Contrast Echocardiography in the Multimodal Diagnosis of a Giant Primary Cardiac Angiosarcoma: A Case Report

We report the case of a 26-year-old woman presenting with atypical symptoms of palpitations and dizziness. Transthoracic echocardiography (TTE) revealed a large hypoechoic mass in the right atrium accompanied by pericardial effusion. Contrast echocardiography showed rapid, intense homogeneous enhancement within one cardiac cycle, suggesting hypervascular malignancy. Subsequent computed tomography (CT) and magnetic resonance imaging (MRI) confirmed the findings and excluded distant metastases. Following surgical excision of the mass, pathological and immunohistochemical analysis confirmed the diagnosis of angiosarcoma. The patient was started on postoperative AIM chemotherapy. This case demonstrates the diagnostic value of contrast echocardiography within multimodal imaging, especially in atypical presentations of cardiac angiosarcoma.