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Adzic NM, Obradovic KV, Urban VP, Mijaljevic MB, Radmanovic BJ, Milosevic ZC. Computed tomography features of pulmonary metastases from angiosarcoma: Lessons learned from one case study. Radiol Case Rep 2021; 16:2646-2650. [PMID: 34345325 PMCID: PMC8319485 DOI: 10.1016/j.radcr.2021.06.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 06/14/2021] [Accepted: 06/16/2021] [Indexed: 11/25/2022] Open
Abstract
A distinctive feature of some angiosarcomas is that two or more atypical forms of pulmonary metastases may be detected concomitantly. In this case report, we present a 37-year-old man diagnosed with angiosarcoma of the neck, with extreme diversity of lung metastases on chest computed tomography (CT). We analyzed CT features of metastases and discussed possible reasons for their pleomorphism, as well as clinical implications of these findings.
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Affiliation(s)
- Nina M Adzic
- Institute of Oncology and Radiology of Serbia, Department or Radiology, Belgrade, Serbia
| | - Katarina V Obradovic
- Institute of Oncology and Radiology of Serbia, Department or Radiology, Belgrade, Serbia
| | - Vladimir P Urban
- Institute of Oncology and Radiology of Serbia, Department or Radiology, Belgrade, Serbia
| | - Marija B Mijaljevic
- Institute of Oncology and Radiology of Serbia, Department or Radiology, Belgrade, Serbia
| | - Branka J Radmanovic
- Institute of Oncology and Radiology of Serbia, Clinic of Surgical Oncology, Belgrade, Serbia
| | - Zorica C Milosevic
- Institute of Oncology and Radiology of Serbia, Department or Radiology, Belgrade, Serbia.,School of Medicine, University of Belgrade, Belgrade, Serbia
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Chen Y, He X, Shang J, Zhang N, Li X, Liu J, Xu L, Liu D, Li Y, Sun Z, Wen Z. CT Findings of Pulmonary Metastases from Primary Cardiac Angiosarcoma. Curr Med Imaging 2021; 17:1216-1220. [PMID: 34061006 DOI: 10.2174/1573405617666210521151753] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 02/01/2021] [Accepted: 02/17/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Primary cardiac angiosarcoma is a rare malignancy with high predilection to involve surrounding structures such as pulmonary metastases. We analysed the chest computed tomography (CT) imaging features of patients diagnosed with primary cardiac angiosarcoma with pulmonary metastases in this study. METHODS This study retrospectively reviewed 12 patients with confirmed primary cardiac angiosarcoma, out of which eight (all men) with pulmonary metastasis were included in the analysis. The patients' age ranged from 17 to 74 (mean: 48) years. CT was performed in all patients with unenhanced, contrast-enhanced, and both scans were done in 1, 3 and 4 patients, respectively. RESULTS Nodular lesions were observed in 7 patients with multiple solid nodules observed in 6 out of 7 patients. A solitary solid nodule was found in the remaining patient in the upper lobe and apical segment of the right lung with a diameter of 11.7 mm. All solid nodules were distributed along with bronchovascular bundles in the lungs, and their maximum diameter ranged from 2.3 to 19.9 mm. Nodules larger than 10 mm in diameter were heterogeneously enhanced on contrast-enhanced CT images (5/8 patients), whereas those smaller than 10 mm were homogeneously enhanced (3/8 patients). Other imaging features, namely the tree-in-bud pattern, emphysema, pleural effusion, and mediastinal lymph node enlargement, were observed in 4, 3, 3, and 2 patients, respectively. CONCLUSION CT enhancement features of pulmonary metastasis in patients with primary cardiac angiosarcoma depend on the size of pulmonary nodules, with larger ones being heterogeneous and smaller ones homogeneous. Other signs are less noticed.
