Angiossarcoma de átrio direito

Iglézias, José Carlos R; Velloso, Luiz Guilherme Carneiro; Dallan, Luís Alberto; Benvenuti, Luiz Alberto; G, Verginelli; Stolf, Noedir A. G

doi:10.1590/s0102-76382000000200013

Cited by 5 publications

(5 citation statements)

References 20 publications

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“…The majority of cardiac tumors are benign (75%), and the myxoma is the most common. Among malignant cardiac tumors, sarcomas are the most frequent 7 , 8. Cardiac angiosarcomas are very aggressive neoplasms, with a high rate of local recurrence and systemic metastasis 7 - 9.…”

Section: Discussionmentioning

confidence: 99%

Multiple hepatic metastases of cardiac angiosarcoma

et al. 2018

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The differential diagnosis of hepatic focal lesions is challenging because the etiology can be inflammatory, infectious, and even neoplastic. A rare cause of metastatic liver nodules is cardiac angiosarcoma. We report a case of this tumor, which was diagnosed only after autopsy.A 26-year-old Caucasian man was admitted for progressive dyspnea and cough over the past 3 weeks. Physical examination showed only hypophonetic heart sounds. Laboratory analysis demonstrated anemia and elevated inflammatory markers, despite normal biochemical parameters and liver function. Transthoracic echocardiography revealed massive pericardial effusion. Abdomen computed tomography (CT) showed multiple hepatic nodules, the largest of which measured 3 cm, but the percutaneous biopsy revealed only lobular necrosis and perisinusoidal fibrosis without granulomas or neoplastic cells. During hospitalization, the patient had fever and night sweats with weight loss, and empiric treatment for extrapulmonary tuberculosis associated with corticosteroids was initiated. The outpatient follow-up revealed complete improvement of the pericardial effusion, but maintenance of the liver lesions. After 2 months of hospital discharge, the patient was readmitted with hemorrhagic shock due to bleeding liver lesions, which were evidenced by CT. Embolization of the right hepatic artery was performed, but the patient soon died. The autopsy revealed a primary cardiac angiosarcoma with multiple hepatic metastases, rupture of the Glisson’s capsule and laceration of the liver. The case shows how important and difficult the diagnosis of focal liver lesions is, since it may result in an unexpected fatal outcome.

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Section: Discussionmentioning

confidence: 99%

Multiple hepatic metastases of cardiac angiosarcoma

et al. 2018

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“…The first is a well-defined mass protruding into one of the cardiac chambers, usually the right atrium. 17 , 18 CT often shows a low-attenuating right atrium mass, which may be irregular or nodular. The contrast medium enhancement is heterogeneous.…”

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confidence: 99%

Cardiac angiosarcoma: an unexpected diagnosis

Crenitte¹,

Galvão²,

Bernardi³

et al. 2014

ACR

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Cardiac angiosarcoma is a rare entity. The incidence through autopsy findings ranges between 0.001% and 0.03%. The disease usually presents with non-specific symptoms, although asymptomatic cases are frequent; therefore, diagnosis is unexpected and consequently delayed. The authors report the case of a middle-aged man with a recent onset cough and dyspnea. He sought medical care several times without receiving a definite diagnosis until a plain chest radiography was taken showing a mediastinal enlargement, which was the reason why he was hospitalized for clinical investigation. During the diagnostic workup, an echodopplercardiogram and a thoracic computed tomography were performed, showing a heterogeneous soft-tissue mass infiltrating the pericardium and the anterior atrial wall. Multiple and scattered pulmonary nodules were also present. A pulmonary nodule was biopsied, which revealed an angiosarcoma. The clinical features added to the radiological and histological findings permitted the diagnosis of right atrial angiosarcoma. The authors highlight the unexpected pattern in the presentation of cardiac tumors.

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“…Cardiac metastases are found in the autopsies of 10% of the patients who die from pulmonary cancer and of 25% of those with tumors in other organs. In children, cardiac tumors are rare, not exceeding 10% of all neoplasias in this age bracket 3 .Approximately 75% of the primary cardiac tumors are benign 4 , myxomas being the most common, followed by rhabdomyomas, lipomas, fibromas, and teratomas 3 . Cardiac lipomas, initially reported by Orth in 1886 5 , account for 8.4% of the primary tumors of the heart and pericardium.…”

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Right atrial lipoma

Pêgo‐Fernandes

Costa

Fernandes

et al. 2003

Arq. Bras. Cardiol.

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Primary cardiac tumors are rare, not easily clinically diagnosed, and differ in regard to clinical manifestations, location, morphology, size, and radiological findings 1 .The incidence of primary tumors of the heart and pericardium ranges from 0.02% to 0.28%, according to a series of autopsies reported by McAllister HA Jr 2 . On the other hand, neoplasias, mainly mammary and pulmonary neoplasias (that send more metastases to the heart), followed by leukemias and lymphomas are 10 to 40 times more frequent than primary cardiac tumors. Cardiac metastases are found in the autopsies of 10% of the patients who die from pulmonary cancer and of 25% of those with tumors in other organs. In children, cardiac tumors are rare, not exceeding 10% of all neoplasias in this age bracket 3 .Approximately 75% of the primary cardiac tumors are benign 4 , myxomas being the most common, followed by rhabdomyomas, lipomas, fibromas, and teratomas 3 . Cardiac lipomas, initially reported by Orth in 1886 5 , account for 8.4% of the primary tumors of the heart and pericardium. Until 1990, 63 had been reported 6 . According to the available literature, 25% of cardiac lipomas are intramyocardial, 25% are extracavitary of epicardial origin, and 50% are intracavitary of subendocardial origin -those of the right atrium are extremely rare 7 .In the recent literature, a case of intrapericardial lipoma in a 27-year-old female 8 and a case of right atrial lipoma in a 54-year-old male have been reported 9 . In 1994, Diamante et al 10 reported a peculiar case of epicardial lipoma that caused inversion of the left atrial auricle and partial obstruction of the drainage of the left pulmonary veins, leading to pulmonary and systemic arterial hypertension, cardiomegaly, and electrocardiographic changes. In a study of 50 cases of primary cardiac neoplasias by Fernandes et al 11 , only 1 lipoma was reported. Case ReportThe patient was a 48-year-old male who complained of high blood pressure and epistaxis for 2 months. He denied similar previous episodes. He also reported being an exsmoker (2 packs per day) for 20 years and denied alcoholism. His personal and familial antecedents were not relevant.At the time of the symptoms, the patient visited a cardiologist. Due to the nonspecificity of the symptoms, an echocardiography (7/2/98) was performed and revealed a right atrial tumor of 4.6x3.5 cm with characteristics of adipose tissue.The patient was referred to our service. On physical examination, he was in good general condition, eupneic, acyanotic, and had no fever. His blood pressure was 130/ 80mmHg, his heart rate was 60 bpm, and the rest of his physical examination was within the normal range.The laboratory tests showed a mild leukocytosis (13,900 cells/mm 3 ) with no deviation to the left. The remaining tests were within the normal range.The chest X-ray showed normal pulmonary transparency, normal hila, free diaphragmatic sinuses and cupula, and a normal cardiac image.The electrocardiography detected sinus rhythm of 72 bpm with deviation of the cardiac ...

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Angiossarcoma de átrio direito

Cited by 5 publications

References 20 publications

Multiple hepatic metastases of cardiac angiosarcoma

Multiple hepatic metastases of cardiac angiosarcoma

Cardiac angiosarcoma: an unexpected diagnosis

Right atrial lipoma

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