Contrast Echocardiography in the Multimodal Diagnosis of a Giant Primary Cardiac Angiosarcoma: A Case Report.
Han Gao, Haoyi Zhang, Diandian Zhu et al.
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Case in brief
A 26-year-old woman presented with palpitations and dizziness. Transthoracic echocardiography identified a large hypoechoic right atrial mass with pericardial effusion. Contrast echocardiography showed rapid, intense, homogeneous enhancement within one cardiac cycle, raising suspicion for a hypervascular malignancy. CT and MRI supported the imaging findings and showed no distant metastases. The mass was surgically excised, and pathological and immunohistochemical analysis confirmed angiosarcoma. Postoperatively, she began AIM chemotherapy.
What made this case unusual
The mass’s rapid, intense homogeneous enhancement within one cardiac cycle on contrast echocardiography provided a notable imaging clue to its hypervascular malignant nature in a patient with atypical symptoms.
Diagnostic / clinical pearl
In a patient with a cardiac mass, contrast echocardiographic enhancement can help characterize vascularity and inform suspicion for malignancy; correlate with cross-sectional imaging and confirm the diagnosis pathologically.