Author of

• 15577

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  P3.08 - Poster Session/ Thymoma, Mesothelioma and Other Thoracic Malignancies (ID 226)

  • Event: WCLC 2015
  • Type: Poster
  • Track: Thymoma, Mesothelioma and Other Thoracic Malignancies
  • Presentations: 1
  • Moderators:
  • Coordinates: 9/09/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)

  • 15599

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    P3.08-022 - Atypical Presentation of a Malignant Cardiac Tumor (ID 2898)

    09:30 - 09:30  |  Author(s): S. Dumitrache-Rujinski
    • Abstract
    • Slides

    Background:
    primary cardiac tumors are very rare pathological entities with an incidence (autopsy and surgical biopsies reports) ranging between 0,3% - 0,7 %. The main histopathological type of primary malignant cardiac tumors is represented by angiosarcoma, usually located within right atrium. The diagnosis may be delayed due to nonspecific symptomatology. Most cases are presenting with metastases to the lung in the moment of diagnosis and a median survival is less than one year (between 6 and 11 months).
    
    Methods:
    not applicable
    
    Results:
    Case report: we present the case of a non-smoker 19-year-old man, with right atrial angiosarcoma, with pericardial involvement and difuse limphohaematogenous pulmonary metastasis. The symptomatology consisted in: cough, difuse chest pain, progressive dyspnea, night swets, low grade fever and hemoptoic sputum. Chest X-ray revealed a diffuse micro nodular pattern, a resting pulseoxymetry with mild hypoxemia, no ECG abnormalities. No abnormalities on the clinical examination. The differential diagnosis included mainly: miliary tuberculosis (high incidence of tuberculosis in Romania) and Pneumocystosis. Bronchoalveolar lavage shows no fast acid bacilli, no Pneumocystis cysts, no neoplastic cells and HIV was negative. No inflammatory syndrome, normal WBC, no anemia and normal biochemistry. According to this data we decided to start antituberculous treatment and the patient was programed for thoracic CT scan. The clinical status rapidly deteriorated with worsening of dyspnea, respiratory failure and hypotension. Chest X-ray revealed enlargement of cardiac opacity and on ECG a micro voltage with an alternance in the QRS complex was identified. An echocardiography was performed in emergency and a massive mass of tissue occupying almost the entire right atrium with pericardial invasion and cardiac tamponed was identified. A median sternotomy with pericardial drainage , pericardial and tumor biopsy where performed. The patient died one week later with palliative care. The autopsy showed a right massive atrium tumor with myocardium, epicardium, and papillary muscle invasion, difuse lung nodular and micronodular metastases. The hystopatological / immunochemistry exam diagnosed a moderately differentiated angiosarcoma expressing CD 34, CD31.
    
    Conclusion:
    Tardive diagnoses of a massive right atrium angiosarcoma with bilateral pulmonary metastasis. Particularity of the case: rare cardiac malignant tumor revealed by respiratory symptoms dues to diffuse pulmonary micronodular metastases
    
    

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