March 19, 2025Current Medical Imaging Formerly Current Medical Imaging ReviewsOpen Access

Primary Cardiac Angiosarcoma Diagnosed by Multimodality Imaging: A Case Report

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Why the study?

Primary cardiac tumors are rare and mostly benign, prompting this case report of primary cardiac angiosarcoma diagnosed via multimodality imaging to enhance understanding among clinicians and radiologists.

Structured PICO

Population

1 29-year-old woman presenting with chest tightness, chest pain, palpitations, and dyspnea after physical activity, subsequently diagnosed with Primary Cardiac Angiosarcoma (PCA)

Intervention

Multimodality imaging including Ultrasonography, Computed Tomography (CT), Cardiac magnetic resonance imaging, and Positron Emission Tomography-Computed Tomography (PET/CT)

Outcome

Diagnosis of Primary Cardiac Angiosarcoma and detection of metastasessurrogate

Multimodality imaging is crucial for the precise localization, diagnosis, and metastatic evaluation of rare primary cardiac angiosarcomas.

Implication

Multimodality imaging aids rare PCA diagnosis; hypothesis-generating and should not yet change practice.

Abstract

BACKGROUND: Primary cardiac tumors are rare. Most primary cardiac tumors are benign, with approximately 10.83% being malignant. We present a rare case of Primary Cardiac Angiosarcoma (PCA) with multiple metastases diagnosed using multimodality imaging, to enhance the understanding of PCA among clinicians and radiologists. CASE DESCRIPTION: A 29-year-old woman presented to our hospital with a 2-day history of chest tightness, chest pain, palpitations, and dyspnea after physical activity. Ultrasonography and Computed Tomography (CT) of the heart revealed a mass in the right atrium. Cardiac magnetic resonance imaging suggested either a large cardiac lymphoma or angiosarcoma. The histopathological diagnosis confirmed a cardiac angiosarcoma. Positron Emission Tomography-Computed Tomography (PET/CT) revealed intense 18F-fluorodeoxyglucose (18F-FDG) uptake in the right side of the heart, with a maximum standardized uptake value of 10.9. Three months later, the patient was re-examined using abdominal CT, echocardiography, and PET/CT. PET/CT revealed increased 18F-FDG uptake which had become more extensive, with multifocal metastatic nodules in both the lungs and mediastinum. The patient was lost to follow-up after being discharged on May 1, 2022. CONCLUSION: The combined evaluation using multimodality imaging plays a vital role in determining the precise size and localization of the PCA, detecting distant metastases, and assessing patient prognosis.