Effectiveness of Preoperative PET Examination of Huge Angiosarcoma of the Heart

Abstract

We report a 60-year-old-woman with a huge intracardiac angiosarcoma in whom preoperative F-18 fluorodeoxyglucose (FDG) PET was useful for confirming malignancy of the tumor and determining whether surgery was indicated for it. Her chief complaint was dyspnea. Because she was suspected to have a huge intracardiac tumor on the basis of transthoracic echocardiographic and computed tomography (CT) findings, FDG PET was performed, and the maximum standardized uptake value (SUV) of the tumor was found to be 5.6. Because other tests and SUV level suggested a malignant cardiac tumor, surgical resection of it was attempted. On histopathological examination, the tumor was found to be an angiosarcoma. Our experience with this case indicates that, when dealing with patients suspected to have very large tumors, FDG PET is useful in examination for malignant potential and is indispensable in exploration for distant metastases.

Differentiation of Malignant and Benign Cardiac Tumors Using 18F-FDG PET/CT

“…The published cases of 18 F-FDG PET uptake in cardiac tumors are in line with the results of the present study: malignant cardiac tumors typically exhibit a high 18 F-FDG uptake. SUV max was available in 7 cardiac malignancies only (mean 6 SD, 8.8 6 3.63; 9.5 6 4.0 in the present study) (13)(14)(15)(16)21,22,25). Benign cardiac tumors are expected to show only slight 18 F-FDG uptake, although an exception was FIGURE 5.…”

“…The use of 18 F-FDG PET/CT to assess cardiac tumors is infrequently reported as single cases; the results of these reports are summarized in Table 1 (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25). To date, larger patient groups undergoing whole-body 18 F-FDG PET/CT to elucidate the diagnostic performance of PET/CT in cardiac tumors have not yet been published.…”

Metabolic activity assessment of cardiac angiosarcoma by 18FDG PET-CT

“…They are proving its usefulness in assessing malignant potential of the tumour mass and exploration for distant metastases in primary diagnosis together with metabolic response to and detection of local recurrence after applied therapy [5][6][7][8]. In the presented case PET-CT with 18FDG depicted persisted high metabolic activity in the tumour mass despite three courses of adjuvant chemotherapy and metabolically active metastases in the skeleton, not visible on previously scheduled imaging studies.…”

Detection of recurrent cutaneous angiosarcoma of lower extremity with18F-fluorodeoxyglucose positron emission tomography-computed tomography: Report of three cases

“…[9] It has also been shown to be useful in primary angiosarcoma of various sites, even CAS. [1011] Vasanawala, et al . previously reported the utility of 18 F-FDG PET-CT for diagnosis and restaging in a case of CAS of scalp.…”