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cardiac angiosarcoma
Epidemiology:
- most common primary cardiac malignant neoplasm
Pathology:
- typically arise from the right atrium involving wall of right atrium
- often associated with pericardial effusion
- highly vascular neoplasms
- metastases to the lung, liver, lymphatics, bone & adrenal gland common
Clinical manifestations:
- chest pain & dyspnea most common presenting symptoms
Special laboratory:
- pericardiocentesis shows serosanginous, bloody fluid
- cytology often negative for malignancy
- tissue biopsy often required for diagnosis
Radiology:
- cardiac computed tomography or cardiac magnetic resonance imaging to differentiate from right atrial myxoma
Differential diagnosis:
- right atrial myxoma
Management:
- surgical resection with adjuvant chemotherapy or radiation therapy
- prognosis
- most patients die in 6-12 months
- even with complete surgical resection, survival is < 2 years for most patients
General
hemangiosarcoma; angiosarcoma
cardiac neoplasm
References
- Medical Knowledge Self Assessment Program (MKSAP) 19
American College of Physicians, Philadelphia 2022