Primary Cardiac Angiosarcoma: A Rare Tumor

Angiosarcomas are malignant mesenchymal proliferations of endothelial elements characterized by rapidly proliferating extensively infiltrating anaplastic cells Well known sites of occurrence include the skin and post radiation breast tissue It is exceedingly rare to find angiosarcoma as a cardiac primary We present a case of primary cardiac angiosarcoma in a year old African American female presenting with sudden and dramatic large hemorrhagic pericardial effusion She had no known prior symptoms Cardiac MRI revealed a ten centimeter mass involving the right atrium right ventricle and encasing the right coronary artery as well as multiple lung nodules Via pericardial window biopsies were simultaneously obtained of the cardiac mass and of the lung nodules Tissue from the cardiac mass showed necrotic cells with noncontributory immunostains However tissue from the lung nodule showed viable tumor cells and confirmed primary cardiac angiosarcoma with pulmonary metastases Immunohistochemical stains on the pulmonary nodule tissue were positive for CD CD and vimentin and negative for AE AE cam TTF desmin OCT and CA This case highlights a sudden and dramatic presentation of rare primary cardiac angiosarcoma