PDF(Pubmed)
Abstract：
BACKGROUND: Primary cardiac angiosarcomas are very rare and present aggressively with high rates of metastasis. Given the poor prognosis, particularly once disease has spread, early diagnosis and multidisciplinary treatment is essential.
METHODS: We present the case of a 46-year-old male who presented with chest pain, intermittent fevers, and dyspnea. Workup with computed tomography scan and transesophageal echocardiography demonstrated a right atrial pseudoaneurysm. Given the concern for rupture, the patient was taken to the operating room, where resection of the pseudoaneurysm and repair using a bovine pericardial patch was performed. Histopathology report initially demonstrated perivascular lymphocyte infiltrate. Six weeks later, the patient represented with chest pain and new word finding difficulty. Workup revealed multiple solid lung, pericardial, brain, and bone nodules. Eventual biopsy of a cardiophrenic nodule demonstrated angiosarcoma, and rereview of the original pathology slides confirmed the diagnosis of primary cardiac angiosarcoma.
CONCLUSIONS: Primary cardiac angiosarcomas are often misdiagnosed given the rarity of these tumors, but early diagnosis and initiation of treatment is essential. The unique presentation of our case demonstrates that clinical suspicion for cardiac angiosarcoma should be maintained for spontaneous pseudoaneurysm originating from the right atrium.
METHODS: We present the case of a 46-year-old male who presented with chest pain, intermittent fevers, and dyspnea. Workup with computed tomography scan and transesophageal echocardiography demonstrated a right atrial pseudoaneurysm. Given the concern for rupture, the patient was taken to the operating room, where resection of the pseudoaneurysm and repair using a bovine pericardial patch was performed. Histopathology report initially demonstrated perivascular lymphocyte infiltrate. Six weeks later, the patient represented with chest pain and new word finding difficulty. Workup revealed multiple solid lung, pericardial, brain, and bone nodules. Eventual biopsy of a cardiophrenic nodule demonstrated angiosarcoma, and rereview of the original pathology slides confirmed the diagnosis of primary cardiac angiosarcoma.
CONCLUSIONS: Primary cardiac angiosarcomas are often misdiagnosed given the rarity of these tumors, but early diagnosis and initiation of treatment is essential. The unique presentation of our case demonstrates that clinical suspicion for cardiac angiosarcoma should be maintained for spontaneous pseudoaneurysm originating from the right atrium.
摘要：
背景：原发性心脏血管肉瘤非常罕见，并且具有高转移率。鉴于预后不良，特别是一旦疾病传播，早期诊断和多学科治疗至关重要。
方法：我们介绍了一个46岁男性胸痛的病例，间歇性发烧,和呼吸困难。计算机断层扫描扫描和经食道超声心动图检查显示右心房假性动脉瘤。考虑到对破裂的担忧，病人被送到手术室,切除假性动脉瘤并使用牛心包补片进行修复。组织病理学报告最初显示血管周围淋巴细胞浸润。六周后,患者表现为胸痛和新词发现困难。检查显示有多个实性肺,心包,大脑,和骨结节。心膈结节的最终活检显示血管肉瘤，并重新检查原始病理切片，证实诊断为原发性心脏血管肉瘤。
结论：原发性心脏血管肉瘤常被误诊，但早期诊断和开始治疗至关重要。我们病例的独特表现表明，对于起源于右心房的自发性假性动脉瘤，应保持对心脏血管肉瘤的临床怀疑。
方法：我们介绍了一个46岁男性胸痛的病例，间歇性发烧,和呼吸困难。计算机断层扫描扫描和经食道超声心动图检查显示右心房假性动脉瘤。考虑到对破裂的担忧，病人被送到手术室,切除假性动脉瘤并使用牛心包补片进行修复。组织病理学报告最初显示血管周围淋巴细胞浸润。六周后,患者表现为胸痛和新词发现困难。检查显示有多个实性肺,心包,大脑,和骨结节。心膈结节的最终活检显示血管肉瘤，并重新检查原始病理切片，证实诊断为原发性心脏血管肉瘤。
结论：原发性心脏血管肉瘤常被误诊，但早期诊断和开始治疗至关重要。我们病例的独特表现表明，对于起源于右心房的自发性假性动脉瘤，应保持对心脏血管肉瘤的临床怀疑。
