed a high-grade angiosarcoma. Postoperative imaging identified a recurrent mass in the right atrium, suggestive of thrombus, alongside Takotsubo cardiomyopathy. Considering the elevated surgical risks and the presence of cardiomyopathy, management included anticoagulation therapy with Warfarin and adjuvant chemotherapy with Paclitaxel. Follow-up cardiac magnetic resonance imaging demonstrated a recurrent angiosarcoma with superimposed thrombus. This case presents the complex diagnostic and therapeutic landscape of angiosarcoma, highlighting the critical importance of early surgical intervention, advanced imaging techniques, and vigilant postoperative monitoring.

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