High Terminal Hemorrhage Risk From Cardiac Angiosarcoma Brain Metastases Warrants Frequent Brain Imaging and Early Intervention

Cardiac angiosarcoma with metastatic to lung, brain, and bone

“…This patient died the day after initiating radiotherapy, but Bishop et al. [28] reported that no deaths from cerebral hemorrhage due to brain metastasis occurred in patients who completed radiotherapy. Considering that the survival period of patients with cardiac angiosarcoma with brain metastasis is 1 month, it is important to diagnose as angiosarcoma by imaging alone.…”

“…Brain metastases are relatively rare but can be fatal. Most cases of brain metastases from cardiac angiosarcoma are associated with hemorrhage, according to previous reports [ [11] , [28] , [29] , [30] , [31] , [32] ]. Hemorrhage occurs in 14% of typical brain metastases, and the rate of bleeding from angiosarcoma is remarkable [33] .…”

“…This may reflect the lethality of brain metastasis of angiosarcoma. Patients diagnosed with brain metastasis in other reports have survived only for about a month [ [28] , [32] ].…”

The 7 Pillars of Primary Cardiac Sarcoma Treatment

“…We have found a high incidence of both lung and brain metastatic disease. 16 Metastatic disease that does not respond well to chemotherapy will not do well with surgery and should be treated with systemic therapy. If metastatic disease has a good response to chemotherapy and becomes undetectable, then surgery can be considered for control of the primary tumor.…”

The 7 Pillars of Nonsurgical Oncology Approaches to Primary Cardiac Sarcoma

“…MRI of the brain at baseline is particularly important in patients with primary cardiac angiosarcoma, as it is associated with an increased risk of brain metastases leading to terminal intracranial hemorrhage. 16 Treatment for metastatic disease is primarily with systemic therapy agents. The regimens used include a combination of adriamycin at a dose of 75 mg/m 2 and ifosfamide at a dose of 10 g/m 2 , a combination of gemcitabine at a dose of 900 mg/m 2 and docetaxel at a dose of 75 mg/m 2 , or single-agent paclitaxel at a dose of 80 mg/ m 2 .…”