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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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