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Bannan B, Ismail HS, Alabdulkarim FM, Sarak B, Vora T, Jimenez-Juan L, Gupta A, Yan AT, Marcuzzi D, Ong G, Latter DA, Nguyen ET, Seidman MA, Cusimano RJ, Deva DP. Right Ventricular Mass 12 Years after Osteosarcoma: Multimodality Imaging with Pathologic Correlation. Radiol Cardiothorac Imaging 2021; 3:e210191. [PMID: 34778786 DOI: 10.1148/ryct.2021210191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 09/12/2021] [Accepted: 10/01/2021] [Indexed: 11/11/2022]
Abstract
The authors report a 27-year-old woman with a remote left femoral osteosarcoma and amputation above the left knee who presented with a large right ventricular mass. Initial evaluation with thoracic CT was inconclusive regarding thrombus versus tumor, but metastatic osteosarcoma was suggested by findings at transthoracic echocardiography, cardiac CT, and cardiac MRI. The patient underwent tumor debulking, and osteosarcoma was confirmed with pathologic examination. She responded to chemotherapy, which resulted in reduction in size of the residual right ventricular tumor and of a few pulmonary metastases. Following induction chemotherapy, patient remains well undergoing maintenance therapy with an oral tyrosine kinase inhibitor. Keywords: CT, Echocardiography, MR Imaging, Intraoperative, Cardiac, Heart, Right Ventricle, Imaging Sequences, Metastases, Oncology Supplemental material is available for this article. © RSNA, 2021.
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Affiliation(s)
- Badr Bannan
- Department of Medical Imaging (B.B., H.S.I., F.M.A., L.J.J., A.T.Y., D.M., D.P.D.), Division of Cardiology (B.S., A.T.Y., G.O.), Keenan Research Centre, Li Ka Shing Knowledge Institute (L.J.J., A.T.Y., D.P.D.), Department of Cardiac Surgery (D.A.L.), and Department of Echocardiography (B.S., G.O.), St. Michael's Hospital, University of Toronto, 30 Bond St, Toronto, ON, Canada, M5B 1W8; Division of Medical Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada (T.V., A.G.); Department of Medicine, University of Toronto, Toronto, Canada (A.T.Y., G.O.); Department of Medical Imaging (E.T.N.), Peter Munk Cardiac Centre (E.T.N.), Laboratory Medicine Program, University Health Network (M.A.S.), Department of Laboratory Medicine and Pathobiology (M.A.S.), and Department of Cardiovascular Surgery (R.J.C.), Toronto General Hospital, University of Toronto, Toronto, Canada
| | - Huda S Ismail
- Department of Medical Imaging (B.B., H.S.I., F.M.A., L.J.J., A.T.Y., D.M., D.P.D.), Division of Cardiology (B.S., A.T.Y., G.O.), Keenan Research Centre, Li Ka Shing Knowledge Institute (L.J.J., A.T.Y., D.P.D.), Department of Cardiac Surgery (D.A.L.), and Department of Echocardiography (B.S., G.O.), St. Michael's Hospital, University of Toronto, 30 Bond St, Toronto, ON, Canada, M5B 1W8; Division of Medical Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada (T.V., A.G.); Department of Medicine, University of Toronto, Toronto, Canada (A.T.Y., G.O.); Department of Medical Imaging (E.T.N.), Peter Munk Cardiac Centre (E.T.N.), Laboratory Medicine Program, University Health Network (M.A.S.), Department of Laboratory Medicine and Pathobiology (M.A.S.), and Department of Cardiovascular Surgery (R.J.C.), Toronto General Hospital, University of Toronto, Toronto, Canada
| | - Faisal M Alabdulkarim
