Veliqi Anna, Hakmi Samer, Kaiser Lukas, Willems Stephan, Chung Da-Un
Department of Cardiology & Critical Care Medicine, Asklepios Klinik St. Georg, Lohmühlenstraße 5, 20099 Hamburg, Germany.
Department of Cardiac Surgery, Asklepios Klinik St. Georg, Lohmühlenstraße 5, 20099 Hamburg, Germany.
Eur Heart J Case Rep. 2024 Aug 24;8(12):ytae433. doi: 10.1093/ehjcr/ytae433. eCollection 2024 Dec.
Cardiac angiosarcomas are exceptionally uncommon, and result in significant morbidity and mortality. Utilizing a multimodality approach enhances the characterization of the mass for optimal diagnostic outcomes. The recommended primary treatment involves complete surgical resection coupled with adjuvant radiochemotherapy. Excimer laser sheaths provide a novel option for extracting substantial tissue samples, facilitating appropriate and targeted treatment.
A 54-year-old female presented with dyspnoea and chest pain. Cardiac imaging showed a large right atrial mass suspected to be malignant. Echocardiography was utilized for diagnosis, follow-ups, and as part of the biopsy procedure. However, adopting an off-label approach involving an excimer laser sheath as a bioptome led to the successful diagnosis of an angiosarcoma. Commencement of radiochemotherapy resulted in a reduction in tumour size and a rapid improvement in the patient's quality of life.
The presented case underlines the significance of multimodality imaging and the use of an excimer laser-assisted intracardiac biopsy in achieving an accurate diagnosis. Cardiovascular imaging not only serves as the primary diagnostic tool but also plays a crucial role in risk stratification and in planning therapeutic interventions.
心脏血管肉瘤极为罕见，会导致严重的发病率和死亡率。采用多模态方法可增强对肿块的特征描述，以实现最佳诊断结果。推荐的主要治疗方法包括完整的手术切除以及辅助放化疗。准分子激光鞘为获取大量组织样本提供了一种新选择，有助于进行适当且有针对性的治疗。
一名54岁女性出现呼吸困难和胸痛。心脏成像显示右心房有一个大肿块，怀疑为恶性。超声心动图用于诊断、随访以及活检过程的一部分。然而，采用一种涉及将准分子激光鞘用作活检刀的非标签方法成功诊断出血管肉瘤。开始放化疗后，肿瘤大小减小，患者生活质量迅速改善。
该病例强调了多模态成像以及使用准分子激光辅助心内活检以实现准确诊断的重要性。心血管成像不仅是主要诊断工具，而且在风险分层和规划治疗干预方面也起着关键作用。
