Ali KÜPELİ, Necmettin YAKUT, Nur YÜCEL, Adnan Kazım USALAN, Tayfun GÖKDOĞAN, Gülru POLAT, Melih BÜYÜKŞİRİN

Primary cardiac angiosarcoma and diffuse pulmonary hemorrhage: a case report

Primer kardiyak anjiyosarkom, çok kötü seyreden, oldukça nadir görülen kötü huylu bir tümördür. Hastalık semptomları nonspesifiktir. Ender klinik görünümlerinden biri de, diffüz pulmoner hemorajidir. Altmış bir yaşında erkek olgu, 10 gündür devam eden sağ yan ağrısı, öksürük ve kan tükürme yakınmaları ile kliniğimize başvurdu. Akciğer grafisinde iki taraflı nodüler lezyonlar ve kardiyotorasik indekste artış izlendi. Toraks bilgisayarlı tomografide, kardiyomegali, sağ atrium anterolateral komşuluğunda 7x5 cm kitle lezyonu, her iki akciğerde orta ve alt zonlarda buzlu cam görünümleri izlendi. Ekokardiyografide sol ventrikül dilate ve hipertrofik idi. Olgu miksoma ön tanısı ile ameliyat edildi. Ameliyat sırasında kardiyak anjiyosarkom saptandı. Hasta, ameliyattan kısa bir süre sonra, solunum yetmezliği nedeniyle kaybedildi. Bu makalede, birtakım tanısal zorluklar ile birlikte, pulmoner semptomlar göz önünde bulundurularak yürütülen tanısal sürecin ayrıntılı olarak irdelenmesi amacıyla bir olgu çalışması sunuldu.

Primer kardiyak anjiyosarkom ve diffüz pulmoner hemoraji: olgu sunumu

Primary cardiac angiosarcoma is a very rare malignant tumor with very poor prognosis. Symptoms of the disease are nonspecific. One of the rare clinical presentations is diffuse pulmonary hemorrhage. A 61-year-old male was admitted to our clinic with the complaints of right side pain lasting for 10 days, cough and hemoptysis. The chest X-ray showed bilateral nodular lessions and increased cardiothoracic index. Thoracic computed tomography revealed cardiomegaly, showing a mass in 7x5 cm in the anterolateral right atrium with ground-glass appearance, predominantly in the mid and lower zones of bilateral lung fields. Echocardiography showed dilatation and hypertrophy of the left ventricle. The case underwent surgery with the initial diagnosis of myxoma. During surgery, cardiac angiosarcoma was diagnosed. The patient died due to respiratory failure soon after surgery. In this article, we present a case report, discussing the details of the diagnostic process based on pulmonary symptoms along with certain challenges.

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