Key result
Multimodal surgery plus paclitaxel chemotherapy yields 1-year survival in cardiac angiosarcoma with atrial rupture.
Why the study?
Cardiac angiosarcoma has an extremely poor prognosis with limited evidence regarding chemotherapy, and no standardized treatment has been established for metastatic primary cardiac tumors.
Case Report (n=1)
Aggressive multidisciplinary management combining surgical resection and chemotherapy can achieve 1-year survival in primary cardiac angiosarcoma even when complicated by right atrial rupture and pulmonary metastases.
May support aggressive multimodal therapy in select cardiac angiosarcoma cases; leaves open optimal strategies pending prospective validation.
Background Malignant tumors account for approximately 20–30% of primary cardiac tumors, and reports remain rare. Cardiac angiosarcoma is a representative type, but prognosis is extremely poor: the median survival is about 4 months in unresectable cases and 14 months after complete resection.1,2 Approximately 29% of angiosarcomas present with metastasis at diagnosis, and the presence of pericardial effusion suggests pericardial invasion. Evidence regarding chemotherapy remains limited, and no standardized treatment has been established for metastatic primary cardiac tumors. Case Summary We report a case of cardiac angiosarcoma in a 74-year-old man. At the time of presentation, masses were detected in the right atrium and the apex of the left ventricle. The right atrial tumor extended widely along the atrial wall and partially formed fistulous tracts, resulting in direct communication of blood flow from the right atrium into the pericardial cavity. Surgical tumor resection with atrial wall reconstruction was performed, and chemotherapy was initiated following histopathological confirmation. Discussion Due to their poor prognosis, cardiac tumors are often managed with palliative care. This case highlights two important points: first, cardiac angiosarcoma can cause atrial wall destruction and rupture, leading to direct communication between the atrium and pericardial space; second, even in cases of primary cardiac angiosarcoma with pulmonary metastases, appropriate cardiac surgery combined with chemotherapy may improve patient outcomes.
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Fukuda et al. (2026) conducted a case report in Cardiac angiosarcoma with right atrial rupture and pulmonary metastases (n=1). Surgical tumor resection and paclitaxel chemotherapy was evaluated on Survival and disease stability. Aggressive multidisciplinary treatment combining surgical resection and paclitaxel chemotherapy resulted in 1-year survival with stable disease in a patient with cardiac angiosarcoma and right atrial rupture.
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