- Department of Medical Imaging (B.B., H.S.I., F.M.A., L.J.J., A.T.Y., D.M., D.P.D.), Division of Cardiology (B.S., A.T.Y., G.O.), Keenan Research Centre, Li Ka Shing Knowledge Institute (L.J.J., A.T.Y., D.P.D.), Department of Cardiac Surgery (D.A.L.), and Department of Echocardiography (B.S., G.O.), St. Michael's Hospital, University of Toronto, 30 Bond St, Toronto, ON, Canada, M5B 1W8; Division of Medical Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada (T.V., A.G.); Department of Medicine, University of Toronto, Toronto, Canada (A.T.Y., G.O.); Department of Medical Imaging (E.T.N.), Peter Munk Cardiac Centre (E.T.N.), Laboratory Medicine Program, University Health Network (M.A.S.), Department of Laboratory Medicine and Pathobiology (M.A.S.), and Department of Cardiovascular Surgery (R.J.C.), Toronto General Hospital, University of Toronto, Toronto, Canada
| | - Bradley Sarak
- Department of Medical Imaging (B.B., H.S.I., F.M.A., L.J.J., A.T.Y., D.M., D.P.D.), Division of Cardiology (B.S., A.T.Y., G.O.), Keenan Research Centre, Li Ka Shing Knowledge Institute (L.J.J., A.T.Y., D.P.D.), Department of Cardiac Surgery (D.A.L.), and Department of Echocardiography (B.S., G.O.), St. Michael's Hospital, University of Toronto, 30 Bond St, Toronto, ON, Canada, M5B 1W8; Division of Medical Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada (T.V., A.G.); Department of Medicine, University of Toronto, Toronto, Canada (A.T.Y., G.O.); Department of Medical Imaging (E.T.N.), Peter Munk Cardiac Centre (E.T.N.), Laboratory Medicine Program, University Health Network (M.A.S.), Department of Laboratory Medicine and Pathobiology (M.A.S.), and Department of Cardiovascular Surgery (R.J.C.), Toronto General Hospital, University of Toronto, Toronto, Canada
| | - Tushar Vora
- Department of Medical Imaging (B.B., H.S.I., F.M.A., L.J.J., A.T.Y., D.M., D.P.D.), Division of Cardiology (B.S., A.T.Y., G.O.), Keenan Research Centre, Li Ka Shing Knowledge Institute (L.J.J., A.T.Y., D.P.D.), Department of Cardiac Surgery (D.A.L.), and Department of Echocardiography (B.S., G.O.), St. Michael's Hospital, University of Toronto, 30 Bond St, Toronto, ON, Canada, M5B 1W8; Division of Medical Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada (T.V., A.G.); Department of Medicine, University of Toronto, Toronto, Canada (A.T.Y., G.O.); Department of Medical Imaging (E.T.N.), Peter Munk Cardiac Centre (E.T.N.), Laboratory Medicine Program, University Health Network (M.A.S.), Department of Laboratory Medicine and Pathobiology (M.A.S.), and Department of Cardiovascular Surgery (R.J.C.), Toronto General Hospital, University of Toronto, Toronto, Canada
| | - Laura Jimenez-Juan
- Department of Medical Imaging (B.B., H.S.I., F.M.A., L.J.J., A.T.Y., D.M., D.P.D.), Division of Cardiology (B.S., A.T.Y., G.O.), Keenan Research Centre, Li Ka Shing Knowledge Institute (L.J.J., A.T.Y., D.P.D.), Department of Cardiac Surgery (D.A.L.), and Department of Echocardiography (B.S., G.O.), St. Michael's Hospital, University of Toronto, 30 Bond St, Toronto, ON, Canada, M5B 1W8; Division of Medical Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada (T.V., A.G.); Department of Medicine, University of Toronto, Toronto, Canada (A.T.Y., G.O.); Department of Medical Imaging (E.T.N.), Peter Munk Cardiac Centre (E.T.N.), Laboratory Medicine Program, University Health Network (M.A.S.), Department of Laboratory Medicine and Pathobiology (M.A.S.), and Department of Cardiovascular Surgery (R.J.C.), Toronto General Hospital, University of Toronto, Toronto, Canada
| | - Abha Gupta
- Department of Medical Imaging (B.B., H.S.I., F.M.A., L.J.J., A.T.Y., D.M., D.P.D.), Division of Cardiology (B.S., A.T.Y., G.O.), Keenan Research Centre, Li Ka Shing Knowledge Institute (L.J.J., A.T.Y., D.P.D.), Department of Cardiac Surgery (D.A.L.), and Department of Echocardiography (B.S., G.O.), St. Michael's Hospital, University of Toronto, 30 Bond St, Toronto, ON, Canada, M5B 1W8; Division of Medical Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada (T.V., A.G.); Department of Medicine, University of Toronto, Toronto, Canada (A.T.Y., G.O.); Department of Medical Imaging (E.T.N.), Peter Munk Cardiac Centre (E.T.N.), Laboratory Medicine Program, University Health Network (M.A.S.), Department of Laboratory Medicine and Pathobiology (M.A.S.), and Department of Cardiovascular Surgery (R.J.C.), Toronto General Hospital, University of Toronto, Toronto, Canada
