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Vasc Health Risk Manag. 2008 August; 4(4): 937–941.
PMCID: PMC2597752
Early detection and efficient therapy of cardiac angiosarcoma due to routine transesophageal echocardiography after cerebrovascular stroke
Dirk Vogelgesang,1 Johannes B Dahm,2 Holm Großmann,3 Andre Hippe,4 Astrid Hummel,5 Christian Lotze,6 and Silke Vogelgesang7
1Practice of Cardiology, Greifswald
2Practice of Cardiology, Goettingen
3Department of Cardiovascular Surgery, Herzzentrum Karlsburg
4Department of Neurology
5Department of Cardiology
6Department of Haematology and Oncology
7Department of Pathology, University of Greifswald, Greifswald, Germany
Correspondence: Silke Vogelgesang Department of Pathology, University of Greifswald, F.-Loeffler-Str. 23e, 17475 Greifswald, Germany Tel +49 3834 865716 Fax +49 3834 865704 Email silke.vogelgesang/at/uni-greifswald.de
Abstract
Primary malignant cardiac tumors (cardiac angiosarcomas) are exceedingly rare. Since there are initially nonspecific or missing symptoms, these tumors are usually diagnosed only in an advanced, often incurable stage, after the large tumor mass elicits hemodynamic obstructive symptoms. A 59-year-old female presented with symptoms of cerebral ischemia. A computed tomography (CT) scan showed changes suggestive of stroke. Transesophageal echocardiography revealed an inhomogeneous, medium-echogenic, floating mass at the roof of the left atrium near the mouth of the right upper pulmonary vein, indicative of a thrombus. At surgery, a solitary tumor was completely enucleated. Histologically, cardiac angiosarcoma was diagnosed. The patient received adjuvant chemotherapy and was free of symptoms and recurrence of disease at 14 months follow-up. Due to the fortuitous appearance of clinical signs indicative of stroke, cardiac angiosarcoma was diagnosed and effectively treated at an early, nonmetastatic, and therefore potentially curable stage. Although cardiac angiosarcoma is a rare disease, it should be taken into consideration as a potential cause of cerebral embolic disease.
Keywords: cardiac angiosarcoma, stroke, embolism