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Different prognostic outcomes in two cases of FDG-PET/CT-Positive and -negative cardiac angiosarcoma

Ryo Yamakuni, Shiro Ishii, Shoki Yamada, Junko Hara, Hiroki Suenaga, Shigeyasu Sugawara, Hirofumi Sekino, Takayoshi Yamaki, Keiichi Ishida, Yuko Hashimoto, Hiroshi Ito

Author information

  • Ryo Yamakuni

    Department of Radiology and Nuclear Medicine, Fukushima Medical University

  • Shiro Ishii

    Department of Radiology and Nuclear Medicine, Fukushima Medical University

  • Shoki Yamada

    Department of Diagnostic Pathology, Fukushima Medical University

  • Junko Hara

    Department of Radiology and Nuclear Medicine, Fukushima Medical University

  • Hiroki Suenaga

    Department of Radiology and Nuclear Medicine, Fukushima Medical University

  • Shigeyasu Sugawara

    Department of Radiology and Nuclear Medicine, Fukushima Medical University

  • Hirofumi Sekino

    Department of Radiology and Nuclear Medicine, Fukushima Medical University

  • Takayoshi Yamaki

    Department of Cardiovascular Medicine, Fukushima Medical University

  • Keiichi Ishida

    Department of Cardiovascular Surgery, Fukushima Medical University

  • Yuko Hashimoto

    Department of Diagnostic Pathology, Fukushima Medical University

  • Hiroshi Ito

    Department of Radiology and Nuclear Medicine, Fukushima Medical University

Abstract

Cardiac angiosarcoma is a rare malignant tumor with a poor prognosis, characterized by the high uptake of 18F-fluorodeoxyglucose (FDG). This case report presents two cases of cardiac angiosarcoma with a marked difference in FDG uptake and prognosis.


Case Summary:


Case 1: A 40-year-old male presented with syncope. Ultrasound echocardiography demonstrated a cardiac tumor with a high uptake of 18F-FDG (maximum standardized uptake value=9.2). The patient underwent heart catheterization and tumor biopsy. The pathological result was high-grade angiosarcoma, and the MIB-1(Ki-67) proliferation index was approximately 20%. Systemic chemotherapy was administered; however, the patient died 2 years and 5 months after disease onset.


Case 2: A 65-year-old female had a right atrial tumor incidentally diagnosed during routine ultrasound echocardiography. The tumor exhibited a low uptake of 18F-FDG (maximum standardized uptake value=1.8). Open heart surgery was performed, and the tumor was completely resected. Histological analysis revealed low-grade angiosarcoma, and the MIB-1(Ki-67) proliferation index was less than 5%. The patient was followed-up and had not relapsed 2 years after surgery.


Conclusion: 18F-FDG uptake may reflect pathological tumor grade and prognosis in cardiac angiosarcoma.

The cintent of reseach paper

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