J Cardiovasc Ultrasound.  2008 Sep;16(3):80-83. 10.4250/jcu.2008.16.3.80.

Echocardiographic Diagnosis of Right Atrial Perforation due to Primary Cardiac Angiosarcoma Using Hand-Agitated Saline Contrast

• Kim YG
• Kim WJ
• Park GM
• Song JM
• Kang DH
• Song JK

• KMID: 1486582
• DOI: http://doi.org/10.4250/jcu.2008.16.3.80

Abstract

Primary cardiac angiosarcoma is a rare and rapidly progressing tumor characterized by high predilection for right-sided heart involvement and a very poor prognosis. In this report, we present a case of angiosarcoma involving right atrium and ventricle in 61-year old woman with clinical presentation of repeated bloody pericardial effusion. Right atrial perforation was confirmed by contrast echocardiography using hand-agitated saline contrast. Primary cardiac angiosarcoma was confirmed by histological and immunohistochemical studies.

Keyword

Primary cardiac angiosarcoma; Pericardial effusion; Contrast echocardiography

MeSH Terms

Echocardiography
Female
Heart
Heart Atria
Hemangiosarcoma
Humans
Pericardial Effusion
Prognosis

Figure

• 

  Fig. 1 Two-dimensional and contrast echocardiographic findings. In right ventricle beneath the tricuspid valve, multiple nodular masses were found (A) and contrast passage from right atrium to pericardial effusion through suspicious tissue defect in right atrial free wall was documented (B and C). RA: right atrium, PE: pericardial effusion. Arrow: masses, arrowhead : contrast passage.

• 

  Fig. 2 Computed tomographic images. Multiple nodular masses were found in the pericardial space and right atrial free wall (A). A suspicious of direct communication between right atrium and pericardial effusion was demonstrated (B). LV: left ventricle, PE: pericardial effusion, RA: right atrium. Arrow: mass, arrowhead: direct communication.

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  Fig. 3 Biopsy showed pleomorphic and atypical cells forming multiple anastomosing vascular channels on hematoxylin-eosin stain (A). Immunohistochemical staining showed positive cells for CD31 (B).

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