| | - Andrew T Yan
- Department of Medical Imaging (B.B., H.S.I., F.M.A., L.J.J., A.T.Y., D.M., D.P.D.), Division of Cardiology (B.S., A.T.Y., G.O.), Keenan Research Centre, Li Ka Shing Knowledge Institute (L.J.J., A.T.Y., D.P.D.), Department of Cardiac Surgery (D.A.L.), and Department of Echocardiography (B.S., G.O.), St. Michael's Hospital, University of Toronto, 30 Bond St, Toronto, ON, Canada, M5B 1W8; Division of Medical Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada (T.V., A.G.); Department of Medicine, University of Toronto, Toronto, Canada (A.T.Y., G.O.); Department of Medical Imaging (E.T.N.), Peter Munk Cardiac Centre (E.T.N.), Laboratory Medicine Program, University Health Network (M.A.S.), Department of Laboratory Medicine and Pathobiology (M.A.S.), and Department of Cardiovascular Surgery (R.J.C.), Toronto General Hospital, University of Toronto, Toronto, Canada
| | - Danny Marcuzzi
- Department of Medical Imaging (B.B., H.S.I., F.M.A., L.J.J., A.T.Y., D.M., D.P.D.), Division of Cardiology (B.S., A.T.Y., G.O.), Keenan Research Centre, Li Ka Shing Knowledge Institute (L.J.J., A.T.Y., D.P.D.), Department of Cardiac Surgery (D.A.L.), and Department of Echocardiography (B.S., G.O.), St. Michael's Hospital, University of Toronto, 30 Bond St, Toronto, ON, Canada, M5B 1W8; Division of Medical Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada (T.V., A.G.); Department of Medicine, University of Toronto, Toronto, Canada (A.T.Y., G.O.); Department of Medical Imaging (E.T.N.), Peter Munk Cardiac Centre (E.T.N.), Laboratory Medicine Program, University Health Network (M.A.S.), Department of Laboratory Medicine and Pathobiology (M.A.S.), and Department of Cardiovascular Surgery (R.J.C.), Toronto General Hospital, University of Toronto, Toronto, Canada
| | - Géraldine Ong
- Department of Medical Imaging (B.B., H.S.I., F.M.A., L.J.J., A.T.Y., D.M., D.P.D.), Division of Cardiology (B.S., A.T.Y., G.O.), Keenan Research Centre, Li Ka Shing Knowledge Institute (L.J.J., A.T.Y., D.P.D.), Department of Cardiac Surgery (D.A.L.), and Department of Echocardiography (B.S., G.O.), St. Michael's Hospital, University of Toronto, 30 Bond St, Toronto, ON, Canada, M5B 1W8; Division of Medical Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada (T.V., A.G.); Department of Medicine, University of Toronto, Toronto, Canada (A.T.Y., G.O.); Department of Medical Imaging (E.T.N.), Peter Munk Cardiac Centre (E.T.N.), Laboratory Medicine Program, University Health Network (M.A.S.), Department of Laboratory Medicine and Pathobiology (M.A.S.), and Department of Cardiovascular Surgery (R.J.C.), Toronto General Hospital, University of Toronto, Toronto, Canada
| | - David A Latter
- Department of Medical Imaging (B.B., H.S.I., F.M.A., L.J.J., A.T.Y., D.M., D.P.D.), Division of Cardiology (B.S., A.T.Y., G.O.), Keenan Research Centre, Li Ka Shing Knowledge Institute (L.J.J., A.T.Y., D.P.D.), Department of Cardiac Surgery (D.A.L.), and Department of Echocardiography (B.S., G.O.), St. Michael's Hospital, University of Toronto, 30 Bond St, Toronto, ON, Canada, M5B 1W8; Division of Medical Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada (T.V., A.G.); Department of Medicine, University of Toronto, Toronto, Canada (A.T.Y., G.O.); Department of Medical Imaging (E.T.N.), Peter Munk Cardiac Centre (E.T.N.), Laboratory Medicine Program, University Health Network (M.A.S.), Department of Laboratory Medicine and Pathobiology (M.A.S.), and Department of Cardiovascular Surgery (R.J.C.), Toronto General Hospital, University of Toronto, Toronto, Canada
