Primary cardiac angiosarcoma evaluated with contrast two-dimensional and real-time three-dimensional echocardiography

Elusive Cardiac Angiosarcoma in a Young Pregnant Female: Rare Presentation With Fatal Outcome

Heart tumors are rare occurrences. They can present diagnostic challenges and severe complications especially in pregnant women. We report a rare case of angiosarcoma (AS) cordis of the right atrium in a young healthy pregnant female. Her diagnosis remained elusive for some time until development of advanced disease symptomatology. The diagnosis was unfortunately clinched when her tumor grew to be detected by imaging modalities. An emergency cesarean section was performed delivering a healthy baby. The patient was aggressively treated with chemotherapy to no avail. She passed away 2 months after her diagnosis was established. Only few cases of the occurrence of aggressive cardiac AS and human pregnancy are documented. The course of this disastrous combination is usually marked by severe complications, difficult therapeutic options and ultimately fast demise. Physicians need to be more aware of such diagnosis and diligently try to diagnose it as early as possible.

Severe right ventricular outflow tract obstruction caused by non-hodgkin lymphoma: complete regression after one course of bendamustine/rituximab therapy

We present the case of a 67-year-old woman presenting with symptoms of predominantly right heart failure caused by cardiac tumor infiltration. Echocardiography showed almost complete obstruction, particularly of the right ventricular outflow tract. After complete diagnostic workup, treatment with only one course of bendamustine and rituximab resulted in complete resolution of the obstruction. Right ventricular outflow tract restriction due to infiltrative large B-cell lymphoma is a rare finding. Compression of the heart and great vessels, such as by mediastinal tumors, is not as rare. Prompt and accurate diagnosis by echocardiography and immediate initiation of treatment can be lifesaving.

Primary Cardiac Angiosarcoma in a Young Woman

A 30-year-old woman was admitted to our hospital with severe shortness of breath. A transthoracic echocardiogram showed moderate pericardial effusion with a lesion in the right atrium, confirmed by chest CT scan and cardiac RMN. Pleural and middle lobe involvement occurred within one month. Middle lobe biopsy was performed and pathological examination confirmed the diagnosis of metastatic angiosarcoma. After two months, because of recurrent pleural effusions, chemical pleurodesis was performed. Chemotherapy was started but the patient died four months after the diagnosis. This case highlights the misdiagnosis at initial clinical presentation, available diagnostic approaches and therapeutic options for cardiac angiosarcoma.