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Japanese Journal of Clinical Oncology Advance Access originally published online on June 2, 2009
Japanese Journal of Clinical Oncology 2009 39(9):612-615; doi:10.1093/jjco/hyp044
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© The Author (2009). Published by Oxford University Press. All rights reserved

Cardiac Angiosarcoma with Cardiac Tamponade Diagnosed as a Ruptured Aneurysm of the Sinus Valsalva

Isamu Yoshitake1, Mitsumasa Hata1, Akira Sezai1, Tetsuya Niino1, Satoshi Unosawa1, Kazuma Shimura1, Yuji Kasamaki2 and Kazutomo Minami1

1 Department of Cardiovascular Surgery, Nihon University School of Medicine
2 Department of Cardiology, Nihon University School of Medicine, Tokyo, Japan

For reprints and all correspondence: Isamu Yoshitake, 30-1 Ohyaguchi-kami-machi, Itabashi-ku, Tokyo 173-8610, Japan. E-mail: iyoshing{at}yahoo.co.jp

Received October 14, 2008; accepted April 19, 2009

Primary cardiac angiosarcoma is a rare, diagnostically elusive disease with a poor prognosis. In this report, we describe the case of a 56-year-old woman with a right atrial angiosarcoma. The patient presented with impending cardiac tamponade caused by right atrial perforation, but was misdiagnosed as a ruptured aneurysm of the sinus valsalva based on findings of a continuous murmur and an aorta to right atrium shunt by echocardiography. In the emergent operation that ensued, we found a right atrial perforation and a right coronary artery fistula to the right atrium. Coronary artery fistula is a rare complication of primary cardiac angiosarcoma, and a continuous murmur is also extremely rare as a clinical finding of angiosarcoma. We report the case and review the literature.

Key Words: angiosarcoma • cardiac tamponade • cardiac tumor • continuous murmur • coronary artery fistula


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