Case report: Primary cardiac angiosarcoma with multiple metastases

Figures

• 

  Figure 1. CT from chest to pelvis with enhancement shows right atrial tumor, small ground-glass pulmonary nodule, and bone destructions. (A) Arterial phase imaging reveals a filling defect in the right atrium (arrowhead). (B) Venous phase imaging shows the tumor inhomogeneously enhancing (arrowhead). (C) A lung window image shows a metastatic nodule in the upper right lung. (D) Bone destructions in the right ilium and sacrum.

• 

  Figure 2. Cardiac magnetic resonance imaging. (A) On SSFP cine imaging planned in the four chambers, the tumor shows isointense (arrowhead). (B) On T2-short tau inversion recovery sequence images, the tumor displays high-signal intensity (arrowhead). (C,D) On enhanced MR imaging, the tumor shows arterial heterogeneous enhancement and progressive but incomplete enhancement in the delayed phase (dynamic acquisition).

• 

  Figure 3. PET-CT demonstrates the tumor intensely increased FDG uptake with bony metastases (arrowhead).

• 

  Figure 4. Histology of resection from the left lower lung nodule. The spindle cells are CD34 (A, 200 ×) and ERG (ETS-related gene) (B, 200 ×) positive.

• 

  Figure 5. Repeat cardiac magnetic resonance imaging and thoracic CT. (A) SSFP cine imaging planned in the four chambers shows the tumor markedly reduced. (B) Thoracic CT shows the pulmonary nodules obviously decreased too, compared with Figure 1C.