RESUMO
A 19 years-old-female with a primary right atrial angiosarcoma partially obstructing the tricuspid valva, developed severe hypoxemia due to right-to-left shunting through a patent foramen ovale. This is the first report of such clinical situation with this type of tumor. A complete resection of the tumor was attempted, and the right atrium had to be rebuilt with a bovine pericardium patch. Post-operative cranial, thoracic and abdominal CT scans and bone scintigraphy did not show metastatic spread. Chest radiation therapy was started on the third postoperative week. Chemotherapy was not used. The patient died five months after surgery due to disseminated metastatic disease but no evidence of the tumor was found in the necroscopic study of the heart
Mulher de 19 anos com angiossarcoma de átrio direito que obstruía parcialmente a valva tricúspide, desenvolveu hipoxemia severa conseqüente a shunt direito-esquerdo através de forame oval pérvio, situação descrita pela primeira vez nesse tipo de tumor. Realizou-se ressecção tumoral ampla, embora incompleta, e reconstrução do átrio com fragmento de pericárdio bovino. No pós-operatório, tomografias de crânio, tórax e abdome e cintilografia óssea não mostraram metástases. Optou-se por radioterapia local complementar, sem quimioterapia. A paciente faleceu em conseqüência de metástases generalizadas, porém sem recidiva local do tumor, cinco meses após a cirurgia