| | - Elsie T Nguyen
- Department of Medical Imaging (B.B., H.S.I., F.M.A., L.J.J., A.T.Y., D.M., D.P.D.), Division of Cardiology (B.S., A.T.Y., G.O.), Keenan Research Centre, Li Ka Shing Knowledge Institute (L.J.J., A.T.Y., D.P.D.), Department of Cardiac Surgery (D.A.L.), and Department of Echocardiography (B.S., G.O.), St. Michael's Hospital, University of Toronto, 30 Bond St, Toronto, ON, Canada, M5B 1W8; Division of Medical Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada (T.V., A.G.); Department of Medicine, University of Toronto, Toronto, Canada (A.T.Y., G.O.); Department of Medical Imaging (E.T.N.), Peter Munk Cardiac Centre (E.T.N.), Laboratory Medicine Program, University Health Network (M.A.S.), Department of Laboratory Medicine and Pathobiology (M.A.S.), and Department of Cardiovascular Surgery (R.J.C.), Toronto General Hospital, University of Toronto, Toronto, Canada
| | - Michael A Seidman
- Department of Medical Imaging (B.B., H.S.I., F.M.A., L.J.J., A.T.Y., D.M., D.P.D.), Division of Cardiology (B.S., A.T.Y., G.O.), Keenan Research Centre, Li Ka Shing Knowledge Institute (L.J.J., A.T.Y., D.P.D.), Department of Cardiac Surgery (D.A.L.), and Department of Echocardiography (B.S., G.O.), St. Michael's Hospital, University of Toronto, 30 Bond St, Toronto, ON, Canada, M5B 1W8; Division of Medical Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada (T.V., A.G.); Department of Medicine, University of Toronto, Toronto, Canada (A.T.Y., G.O.); Department of Medical Imaging (E.T.N.), Peter Munk Cardiac Centre (E.T.N.), Laboratory Medicine Program, University Health Network (M.A.S.), Department of Laboratory Medicine and Pathobiology (M.A.S.), and Department of Cardiovascular Surgery (R.J.C.), Toronto General Hospital, University of Toronto, Toronto, Canada
| | - Robert J Cusimano
- Department of Medical Imaging (B.B., H.S.I., F.M.A., L.J.J., A.T.Y., D.M., D.P.D.), Division of Cardiology (B.S., A.T.Y., G.O.), Keenan Research Centre, Li Ka Shing Knowledge Institute (L.J.J., A.T.Y., D.P.D.), Department of Cardiac Surgery (D.A.L.), and Department of Echocardiography (B.S., G.O.), St. Michael's Hospital, University of Toronto, 30 Bond St, Toronto, ON, Canada, M5B 1W8; Division of Medical Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada (T.V., A.G.); Department of Medicine, University of Toronto, Toronto, Canada (A.T.Y., G.O.); Department of Medical Imaging (E.T.N.), Peter Munk Cardiac Centre (E.T.N.), Laboratory Medicine Program, University Health Network (M.A.S.), Department of Laboratory Medicine and Pathobiology (M.A.S.), and Department of Cardiovascular Surgery (R.J.C.), Toronto General Hospital, University of Toronto, Toronto, Canada
| | - Djeven P Deva
- Department of Medical Imaging (B.B., H.S.I., F.M.A., L.J.J., A.T.Y., D.M., D.P.D.), Division of Cardiology (B.S., A.T.Y., G.O.), Keenan Research Centre, Li Ka Shing Knowledge Institute (L.J.J., A.T.Y., D.P.D.), Department of Cardiac Surgery (D.A.L.), and Department of Echocardiography (B.S., G.O.), St. Michael's Hospital, University of Toronto, 30 Bond St, Toronto, ON, Canada, M5B 1W8; Division of Medical Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada (T.V., A.G.); Department of Medicine, University of Toronto, Toronto, Canada (A.T.Y., G.O.); Department of Medical Imaging (E.T.N.), Peter Munk Cardiac Centre (E.T.N.), Laboratory Medicine Program, University Health Network (M.A.S.), Department of Laboratory Medicine and Pathobiology (M.A.S.), and Department of Cardiovascular Surgery (R.J.C.), Toronto General Hospital, University of Toronto, Toronto, Canada
