Sarcomas are the most malignant tumors in the myocardium. Most common sarcoma is the
angiosarcoma, classically located in the right atrium. Surgical resection is the primary treatment
of choice for these patients. In July 2003, an 18 years old man with chest pain and dyspnea,
referred to the Imam Khomeini Hospital. Chest X-ray showed cardiac enlargement and
transthoracic echocardiography demonstrated a large lobulated tumoral mass in right atrium.
Cytologic examination of the pericardial effusion reported as no evidence of malignancy and
chest CT scan showed cardiac dilatation with blood density and pericardial effusion. The patient
underwent operation and tumor bulk was resected. Based on histological examination and
immunohistochemistry, diagnosis of cardiac angiosarcoma was made and the patient received
postoperative radiotherapy through parallel-opposed AP-PA cobalt beam technique. After
combined modality treatment with surgery and postoperative radiotherapy, symptoms were
disappeared and after 20 month follow up patient is symptom free. Despite of the ominous
outcome of this malignancy an multimodality approach is worthy of consideration.
Radiat. Res., 2005 2 (4): 215-218