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BMJ Case Rep. 2010; 2010: bcr08.2009.2157.
Published online 2010 February 19. doi:  10.1136/bcr.08.2009.2157
PMCID: PMC3027499
Unexpected outcome (positive or negative) including adverse drug reactions

Extended remission of metastatic epithelioid angiosarcoma of the heart with liposomal doxorubicin


Angiosarcoma is the most common primary malignant tumour of the heart. It is a rare and aggressive neoplasm that almost always has a short and fatal evolution. By the time it produces symptoms it has usually progressed to a mass causing haemodynamic compromise. Initial presentation with metastatic disease is unusual. We report the case of a 72-year-old man who presented with painful skin lesions on both hands. The skin biopsy was diagnosed as intravascular metastasis of epithelioid angiosarcoma. Body computed tomography scan disclosed a solid mass in the left atrium. The tumour was judged unresectable and the patient was treated with systemic chemotherapy, consisting of liposomal doxorubicin, which resulted in a complete clinical response. The patient remains free of disease after 48 months of follow-up. The excellent clinical evolution of our patient verifies that liposomal doxorubicin may be effective in the treatment of these tumours and significantly prolong patients’ lifespan.

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