case_images: PMC5873788_01
case_images: A) Pericardial effusion in transthoracic echocardiography. B)
  Hyperechogenic mass arising from the right atrium and invading the right
  ventricle on transthoracic echocardiography in four-chamber view. C)
  Axial thoracic computed tomography (CT). D) Coronal thoracic CT. E)
  Sagittal thoracic CT; soft tissue lesion (5 cm in size) filling the
  right atrial lumen and invading the right ventricle and, partially, the
  suprahepatic segment; pericardial and pleural effusion. F) Soft tissue
  lesion in left upper mediastinum (white arrow). G)
  (18)F-fluorodeoxyglucose (FDG) positron emission tomography/computed
  tomography (PET/CT) images demonstrate hypermetabolic mass (SUVmax:
  14.29) in the right atrium, bilateral pleural and pericardial effusion,
  and mediastinal metastatic lymphadenopathy (SUVmax: 15.07). H) FDG
  PET/CT images demonstrate hypermetabolic mass (SUVmax: 15) in the medial
  left kidney.
case_images: rbccv-33-01-0104-g01.jpg
case_images: PMC5873788_01_rbccv-33-01-0104-g01.jpg
case_images: f1
case_images: There was a massive pericardial and moderate right pleural effusion (Figure 1). Echocardiogram showed massive pericardial effusion and a solid tumor in the right atrium expanding towards the right ventricule (Figure 1). (18)F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) scan revealed increased FDG uptake in the mediastinum and over the heart. Pleural and pericardial effusion and intra-abdominal free fluid were also seen (Figure 1).
case_images: A) Mass (M) before right atriotomy. B) Mass infiltrating atrial
  appendage (AA). C) Removal of the mass. D) The defect was repaired
  by pericardial tissue.. Ao=aorta; P=pericardium; VCS=vena cava superior
case_images: rbccv-33-01-0104-g02.jpg
case_images: PMC5873788_01_rbccv-33-01-0104-g02.jpg
case_images: f2
case_images: This resected area was repaired by using glutaraldehyde-treated autologous pericardium (0.1%) (Figure 2).
case_images: A) Gross pathological picture of the tumor. B) Cellularity and
  necrosis of the angiosarcoma (HE, x100). C) Angiosarcoma cells
  round, oval, or spindle shaped (arrow) (HE, x200). D) Tumor cells
  (arrow) were immunohistochemistry cytoplasmic stained by cluster of
  differentiation 34 (CD34, x200). E) Tumor cells (arrow) show nuclear
  positive immunohistochemical staining with friend leukemia
  integration-1 (FLI-1) (CD34, x100).
case_images: rbccv-33-01-0104-g03.jpg
case_images: PMC5873788_01_rbccv-33-01-0104-g03.jpg
case_images: f3
case_images: On immunohistochemical analysis, tumor cells were positive for cluster of differentiation 31 (CD31), CD34, friend leukemia integration-1 (FLI-1) and erythroblast transformation specific regulated gene-1 (ERG), but they were negative for keratin, desmin, smooth muscle actin (SMA), myogenin, Human melanoma black 45 (HMB45) and human herpesvirus 8 (HHV-8) (Figure 3).