Primary left atrial angiosarcoma mimicking pericarditis: a case report and review of the literature

Abstract

A 45-year-old male presented with symptoms mimicking pericarditis, including rapidly worsening dyspnea and retrosternal chest pain. On imaging workup, an abnormal mass of 50x53 mm in size was detected at the left atrium, which partially obstructed blood flow through the mitral valve. PET/CT was done in searching for the probable site of origin but revealed no abnormal uptake lesions. The tumorectomy and excision of the posterior wall of the left atrium were then performed with curative intent. The postoperative histology of the tumor was in favor of a spindle cell sarcoma, originating from the left atrium, grade 2, which was confirmed as epithelioid angiosarcoma by immunohistochemistry. The patient denied adjuvant radiation, thus we treated him with six cycles of Paclitaxel monotherapy, which was completed six months ago. At present, he is doing well with no signs of recurrence on the imaging technique. This paper illustrates the rarity of cardiac angiosarcoma, its complex presentation, and a brief review of available treatment options for this devastating disease.