2021 Volume 85 Issue 3 Pages 318-
A 62-year-old-Japanese man was admitted to our hospital because of a cardiac tumor. He had no symptoms. Magnetic resonance image performed for the precise evaluation of the hepatic tumor revealed a cardiac tumor in the atrial septum in addition to a hepatic tumor (Figure A,B). Those tumors did not connect with each other (Figure C). Chest X-ray and electrocardiography were normal. Transthoracic echocardiography revealed a large mass protruding into the bilateral atria (right atrium, 3.8×3.5×3.2 cm; left atrium, 3.4×3.4×2.7 cm) (Figure D). Laboratory data were normal. Coronary angiography demonstrated tumor-staining (Figure E). The cardiac tumor was completely resected 1 week after admission (Figure F,G). Histologically, large atypical cells formed lumen and irregular anastomosing vascular networks (Figure H,I). Immunohistochemically, those cells were positive for CD31 (Figure J), CD34 (Figure K), and Factor VIII (Figure L). Therefore, this tumor was diagnosed as cardiac angiosarcoma. Seven weeks after the operation, the hepatic tumor was resected. Pathological examination indicated typical cavernous hemangioma (Figure M). No additional treatment was decided at the meeting with oncologists.
Magnetic resonance image demonstrates a cardiac tumor (arrows) and a hepatic tumor (arrow heads) (A, T1-weighed image; B and C, T2-weighed image). Transthoracic echocardiography shows a cardiac mass (D; RA, right atrium; LA, left atrium; RV right ventricle; LV, left ventricle). Coronary angiography shows tumor staining (E). The tumor is dumbbell-shaped (F) and the inside is red (G). Histopathology shows cardiac angiosarcoma [hematoxylin and eosin (H,I); immunostaining for CD31 (J), CD34 (K), and Factor VIII (L)], and hepatic cavernous hemangioma (M).
As a coexisting cardiac angiosarcoma and hepatic hemangioma is very rare, this patient should be observed carefully.
K.M. is a member of Circulation Journal’s Editorial Team. The authors have no conflicts of interest to declare.
