Cardiac Angiosarcoma: A Case with Bilateral Pleural and Pericardial Effusion

2014 ◽  
Vol 16 (6) ◽  
pp. 353 ◽  
Author(s):  
Mehmet Oc ◽  
Bora Farsak ◽  
Oguzhan Arun ◽  
Bahar Oc ◽  
Murat Simsek ◽  
...  

Cardiac sarcomas are rare malignant tumors. Angiosarcoma is the most common cardiac sarcoma and is present in up to 33% of cases. Angiosarcomas have a poor prognosis, with a short survival expectancy. We report a case of a right atrial angiosarcoma treated by partial tumor resection followed by chemotherapy.

Author(s):  
Dana M. DeSandre-Robinson ◽  
Mariana T. Quina ◽  
David M. Lurie

ABSTRACT A 10 yr old papillon was evaluated for lethargy, inappetence, tachypnea, and labored breathing. Physical examination findings included dehydration, tachypnea, tachycardia, and muffled heart sounds. Thoracic radiographs revealed an enlarged cardiac silhouette. Echocardiography revealed a mild volume of pericardial effusion and no evidence of right atrial tamponade or a cardiac-associated mass. Cytological analysis of the pericardial effusion was consistent with blood. There was no evidence of neoplasia. Coagulation parameters were within normal limits. Initial treatment consisted of pericardiocentesis. A subtotal pericardiectomy was later performed. No surgical complications were noted, and the dog was discharged 2 days following surgery. Results of the histological examination of the pericardium revealed hemangiosarcoma. Treatment with doxorubicin was initiated 12 days after surgery, at which time, pulmonary metastasis was suspected. The dog survived for 18 days after subtotal pericardiectomy, when it was euthanized because of complications presumably related to pulmonary metastatic disease. This is the first published report of primary pericardial hemangiosarcoma. The dog had a short survival time; thus, the response to subtotal pericardiectomy combined with adjuvant doxorubicin treatment could not be determined. Pulmonary metastatic disease was suspected 12 days following surgery. Based on this case report, pericardial hemangiosarcoma carries a guarded prognosis.


2011 ◽  
Vol 2011 ◽  
pp. 1-3
Author(s):  
Monique Esteves Cardoso ◽  
Leonardo Secchin Canale ◽  
Rosana Grandelle Ramos ◽  
Edson da Silva Salvador Junior ◽  
Stephan Lachtermacher

Despite cardiac metastases are found in about 20% of cancer deaths, the presence of primary cardiac tumors is rare. Most primary tumors are benign, and malignant tumors comprise about 15%. We report a 21-year-old man with fever, dyspnea, and hemoptysis that was diagnosed with angiosarcoma of the right atrium and pulmonary metastasis. Patient was submitted to surgical tumor resection without adjuvant therapy and died four months after diagnosis.


2008 ◽  
Vol 94 (6) ◽  
pp. 892-897 ◽  
Author(s):  
Ozge Petek Erpolat ◽  
Fikri Icli ◽  
Orhan Veli Dogan ◽  
Gokhan Gokaslan ◽  
Muge Akmansu ◽  
...  

Primary tumors of the heart are rarely seen. Cardiac angiosarcomas are malignant tumors that almost always have a poor prognosis. We describe a 29-year-old man with primary cardiac angiosarcoma with multiple site metastases. The therapeutic approach includes surgery, chemotherapy and radiotherapy alone or in combination. New techniques of radiotherapy and combined chemotherapeutic agents may relieve symptoms and prolong a patient's life. We discuss the diagnosis and treatment of cardiac angiosarcoma in the light of a case report.


Author(s):  
Limin Luo ◽  
Weipeng Zhao ◽  
Kun Liu

Primary cardiac tumors are extremely rare.Most primary tumors are benign,and malignant tumors comprise about 15%1.Angiosarcoma is the most common type of primary cardiac malignant tumors.Compared with the left atrium or ventricle,the tumor prefer to occur in the right atrium or ventricle,especially the right atrium.In this case report,we present the case of a 32-year-old female with cardiac angiosarcoma primary to the right atrial appendage(RAA).


2021 ◽  
Vol 7 ◽  
Author(s):  
Fei F. Chen ◽  
Shu F. Jiang ◽  
Chang Dong ◽  
Ying Che ◽  
Lin Y. Du ◽  
...  

