Primary Angiosarcoma in the Right Atrium Diagnosed by a Cardiac Tumor Biopsy Using Intracardiac Echocardiography

Genki Naruse; Masanori Kawasaki; Komei Yanase; Toshiki Tanaka

doi:10.4103/JMU.JMU_93_19

Primary Angiosarcoma in the Right Atrium Diagnosed by a Cardiac Tumor Biopsy Using Intracardiac Echocardiography

J Med Ultrasound. 2020 Feb 19;28(2):120-122. doi: 10.4103/JMU.JMU_93_19. eCollection 2020 Apr-Jun.

Authors

Genki Naruse¹, Masanori Kawasaki², Komei Yanase³, Toshiki Tanaka¹

Affiliations

¹ Department of Cardiology, Gifu University Graduate School of Medicine, Gifu, Japan.
² Department of Cardiovascular Medicine, Gifu Heart Center, Gifu, Japan.
³ Department of Respirology, Gifu University Graduate School of Medicine, Gifu, Japan.

Abstract

A 47-year-old woman consulted a doctor due to a persistent cough. Computed tomography revealed a 30 mm × 60 mm intracardiac mass in the right atrium. Because of lung metastasis, her respiratory status did not allow a more invasive procedure, such as general anesthesia. Although intracardiac echocardiography (ICE) during percutaneous transcatheter biopsy (PTB) is not covered by medical insurance, we performed PTB under ICE guidance. Pathology and immunohistochemistry revealed primary cardiac angiosarcoma. Primary cardiac angiosarcoma is a rare tumor with a poor prognosis. After seven cycles of chemotherapy, the pulmonary metastasis was clearly improved. The patient is alive 18 months after the first consult, even though the mortality of angiosarcoma is high. ICE during PTB allowed us to choose appropriate chemotherapy and improve her pulmonary metastasis. ICE during PTB reduces the need for a diagnostic open-chest procedure that requires a more invasive approach.

Keywords: Biopsy; intracardiac echocardiography; primary angiosarcoma; right atrium.

Publication types

Case Reports