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Affiliation(s)
- Yan Chen
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Xiang He
- Department of Diagnostic CT, Cangzhou Central Hospital, No. 16, Xinhua Road, Cangzhou 061001, Hebei, China
| | - Jianfeng Shang
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Nan Zhang
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Xiaodan Li
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Jiayi Liu
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Lei Xu
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Dongting Liu
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Yu Li
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Zhonghua Sun
- Discipline of Medical Radiation Science, Curtin Medical School, Curtin University, Perth, Australia
| | - Zhaoying Wen
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
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Corrias G, Escalon JG, Tang L, Monti S, Saba L, Mannelli L. Hepatic angiosarcomatous transformation of a mediastinal germinal cell tumor: A care case report. Medicine (Baltimore) 2017; 96:e9152. [PMID: 29390446 PMCID: PMC5758148 DOI: 10.1097/md.0000000000009152] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
RATIONALE Mediastinal nonseminomatous germ cell tumor (NSGCT) is an uncommon entity. Metastatic hepatic sarcomatous transformation is rare. PATIENT CONCERNS We report a 24-year-old man with no previous related medical history presented with chest pain and left arm numbness. DIAGNOSES The x-ray showed an anterior mediastinal mass. The chest computed tomography (CT) confirmed the presence of a mildly enhancing mass in the same location, without invasion of any vascular structure. A CT-guided biopsy was performed, revealing a primary mediastinal nonseminomatous germ cell tumor (NSGCT), yolk sac histology, with areas of somatic transformation to malignant nerve sheath tumor. After surgery patient was followed-up with imaging. Two years later a CT scan showed a new hepatic hyper vascular lesion, confirmed by a subsequent magnetic resonance imaging (MRI) and positron emission tomography (PET) scan. A CT-guided biopsy revealed a hepatic metastatic transformation to angiosarcoma of the primitive NSGCT. INTERVENTIONS The patient went on to received palliative chemotherapy. OUTCOMES The patient is being followed-up regularly at the outpatient department. LESSONS Because of the potential of metastatic sarcoma arising from germ cell tumors, these patients should undergo periodical follow-up, with periodical scans. PET\CT scan might have a role in the follow-up of these patients.
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Affiliation(s)
- Giuseppe Corrias
- Department of Radiology, Memorial Sloan Kettering Cancer Center, York Avenue, New York, NY, USA
- Department of Radiology, University of Cagliari, via Università, Cagliari, Italy
| | - Joanna G. Escalon
- Department of Radiology, Memorial Sloan Kettering Cancer Center, York Avenue, New York, NY, USA
- Department of Radiology, New York-Presbyterian/Weill Cornell Medical Center, New York, NY
- Department of Radiology, University of Colorado, Aurora, CO
| | - Laura Tang
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - Luca Saba
- Department of Radiology, University of Cagliari, via Università, Cagliari, Italy
| | - Lorenzo Mannelli
- Department of Radiology, Memorial Sloan Kettering Cancer Center, York Avenue, New York, NY, USA
- Department of Radiology, New York-Presbyterian/Weill Cornell Medical Center, New York, NY
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Liu B, Sun W, Wang K. A successful insertion of PICC in patient with cardiac angiosarcoma and neoplasty of right atrium and pacemaker: A case report. Medicine (Baltimore) 2017; 96:e9225. [PMID: 29390474 PMCID: PMC5758176 DOI: 10.1097/md.0000000000009225] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Primary cardiac angiosarcoma is a rare tumor and the common treatment is surgical resection followed by chemotherapy. Peripherally inserted central venous catheters (PICCs) are widely used in cancer patients and ultrasound-guided PICC insertion could improve success rate especially in patient with abnormal anatomy structure. Reports about PICCs being placed in patient who had suffered from the cardiac angiosarcoma and neoplasty of right atrium with an ipsilateral cardiac permanent pacemaker are rarely.After patient's informed consent, we present a case of the successful insertion of PICC into a patient with the ipsilateral cardiac disease with a pacemaker placement, which has not been previously reported. CONCLUSIONS This report highlights PICC could be used in patient with cardiac disease with a pacemaker placement for chemotherapy.
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