Primary cardiac angiosarcoma: a case report

Abstract

Primary cardiac angiosarcoma is relatively rare, and most cases involve metastasis at the time of diagnosis. The median survival time is 14 months for patients who can be treated surgically, versus 3.8 ± 2.5 months for patients with metastasis who could not undergo surgery. Radical surgical resection, radiotherapy, chemotherapy, and targeted therapy are the main treatments, but prognosis remains poor because of rapid progression and high recurrence and metastasis rates. At present, there is no unified standard treatment, and selecting the correct treatment plan and improving patient survival and quality of life remain challenging. We have reported the case of a 45-year-old woman with a primary heart tumor that infiltrated the right atrial wall and pericardium. Angiosarcoma was verified histologically. After palliative resection of the primary tumor followed by concurrent chemoradiotherapy and targeted therapy, the patient exhibited overall survival of 23 months, highlighting the potential utility of this treatment strategy.

Keywords: Primary cardiac tumor; angiosarcoma; anlotinib; case report; chemoradiotherapy; diagnosis; resection; targeted therapy.

Figure 1.

(a, b) Echocardiography and computed tomography revealed a pericardial mass (approximately 5.5 cm × 4.2 cm × 3.1 cm).

Figure 2.

(a, b) Hematoxylin and eosin staining revealed atypical spindle shaped and epithelioid tumor cells (×400). (c, d) On immunohistochemistry, the tumor cells were positive for CD34 and ERG (×400).

Figure 3.

Computed tomography revealed pericardial thickening but not tumor recurrence.

Figure 4.

(a) Hematoxylin and eosin staining disclosed atypical spindle-shaped and epithelioid tumor cells (×200). (b–d) On immunohistochemistry, the tumor cells were positive for CD34, CD31, and Ki-67 (×200).