Pericardial angiosarcoma: an interesting case report

Angiosarcoma, despite being the most common primary malignant tumour of the heart and pericardium, is itself an extremely rare tumour with a 0.001 to 0.003 % prevalence in an autopsy series. Angiosarcoma is the most common form of malignant cardiac tumour, having a tendency to occur in the third to fifth decade of life, with a distinct male preponderance. The tumour is often silent and symptomless for a long period of time, presenting late with locoregional metastasis which hampers the operability and prognosis. Metastasis is mainly to the mediastinal lymph nodes, lungs and vertebra. We present the case of a 58-year-old normotensive diabetic male who presented with dyspnea on exertion and recurrent pericardial effusion with an impending cardiac tamponade. It was identified as a large pericardial mass on CT thorax, and partial pericardiectomy was done. Histopathology identified it as a poorly differentiated carcinoma. It was only by immunohistochemistry that the diagnosis of pericardial angiosarcoma was confirmed.