Key result
Combination chemotherapy following elective abortion resulted in decreased tumor burden and no disease progression at 9 months in a 23-year-old woman diagnosed with primary cardiac angiosarcoma.
Why the study?
Primary cardiac angiosarcoma is seldom seen in pregnancy and a standardised treatment protocol continues to elude the medical community.
Case Report (n=1)
Advanced imaging modalities such as cardiac MRI are crucial for diagnosing primary cardiac angiosarcoma when clinical suspicion is high and echocardiography is unrevealing, particularly in pregnant patients.
Answers are grounded in this paper and cite their sources.
CMRI may detect PCAS missed by TTE in pregnancy; leaves open optimal management strategies.
Primary cardiac angiosarcoma (PCAS) is a malignancy seldom seen in pregnancy. A 23-year-old G1P0 Chinese female was found to have PCAS during her first trimester when she presented with tamponade physiology. The transthoracic echocardiography (TTE) results did not indicate the presence of an intracardiac lesion, and pericardial fluid cytology analysis showed no evidence of malignancy. Cardiac magnetic resonance imaging (CMRI) exhibited a right atrial mass, and tissue biopsy indicated a high-grade angiosarcoma. MRI of the abdomen was suggestive of liver metastasis. She underwent an abortion and was started on combination chemotherapy, with a reduction in both the cardiac and liver masses. In cardiac angiosarcomas, advanced imaging modalities such as MRI should be utilised when there is high clinical suspicion or in the case of pregnancy when trying to minimise foetal harm. Prognosis is poor, and a standardised treatment protocol regardless of pregnancy continues to elude the medical community.
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Burns et al. (2019) conducted a case report in Primary cardiac angiosarcoma in pregnancy (n=1). Combination chemotherapy (adriamycin/ifosfamide, then gemcitabine/docetaxel) following elective abortion was evaluated on Tumor response and disease progression. Combination chemotherapy following elective abortion resulted in decreased tumor burden and no disease progression at 9 months in a 23-year-old woman diagnosed with primary cardiac angiosarcoma.
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