Key result
Primary cardiac angiosarcoma often presents deceptively with cytologically negative hemorrhagic pericardial effusion.
Why the study?
Primary cardiac angiosarcoma is a rare malignancy with diagnostic challenges due to nonspecific symptoms, initial imaging showing only pericardial effusion, and negative pericardial fluid cytology.
Case Report
Highlights the diagnostic challenge of identifying primary cardiac angiosarcoma, which can initially mimic a benign hemorrhagic pericardial effusion due to non-diagnostic imaging and cytology.
Raises suspicion for angiosarcoma in unexplained RA effusion; leaves open standardized diagnostic pathways pending larger series.
Primary cardiac angiosarcoma is a rare and aggressive malignancy that typically arises from the right atrium (RA), reflecting its endothelial origin, and presents with nonspecific cardiopulmonary symptoms, including pericardial effusion and signs of right-sided heart failure.1-3 Diagnostic challenges frequently delay recognition. Initial imaging may demonstrate only a pericardial effusion without a discrete mass, and pericardial fluid cytology may fail to identify malignant cells due to low cellularity, hemorrhagic background, or sampling error.
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Ralhan et al. (2026) conducted a case report in Primary cardiac angiosarcoma. Primary cardiac angiosarcoma often presents diagnostic challenges due to initial imaging demonstrating only hemorrhagic pericardial effusion with negative cytology.
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