Primary Left Atrial Angiosarcoma Presenting as Acute Coronary Syndrome

  • Sandra Jaksic Jurinjak Department of Cardiovascular Diseases, University Hospital Dubrava, Avenija Gojka Šuška 6, 10 000 Zagreb, Croatia
  • Josip Vincelj Dubrava University Hospital, Institute of Cardiovascular Diseases, Av. Gojka Suska 6, 10000 Zagreb, Croatia
  • Igor Rudez Dubrava University Hospital,Department of Cardiac and Transplant Surgery, Av. Gojka Suska 6, 10000 Zagreb, Croatia
  • Ante Lisicic Dubrava University Hospital, Institute of Cardiovascular Diseases, Av. Gojka Suska 6, 10000 Zagreb, Croatia
  • Ivana Jurin Dubrava University Hospital, Institute of Cardiovascular Diseases, Av. Gojka Suska 6, 10000 Zagreb, Croatia
  • Spomenka Manojlovic Dubrava University Hospital, Department of Pathology, Av. Gojka Suska 6, 10000 Zagreb, Croatia
  • Mario Udovicic Dubrava University Hospital, Institute of Cardiovascular Diseases, Av. Gojka Suska 6, 10000 Zagreb, Croatia
  • Boris Starcevic Dubrava University Hospital, Institute of Cardiovascular Diseases, Av. Gojka Suska 6, 10000 Zagreb, Croatia

Abstract

Primary cardiac neoplasms are extremely rare and often overlooked as differential diagnosis. Angiosarcomas are the most common primary malignant neoplasms of the heart often with nonspecific symptoms. We present a 43-year-old woman admitted to our hospital with chest pain and inferoposterolateral myocardial infarction. Coronary angiography indicated the distal occlusion of the left circumflex artery. Transthoracic and transoesophagic echocardiography revealed a mass in the left atrium with probable myocardial infiltration and vascularisation. The mass in the left atrium was removed by surgical resection, and histopathology confirmed angiosarcoma. We emphasize the pivotal role of transthoracic and transoesophageal echocardiography in evaluating even rare differential diagnosis of acute coronary syndrome as cardiac neoplasms.

References

Baay P, Karwande SV, Kushner JP, et al. 1994. Successful treatment of a cardiac angiosarcoma with combined modality therapy. J Heart Lung Transplant 13:923–925.

Bakaeen FG, Reardon MJ, Coselli JS, et al. 2003. Surgical outcome in 85 patients with primary cardiac tumors. Am J Surg 186: 641–47.

Blackmon SH, Reardon MJ. 2009. Surgical treatment of primary cardiac sarcomas. Tex Heart Ins J 36: 451–52.

Crespo MG, Pulpon LA, Pradas G, et al. 1993. Heart transplantation for cardiac angiosarcoma: should its indication be questioned? J Heart Lung Transplant 12:527–530.

Duyuler S, Demirkan B, Guray Y, et al. 2015. Echocardiography in differential diagnosis of chest pain and elevated cardiac biomarkers: a case of cardiac angiosarcoma. J Eur Echocariogr 12:406–407.

Engelen M, Bruch C, Hoffmeier A, et al. 2005. Primary left atrial angiosarcoma mimicking severe mitral valve stenosis, Heart 91:4- e27.

Ferguson ER, Walsh GL. 2002. Sarcomas of the heart and great vessels. In: Pollock, RE. Soft tissue sarcomas. Hamilton: CB Decker Inc. 155–56, 158-60.

Herrmann MA, Shankerman RA, Edwards WD, et al. 1992. Primary cardiac angiosarcoma: a clinicopathologic study of six cases. J Thorac Cardiovasc Surg 103:655–664.

Holloway BJ, Agarwal PP. 2009. AJR teaching file: right atrial mass in a woman with dyspnoea on exertion. AJR Am J Roentgenol 192: S49-52.

Kurian KC, Weisshaar D, Parekh H, et al. 2006. Primary cardiac angiosarcoma: case report and review of the literature. Cardiovascular Pathology 15:110–112.

Michler RE, Goldstein DJ. 1997. Treatment of cardiac tumors by orthotopic cardiac transplantation. Seminars in Oncology 24:534–539.

Movsas B, Teruya-Feldstein J, Smith J, et al. 1998. Primary cardiac sarcoma: a novel treatment approach. Chest 114:648–652. Selected Reports.

Oh SY, Yeom SY, Kim KH. 2013. Clinical Implication of Surgical Resection for the Rare Cardiac Tumors Involving Heart and Great Vessels. J Korean Med Sci 28:717–24.

Putnam JB Jr, Sweeney MS, Colon R, et al.1991. Primary cardiac sarcomas. Annals of Thoracic Surgery 51:906–910.

Silverman NA. 1980. Primary cardiac tumor. Ann Surg 191:127-138.

Sturgis EM, Potter BO. 2003. Sarcomas of the head and neck region. Curr Opin Oncol 15: 239–52.

Talbot SM, Taub RN, Keohan ML, et al. 2002. Combined heart and lung transplantation for unresectable primary cardiac sarcoma. J Thorac Cardiovasc Surg 124:1145–1148.

Published
2019-04-12
How to Cite
Jaksic Jurinjak, S., Vincelj, J., Rudez, I., Lisicic, A., Jurin, I., Manojlovic, S., Udovicic, M., & Starcevic, B. (2019). Primary Left Atrial Angiosarcoma Presenting as Acute Coronary Syndrome. The Heart Surgery Forum, 22(2), E162-E164. https://doi.org/10.1532/hsf.2381
Section
Articles