The use of NPWT dressings as a bridge to definitive closure may reduce the need for more burdensome flap reconstruction, does not delay definitive reconstruction or prolong hospital stay and may reduce post-reconstruction complications requiring re-operation.

Primary angiosarcoma of pulmonary artery is a very rare lesion. We present a case of primary angiosarcoma that was initially misdiagnosed as a subacute massive pulmonary thromboembolism in a 30-year-old man. This rare disease is usually indistinguishable from acute or chronic thromboembolic disease of the pulmonary arteries. The clinical and radiological findings of pulmonary artery angiosarcoma are similar to those of pulmonary thromboembolism. Although the incidence of pulmonary artery angiosarcoma is very low, our case demonstrates that this disease entity should be included in the differential diagnosis of pulmonary thromboembolism. Patients with early identification can have curative potential with aggressive surgical intervention.

Cardiac calcified amorphous tumor (CAT) is a rare pseudoneoplastic mass composed of calcium deposits in a background of amorphous degenerating fibrin. Although the pathogenesis of this entity is not well understood CAT is a clinically important pseudoneoplasm because it often raises high suspicion for malignancy. CLINICAL SUMMARYA 75-year-old woman presented with episodic presyncope associated with palpitations. She was diabetic and hypertensive with a history of rheumatic fever with associated valvular dysfunction. Physical examination revealed an irregular pulse rate of 82 beats/min and no signs of left heart failure. On auscultation, a soft diastolic murmur was heard.Biochemical investigation results were all within normal limits, including serum calcium, parathormone levels, and proteins C and S. Electrocardiography confirmed atrial fibrillation and showed periods of sinus rhythm and firstdegree heart block. In-hospital telemetry demonstrated episodes of complete heart block rate that required permanent pacemaker.Transthoracic and transesophageal echocardiography showed the presence of a large echogenic mass at the basal inferior wall and inferoposterior mitral annulus extending into both the interventricular and interatrial septae. The mass appeared encapsulated, intramyocardial, and extensive (5.4 3 4.2 cm). The posterior mitral valve leaflet was clearly compressed by the mass, causing mild mitral stenosis and mild mitral regurgitation. Left ventricular function was preserved. Transthoracic echocardiography, performed 3 years previously to investigate a diastolic murmur, revealed a 2.5 3 1.8-cm calcific mass behind the posterior mitral valve leaflet. The patient was lost to follow-up.Computed tomography (Figure 1) of the chest and cardiac magnetic resonance imaging confirmed the presence From the

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