The authors report the case of a right atrial angiosarcoma extending to the right ventricle, presenting with a massive pericardial effusion, in a 30 year old man. The patient underwent surgical ablation of the tumour with right atrial reconstruction, tricuspid valvuloplasty, plicature of the right ventricle and a right coronary artery bypass graft with complementary chemotherapy. This case illustrates the decisive contribution of multiplane transoesophageal echocardiography in the preoperative investigation, providing accurate information about the site and extension of the tumour, and even about the malignant character of the pathology. Magnetic resonance imaging, though useful, did not provide any further information in this case. Unfortunately, thoracic CT scan, performed 15 days after surgery, showed the presence of pulmonary metastases, confirming the very poor prognosis of these tumours.
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