Background: Primary cardiac angiosarcomas, especially those originating in the pericardium, are extremely rare and aggressive tumors with poor prognosis. These types of malignant tumors have diverse clinical presentations and are often masked by other comorbidities.Case Summary: Our hospital reported a 59-year-old woman who initially presented with pulmonary thromboembolism (PTE) and was subsequently treated with low-molecular-weight heparin. However, she experienced acute pericardial tamponade after anticoagulation therapy, where no obvious mass was primarily identified upon imaging, both in the pericardium or within the heart. Emergency pericardiocentesis and drainage were performed, where a total of 210 mL of bloody effusion was drained. Four months later, she was hospitalized with progressive hemoptysis and dyspnea. A large mixed mass occupying the right pericardium was later identified by coronary computed tomography angiography (CCTA). The mass was consistent with the right atrium, with heterogeneous thickened pericardium and localized moderate pericardial effusion. CCTA and positron emission tomography scans later showed metastases in both lungs and bilateral pleura. Nodules in hilar and mediastinal lymph nodes were also significant. Ultrasound-guided biopsy was performed, and the patient was ultimately diagnosed with an angiosarcoma based on final positive results for both CD31 and CD34 markers. The patient refused chemotherapy and passed away while waiting for her pathology results. The patient survived for 6 months since the first reported episode of PTE.Conclusions: Our case indicates that patients presenting with both embolism and hemorrhage should urgently be channeled to a clinical specialist to confirm any malignant etiology. This would be beneficial to confirm an early diagnosis and lengthen the duration of patient survival. However, the diagnosis of primary cardiac angiosarcoma is still challenging and requires multiple imaging modalities and biopsies in order to assist the accurate diagnosis of disease and achieve effective patient management.


1989 ◽  
Vol 28 (06) ◽  
pp. 247-254
Author(s):  
E. Aulbert

The cellular uptake and lysosomal accumulation of 67Ga-labelled transferrin within tumors of different malignancy were examined using tissue fractionation and immunological techniques. As tumor models the slowly growing Morris hepatoma 5123C, the moderately growing Novikoff hepatoma and the fast and aggressive Yoshida hepatoma AH 130 were investigated. Isolation of subcellular fractions of tumor homogenates was performed by differential centrifugation and density-gradient centrifugation. The intracellular 67Gatransferrin was found to be highly concentrated within the purified lysosomes. The transferrin within the lysosomal fraction was identified by radial immunodiffusion technique using monospecific antiserum. The accumulation of 67Gatransferrin by the tumors resulted in a faster disappearance of 67Ga-transferrin from the blood. This loss of circulating 67Ga-transferrin correlated with the proliferation activity and the spread of the tumors. Since transferrin is indispensible for the utilization of iron by the heme-synthesizing red cell precursors, transferrin concentration in the blood is the limiting factor for the utilization of iron in hemoglobin synthesis. Thus, in a further series of experiments we investigated the development of anemia in tumor-bearing rats. With increasing tumor mass a progressive fall of hemoglobin concentration was found. The anemia was more severe in the faster growing Novikoff hepatoma than in the slowly growing Morris hepatoma. The most significant reduction of hemoglobin concentration was found in the very fast growing Yoshida hepatoma. After total tumor resection hemoglobin concentration and red blood cell count normalized completely within 6-8 weeks. We conclude from these data that the uptake of transferrin by the tumor cells results in a faster disappearance of transferrin from the blood. This loss of circulating transferrin correlates with tumor mass and proliferation activity and is one of the factors responsible for the anemia seen in patients with malignant tumors.


2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Matthew G. Hanson ◽  
Barry Chan

Abstract Background Symptomatic pericardial effusion (PCE) presents with non-specific features and are often missed on the initial physical exam, chest X-ray (CXR), and electrocardiogram (ECG). In extreme cases, misdiagnosis can evolve into decompensated cardiac tamponade, a life-threatening obstructive shock. The purpose of this study is to evaluate the impact of point-of-care ultrasound (POCUS) on the diagnosis and therapeutic intervention of clinically significant PCE. Methods In a retrospective chart review, we looked at all patients between 2002 and 2018 at a major Canadian academic hospital who had a pericardiocentesis for clinically significant PCE. We extracted the rate of presenting complaints, physical exam findings, X-ray findings, ECG findings, time-to-diagnosis, and time-to-pericardiocentesis and how these were impacted by POCUS. Results The most common presenting symptom was dyspnea (64%) and the average systolic blood pressure (SBP) was 120 mmHg. 86% of people presenting had an effusion > 1 cm, and 89% were circumferential on departmental echocardiogram (ECHO) with 64% having evidence of right atrial systolic collapse and 58% with early diastolic right ventricular collapse. The average time-to-diagnosis with POCUS was 5.9 h compared to > 12 h with other imaging including departmental ECHO. Those who had the PCE identified by POCUS had an average time-to-pericardiocentesis of 28.1 h compared to > 48 h with other diagnostic modalities. Conclusion POCUS expedites the diagnosis of symptomatic PCE given its non-specific clinical findings which, in turn, may accelerate the time-to-intervention.


2017 ◽  
Vol 11 (3) ◽  
pp. 331
Author(s):  
Andrea D'Amato ◽  
Costantino Mancusi ◽  
Maria Viviana Carlino ◽  
Veronica Lio ◽  
Federica De Pisapia ◽  
...  

