Improved outcome with multimodality therapy in primary cardiac angiosarcoma.

BACKGROUND: A 37-year-old man presented with a history of hemoptysis and associated fever, chills, night sweats, and weight loss. The patient had no other pertinent past medical history. INVESTIGATIONS: Physical examination, CT scan, transesophageal echocardiogram, electrocardiogram, MRI scan, and immunohistochemical staining of tumor biopsy. DIAGNOSIS: Primary cardiac angiosarcoma of the right atrium with systemic metastases to the pericardium, superior vena cava, and lungs. MANAGEMENT: Neoadjuvant and adjuvant chemotherapy with doxorubicin and complete surgical resection of the tumor with reconstruction of the right atrium using bovine pericardium.