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She underwent successful radical en bloc resection and single-stage reconstruction of the right atrium and superior vena cava under normothermic cardiopulmonary bypass with a beating heart. Histopathology confirmed the diagnosis, tiragolumab was used postoperatively, and no recurrence was observed 4 years later.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/surgical-resection-of-a-primary-cardiac-angiosarcoma-and-reconstruction-of-involved-right-atrium/457934/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/surgical-resection-of-a-primary-cardiac-angiosarcoma-and-reconstruction-of-involved-right-atrium/457934.png","ImageObject",300,407,{"name":42,"@type":43},"Logic","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-30","2026-09-30",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",16,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What was the patient’s initial presentation and key findings?","Question",{"text":63,"@type":64},"The 41-year-old patient reported chest pain and shortness of breath for 2 weeks. Examination and labs showed findings such as hypoalbuminemia and elevated D-dimer, while imaging revealed a large right atrial mass and right pleural effusion.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"What treatment approach was performed during surgery?",{"text":68,"@type":64},"A multidisciplinary team proceeded with radical en bloc surgical resection under normothermic cardiopulmonary bypass with a beating heart. The operation included anatomical reconstruction of the right atrium and involved venous structures.",{"name":70,"@type":61,"acceptedAnswer":71},"How was the diagnosis confirmed and how was postoperative therapy managed?",{"text":72,"@type":64},"Histopathology confirmed primary cardiac angiosarcoma. Genetic results supported postoperative immunotherapy with tiragolumab.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},457934,1791033740,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,120,123,127],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":116,"doc_module":4,"doc_module_name":25,"category_name":117,"show_sort_weight":118,"slug":119},9,"Religion & Spirituality",20,"religion-spirituality",{"id":118,"doc_module":4,"doc_module_name":25,"category_name":121,"show_sort_weight":118,"slug":122},"World Cup","world-cup",{"id":124,"doc_module":4,"doc_module_name":25,"category_name":125,"show_sort_weight":124,"slug":126},10,"Lifestyle","lifestyle",{"id":128,"doc_module":4,"doc_module_name":25,"category_name":129,"show_sort_weight":97,"slug":130},19,"General","general",{"code":4,"msg":82,"data":132},{"doc_id":79,"user_id":133,"nickname":42,"user_avatar":134,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":97,"language":140,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":12,"update_tm":144,"read_time":145,"preview_page_count":4},1099513958762,"https://ap-avatar.wpscdn.com/avatar/1000023916a998db790?x-image-process=image/resize,m_fixed,w_180,h_180&k=1784791008015729253","Journal of Surgical Case Reports, 2026, 1, rjaf1046  \n[https://doi.org/10.1093/jscr/rjaf1046](https://doi.org/10.1093/jscr/rjaf1046)  \nCase Report  \nCase Report  \nSurgical resection of a primary cardiac angiosarcoma and reconstruction of involved right atrium  \nJiahong Xie1 ,†, Peiwen Mai2 ,†, Yang Wu1 , Xiaowu Wang1 , *  \n1 Department of Cardiovascular Surgery, Zhujiang Hospital, Southern Medical University, No. 253 Industrial Avenue, Haizhu District, Guangzhou, Guangdong Province 510280, China  \n2 Guangzhou Panyu District Blood Center, No. 25 Huizhong Street, Panyu District, Guangzhou, Guangdong Province 511442, China  \n*Corresponding author. Department of Cardiovascular Surgery, Zhujiang Hospital, Southern Medical University, No. 253 Industrial Avenue, Haizhu District,  \nGuangzhou, Guangdong Province 510280, China. E-mail: [xzwk_wxw@hotmail.com](xzwk_wxw@hotmail.com)  \n†Jiahong Xie and Peiwen Mai contributed equally to this article and are co-first authors.  \nAbstract  \nPrimary cardiac angiosarcoma is an extremely rare malignant neoplasm, typically showing terrible prognosis, the gold standard treatment is surgical resection. We present a case of a 41-year-old woman who was diagnosed with a large right atrium, presenting with complaints of chest pain and shortness of breath for 2 weeks. Multimodality imaging results suggest a cardiac angiosarcoma. The patient underwent successful radical resection and single-stage reconstruction of the right atrium and superior vena cava under normothermic cardiopulmonary bypass with a beating heart. Histopathology confirmed the diagnosis of primary cardiac angiosarcoma. Based on the genetic results, tiragolumab was used for postoperative immunotherapy. Fortunately, no evidence of recurrence of angiosarcoma was showed 4 year after surgery. Radical surgical resection with reconstruction of the resected heart structures was the only possible salvage option for giant angiosarcoma, which led to hemodynamic instability. Followed by chemotherapy, this radical approach may prolong survival.  \nKeywords: primary cardiac angiosarcoma; surgical resection; multimodality imaging; immunotherapy  \nIntroduction  \nPrimary cardiac angiosarcoma is an exceptionally rare and notoriously aggressive malignancy [1], representing the most common histological subtype of primary malignant cardiac tumors. The tumor demonstrates a predilection for the right atrium and ventricle [2], characterized by rapid, invasive growth and a high propensity for metastasis, particularly to the lungs, often at the time of diagnosis. Clinical presentation is often insidious, with non-specific constitutional symptoms such as dyspnea, chest pain, and fatigue leading to frequent delays in diagnosis [3] . While advances in multimodality imaging have improved detection, establishing a timely diagnosis remains challenging [4] .  \nSurgical resection remains the cornerstone of treatment and the only potential for cure. However, complete resection is complex due to the tumor’s frequent invasion of vital cardiac structures, necessitating sophisticated reconstruction. This report details a case of a large right atrial primary cardiac angiosarcoma successfully managed with radical surgical resection and reconstruction, highlighting this approach as a critical salvage option in selected patients.  \nCase presentation  \nA 41-year-old female was admitted to our hospital with chest tightness and dyspnea for the past 2 weeks. Physical examination revealed bilateral lower limb edema without cardiac murmurs or jugular venous distention. Laboratory findings were notable for hypoalbuminemia (30 g/L) and an elevated D-dimer level (6.99 mg/mL), without remarkable blood routine examination and serum chemistry. Electrocardiography demonstrated sinus tachycardia and low-voltage complexes (Fig. 1) . Echocardiography identified a large, well-demarcated hypoechoic mass (82 × 54 × 58 mm), nearly occupying the entire right atrial cavity (Fig. 2a and b) . Contrast-enh","cbCaifgGYs1MR4Mx","https://ap.wps.com/l/cbCaifgGYs1MR4Mx","pdf",1278928,"English","# Abstract\n# Introduction\n# Case presentation","[{\"question\":\"What was the patient’s initial presentation and key findings?\",\"answer\":\"The 41-year-old patient reported chest pain and shortness of breath for 2 weeks. Examination and labs showed findings such as hypoalbuminemia and elevated D-dimer, while imaging revealed a large right atrial mass and right pleural effusion.\"},{\"question\":\"What treatment approach was performed during surgery?\",\"answer\":\"A multidisciplinary team proceeded with radical en bloc surgical resection under normothermic cardiopulmonary bypass with a beating heart. The operation included anatomical reconstruction of the right atrium and involved venous structures.\"},{\"question\":\"How was the diagnosis confirmed and how was postoperative therapy managed?\",\"answer\":\"Histopathology confirmed primary cardiac angiosarcoma. Genetic results supported postoperative immunotherapy with tiragolumab.\"}]","Surgical resection of a primary cardiac angiosarcoma and reconstruction of involved right atrium | PDF",1790750914,13]