We present the case of a 59-year-old patient with severe aortic stenosis, asymptomatic mild to moderate pericardial effusion and no major risk factors for poor prognosis. He underwent four-week course of non-steroidal anti-inflammatory drugs (ibuprofen 600 mg TID) with no improvement of the effusion. After complete diagnostic work-up and examination, we discovered that he had a prostate cancer with bone metastasis. On the bone scintigraphy, there was particular involvement of ribs and sternum. We decided to treat our patient with an association of docetaxel and hormone therapy, after six months we observed a reduction in the pericardial effusion. Even in the presence of a patient without risk factor of poor prognosis, pericardial effusion can be the first sign of occult neoplasia.


2014 ◽  
Vol 58 (8) ◽  
pp. 812-816 ◽  
Author(s):  
Pedro Weslley Rosario ◽  
Maria Regina Calsolari

Objective To determine whether the currently recommended therapy for papillary thyroid carcinoma (PTC) that show no classical factors indicating a poor prognosis is also effective in cases with a family history of this tumor. Subjects and methods: Forty-two patients were studied; 10 were submitted to lobectomy and 32 to total thyroidectomy, including 23 without lymph node dissection and 9 with lymph node dissection. None of the patients received radioiodine or was maintained under TSH suppression. Results No case of recurrence was detected by imaging methods and there was no increase in thyroglobulin or antithyroglobulin antibodies during follow-up (24 to 72 months). Conclusion The treatment usually recommended for patients with PTC does not need to be modified in the presence of a family history of this tumor if no factors indicating a poor prognosis are present (tumor ≤2 cm, non-aggressive histology, no extensive extrathyroid invasion or important lymph node involvement, complete tumor resection, no evidence of persistent disease after surgery).


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A228-A229
Author(s):  
Alexander M Balinski ◽  
Neil J Khatter ◽  
Jeffrey M Gold ◽  
Krishna S Pothugunta ◽  
Vamshi K Garlapaty ◽  
...  

Abstract Background: Hypercalcemia of malignancy (HCM) can present secondary to hypersecretion of parathyroid hormone (PTH)-related protein (PTHrP) from malignant tumors, but rare cases of HCM have also been documented due to inappropriate PTH secretion from ectopic neoplasms. Here, we report an unusual case of HCM due to hypersecretion of PTH from a disseminated mucinous ovarian adenocarcinoma. Case Presentation: A 45-year-old female presented with confusion, constipation, fatigue, and abdominal pain two weeks after total abdominal hysterectomy with bilateral salpingo-oophorectomy and suboptimal debulking of a newly discovered left ovarian mucinous adenocarcinoma with metastasis to the bladder, parametrium, vagina, right ovary, and rectosigmoid. Subsequent CT revealed numerous bilateral pulmonary nodules, hilar adenopathy, liver lesions, and abdominal adenopathy. On exam, she was tachycardic and hypertensive with diaphoresis, dry mucous membranes, respiratory distress, guarded abdominal tenderness, and altered mental status. Her labs were significant for a serum calcium of 21.7 mg/dL, creatinine of 1.93 mg/dL, ferritin of 2,379 ng/mL, leukocytosis of 21.9 bil/L, PTH of 1,061 pg/mL, and PTHrP of 29 pmol/L. Ectopic PTH secretion was highly suspected after negative parathyroid ultrasound. Pamidronate (60 mg IV), calcitonin (200 U IM), and fluid resuscitation were unable to normalize her serum calcium, resulting in the need for dialysis and subsequent continuous renal replacement therapy. Further intervention with denosumab (120 mg SQ), etelcalcetide (5 mg IV), and cinacalcet (60 mg PO) was also attempted. Serum calcium began to decline, but repeat PTH resulted greater than 2,500 pg/mL. Unfortunately, the patient died just one week into her hospital course from septic shock and multi-organ system failure. Discussion: Hypercalcemia of malignancy typically arises from tumor secretion of PTHrP, cytokine release from osteolytic metastases, or tumor production of calcitriol. In cases of hypercalcemia due to excess PTH secretion, primary parathyroid etiologies are typically considered while ectopic PTH-secreting tumors are rare. PTH staining of biopsy specimens and total body sestamibi scan may prove useful in the early detection and treatment of these tumors, but HCM offers a poor prognosis with mean survival of 2 to 3 months and in-hospital mortality of 6.8%. Currently, there are only three cases in the reported literature of ectopic PTH-induced hypercalcemia related to ovarian cancer. To our knowledge, this is the fourth reported case. Conclusion: Ectopic PTH-secreting tumors carry a poor prognosis and should be considered in cancer patients presenting with PTH-associated hypercalcemia. Biopsy staining for PTH and total body sestamibi scan may assist in the early detection of these tumors, but current treatment strategies offer suboptimal outcomes.


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