Angiosarcoma of the right atrium presenting as hemoptysis

Abstract

This case report describes a previously healthy 32-year-old man who presented with several weeks of hemoptysis. Initially he was treated with antibiotics with a preliminary diagnosis of pneumonia. With increasing hemoptysis and additional symptoms, he was referred to our institution. Cardiac magnetic resonance imaging suggested a diagnosis of right atrial angiosarcoma with extensive pulmonary metastases. His extensive pulmonary tumor burden caused the hemoptysis. Pulmonary biopsy was well tolerated, and he was referred to medical oncology for adjuvant therapy. Following the first cycle of chemotherapy, his hemoptysis lessened.

Figure.

Right lung masses. Numerous pulmonary masses were seen and many were peripherally located, ideal for wedge resection biopsy. The right lung was full of numerous transparent bright pink (smaller white arrows) to dark purple masses (large white arrow), from a few millimeters to roughly 2 cm in diameter.