Diagnosis of Venous Angiosarcoma by FDG PET/CT

A 70-year-old man complained of right leg swelling due to right iliac vein stenosis. No mass was identified around the stenotic site, and the vessel wall had not become thickened. Self-expandable stents were positioned at the stenotic site. About two years later, chest CT revealed lung nodules. Pathology showed sarcoma. A mass that was considered to be the primary lesion was found around the stent in the right iliac vein. Although sarcoma of the iliac vein is very rare, it should be considered in the differential diagnosis of iliac vein stenosis, even if there are no suspicious findings from image studies.

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“…Some reports state that PET is helpful for the diagnosis (14). Also, in the present case, accumulation was observed by PET.…”

Section: Discussionsupporting

confidence: 72%

A Case in Which Sarcoma Was Diagnosed Two Years after Stent Placement to Treat Right Iliac Vein Stenosis that Accompanied Severe Unilateral Leg Edema

Shinozaki

Kawaguchi

2012

Intern. Med.

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“…Treglia et al recently reported an SUVmax of 13 for a primary pulmonary epitheloid angiosarcoma that presented as an intrapulmonary mass [18]. There is even less experience in patients with aortic sarcoma [19,20] or sarcoma of the pulmonary veins [21]. Our own results on three patients are also encouraging.…”

Section: Discussionmentioning

confidence: 57%

Imaging features of primary Sarcomas of the great vessels in CT, MRI and PET/CT: a single-center experience

et al. 2013

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BackgroundTo investigate the imaging features of primary sarcomas of the great vessels in CT, MRI and 18 F-FDG PET/CT.MethodsThirteen patients with a primary sarcoma of the great vessels were retrospectively evaluated. All available images studies including F-18 FDG PET(/CT) (n = 4), MDCT (n = 12) and MRI (n = 6) were evaluated and indicative image features of this rare tumor entity were identified.ResultsThe median interval between the first imaging study and the final diagnosis was 11 weeks (0–12 weeks). The most frequently observed imaging findings suggestive of malignant disease in patients with sarcomas of the pulmonary arteries were a large filling defect with vascular distension, unilaterality and a lack of improvement despite effective anticoagulation. In patients with aortic sarcomas we most frequently observed a pedunculated appearance and an atypical location of the filling defect. The F-18 FDG PET(/CT) examinations demonstrated an unequivocal hypermetabolism of the lesion in all cases (4/4). MRI proved lesion vascularization in 5/6 cases.ConclusionIntravascular unilateral or atypically located filling defects of the great vessels with vascular distension, a pedunculated shape and lack of improvement despite effective anticoagulation are suspicious for primary sarcoma on MDCT or MRI. MR perfusion techniques can add information on the nature of the lesion but the findings may be subtle and equivocal. F-18 FDG PET/CT may have a potential role in these patients and may be considered as part of the imaging workup.

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“…With the help of PET-CT imaging we were able to promptly decide to operate. PET-CT imaging in diagnosing the angiosarcoma has been reported before 8. Venous angiosarcomas, though rare, have previously been reported 8–13.…”

Section: Discussionmentioning

confidence: 99%