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Wang J, Cheng Y, Lee YZ, Wang Y, Zheng Y, Dong R, Lai Y, Tang X, Yang Y, Wang S, He N, Jia Y, Cheng W, Liu D, Wang X, Zhang C. Sonography and Transthoracic Echocardiography for Diagnosis of Systemic Cardiovascular Metastatic Tumor Thrombi. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2016; 35:1993-2027. [PMID: 27492390 DOI: 10.7863/ultra.15.10038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Accepted: 12/23/2015] [Indexed: 06/06/2023]
Abstract
Sonography and transthoracic echocardiography (TTE) are seldom used for assessment of metastatic tumor thrombi in the cardiovascular system in routine clinical practice. We performed this retrospective study to evaluate the combination of sonography with TTE for diagnosis of metastatic tumor thrombi in heart and systemic vessels. Vascular, abdominal, pelvic, and small-part sonography was applied in 18 patients, and TTE was conducted simultaneously in 14 patients. Tumor thrombi invaded into the inferior vena cava system in 12 patients, superior vena cava system in 5 patients, and aorta in 1 patient; they extended to the right cardiac chambers in 11 patients. Six patients had diagnoses by pathologic examination. The primary neoplasms were identified by conventional imaging in 17 patients. The morphologic and echogenic characteristics of the tumor thrombi were diverse and depended on their original tumors. The thrombi were either contiguous or discrete from the original tumors. The neoplastic vascularity of the thrombi and the invasive extension were the primary characteristics that distinguished them from bland thrombi. Simultaneous application of sonography and TTE is a feasible way to comprehensively evaluate cardiovascular metastatic tumor thrombi in most patients.
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Affiliation(s)
- Jiong Wang
- Department of Ultrasound, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China, Department of Radiology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina USA, Department of Medical Ultrasonography, Peking University International Hospital, Beijing, China
| | - Yi Cheng
- Department of Ultrasound, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China
| | - Yueh Z Lee
- Department of Radiology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina USA
| | - Yongmei Wang
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China
| | - Ye Zheng
- Department of Ultrasound, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China
| | - Ran Dong
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China
| | - Yongqiang Lai
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China
| | - Xiaobin Tang
- Department of Vascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China
| | - Yaoguo Yang
- Department of Vascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China
| | - Sheng Wang
- Department of Vascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China
| | - Nan He
- Department of Vascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China
| | - Yunfeng Jia
- Department of Vascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China
| | - Wei Cheng
- Department of Vascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China
| | - Dan Liu
- Department of Vascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China
| | - Xiaona Wang
- Department of Vascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China
| | - Chun Zhang
- Department of Echocardiography, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China
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