Clinical and Imaging Features of Primary Cardiac Angiosarcoma

Chen, Yan; Liu, Yu; Zhang, Nan; Shang, Jianfeng; Li, Xiaodan; Liu, Jiayi; Xu, Lei; Liu, Dongting; Sun, Zhonghua; Wen, Zhaoying

doi:10.3390/diagnostics10100776

Cited by 15 publications

(8 citation statements)

References 29 publications

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“…The patterns of lesions are mostly bilateral (82%) and peripheral (56%). Crazy paving pattern, LAP, pericardial and pleural effusion and sub-pleural signs were the other CT scan findings accordingly (6,19,20). However there are positive RT-PCR cases with normal pattern of chest CT scan suggesting not to exclude these patients of 2019-nCoV (21).…”

Section: Grading the Quality Of Evidencementioning

confidence: 98%

Clinical characterization and chest CT findings in laboratory-confirmed COVID-19: a systematic review and meta-analysis

Vaseghi

Mansourian

Karimi

et al. 2020

Preprint

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Background: Imagery techniques have been used as essential parts of diagnostic workup for patients suspected for 2019-nCoV infection, Multiple studies have reported the features of chest computed tomography (CT) scans among a number of 2019-nCoV patients. Method: Study Identification was carried out in databases (PubMed, Embase and Cochrane Library) to identify published studies examining the diagnosis, the 2019 novel coronavirus (2019-nCoV). Heterogeneity among reported prevalence was assessed by computing p-values of Cochrane Q-test and I 2 -statics. The pooled prevalence of treatment failure was carried out with a fixed effects meta-analysis model, generating the pooled 95% confidence interval. A random-effect model was used to pool the results since this model could incorporate the heterogeneity of the studies and therefore proved a more generalized result.Results: According to the combined results of meta-analysis, the total 55% of corona patients were males. The mean age of the patients was 41.31 (34.14, 48.47). Two prevalent clinical symptoms between patients were fever, cough with prevalence of 85%, and 62%, respectively.Either Ground Glass Opacity GGO or consolidation was seen in 86% but 14% had NO GGO or consolidation.The other rare CT symptoms were pericardial effusion, and pleural effusion with 4, 5, 7% prevalence, respectively. The most prevalent event was Either GGO or consolidation in 85% of patients.

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Section: Grading the Quality Of Evidencementioning

confidence: 98%

Clinical characterization and chest CT findings in laboratory-confirmed COVID-19: a systematic review and meta-analysis

Vaseghi

Mansourian

Karimi

et al. 2020

Preprint

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“…CT identifies broad-based masses that are inhomogeneous without contrast and have heterogenous and centripetal enhancement with contrast [ 12 ]. Even with the advent of advanced imaging techniques, this elusive tumor can be easily missed.…”

Section: Discussionmentioning

confidence: 99%

Pericardial Angiosarcoma: A Diagnostic Challenge

Kumaran¹,

Asif²,

Hussain³

et al. 2021

Cureus

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Cardiac angiosarcomas are the most common malignant primary cardiac tumors accounting for 31% of all primary cardiac tumors. However, primary pericardial angiosarcomas are extremely rare and are associated with high mortality.A 41-year-old male with a past medical history of end-stage renal disease (ESRD) on hemodialysis, follicular thyroid carcinoma, hypertension, and asthma presented with recurrent pericardial effusions. Previously, different imaging modalities had shown small hemodynamically stable pericardial effusions with pericardial thickening. His pericardial effusion was attributed to his ESRD until this presentation. However, during the current admission, chest X-ray showed cardiomegaly with lobulated left heart border. Computed tomography (CT) and transthoracic echocardiogram showed an increased posterior complex pericardial effusion when compared to previous imaging. A pericardial window was created and the space was evacuated. Pericardial fluid cytology reported rare atypical cells, which were indeterminate for malignancy. Histopathology from the pericardial biopsy revealed fibrous tissue with cellular proliferation, consistent with an angiosarcoma. A positron emission tomography revealed findings of angiosarcoma (hypermetabolic pericardial soft tissue nodularity and complex pericardial fluid) limited only to the pericardium. Unfortunately, the angiosarcoma was deemed unresectable, and the patient underwent one cycle of chemotherapy with paclitaxel. The patient's hospital course was further complicated by myelosuppression from chemotherapy and disseminated intravascular coagulation. Therefore, no further chemotherapy was pursued. A repeat echocardiogram showed constriction of both ventricles with loculated pericardial effusion. The patient eventually transitioned to comfort care and passed away.Through this case report, we would like to highlight that multiple confounders can be present when considering the etiology of persistent pericardial effusions. We suggest contemplating alternate diagnosis, such as malignancy, and initiate aggressive work-up especially in young individuals with recurrent, unexplained pericarditis.

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“…Primary cardiac tumors are rare, with an autopsy prevalence of .001-.03%, of which 25% are malignant. 1 Angiosarcoma is the most common primary malignant cardiac tumor in adults, originating preferentially in the RA [1][2][3][4] and commonly affecting middle-aged and male patients, 1,3,4 as in this case. The manifestations are nonspecific, and related to tumor size and location, such as chest pain, pericardial effusion, or right heart failure.…”

Section: Discussionmentioning

confidence: 99%

“…The manifestations are nonspecific, and related to tumor size and location, such as chest pain, pericardial effusion, or right heart failure. [2][3][4] The overall prognosis is extremely poor due to its aggressive and metastatic nature and the difficulty in diagnosis at an early stage. 1,3,4 Evaluation and diagnosis of intra-cardiac tumors can be complex and should include a variety of techniques.…”

Section: Discussionmentioning

confidence: 99%

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The value of multimodal imaging in the diagnosis of primary cardiac angiosarcoma

Wen-gang

Fang

et al. 2021

Echocardiography

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A primary cardiac angiosarcoma (PCA) is very rare, highly aggressive, and metastatic in nature. The manifestations are often nonspecific, and the overall prognosis is extremely poor. The diagnosis of PCA can be complex and remains challenging. The key for diagnosis is echocardiography, and multimodality imaging is a more advantageous modality. Here, we present a rare case of a 41-year-old man who was diagnosed with PCA with multiple lung and bone metastases using multimodal imaging technology. Our case emphasizes the value of multimodality imaging in diagnosing PCA and suggests that patients showing intra-cardiac thrombus and hemorrhagic effusion on echocardiography without a clear explanation should be further investigated or closely followed.

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Clinical and Imaging Features of Primary Cardiac Angiosarcoma

Cited by 15 publications

References 29 publications

Clinical characterization and chest CT findings in laboratory-confirmed COVID-19: a systematic review and meta-analysis

Clinical characterization and chest CT findings in laboratory-confirmed COVID-19: a systematic review and meta-analysis

Pericardial Angiosarcoma: A Diagnostic Challenge

The value of multimodal imaging in the diagnosis of primary cardiac angiosarcoma

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