Primary heart angiosarcoma can rarely present with cerebral metastasis appearing as multiple hematomas and carries a poor prognosis despite surgical and systemic treatment.
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Cardiac angiosarcoma with cerebral hematomas carries poor prognosis despite surgery and chemotherapy; Level 5 case leaves open optimal management strategies.
The authors present the case of a 24-year-old woman with cerebral metastasis from a primary heart angiosarcoma, which appeared as multiple cerebral hematomas. Primary or metastatic brain angiosarcomas are exceedingly rare, and only a few cases have been reported with hemorrhage. Initial neurological symptoms were mild hemiparesis with numbness, and chest pain was first misdiagnosed as pericarditis. A computed tomography (CT) scan and magnetic resonance imaging showed 2 hematomas in the left parietal and occipital lobes. A thoracic CT scan revealed angiosarcoma of the right atrium of the heart with multiple infiltrations of the lung. The patient underwent surgical removal and systemic chemotherapy. She died 6 months after surgery.
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Liassides et al. (2004) studied this question.
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