Pulmonary Artery Sarcoma: Diagnosis and Postoperative Follow-Up With Gadolinium-Diethylenetriamine Pentaacetic Acid-Enhanced Magnetic Resonance Imaging

Rafal, Richard B.; Nichols, John N.; Markísz, John A.

doi:10.4065/70.2.173

Cited by 45 publications

(34 citation statements)

References 6 publications

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“…An absence of deep vein thrombosis and the prolonged administration of anticoagulant or anti-thrombolytic agents may also suggest a diagnosis of pulmonary artery sarcoma. Some studies have found that gadolinium-enhanced magnetic resonance imaging is useful for distinguishing tumors from thrombi (11,12). Additionally, one study has shown that FDP-PET is useful for diagnosing intimal sarcoma (13).…”

Section: Discussionmentioning

confidence: 99%

Pulmonary Embolism Caused by Intimal Sarcoma of the Pulmonary Artery

et al. 2012

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We herein report the case of a 39-year-old woman with a pulmonary embolism caused by intimal sarcoma of the pulmonary artery. She presented with shortness of breath and leg edema. Computed tomography showed a low density area that extended from the main pulmonary artery to the bilateral pulmonary arteries. We diagnosed her to have a pulmonary thromboembolism. The thrombosis did not decrease after the administration of anti-coagulant therapy, and she underwent resection of the thrombotic tissue. Histopathologically, the surgical specimen was not found to be thrombotic tissue but rather an intimal sarcoma of the pulmonary artery. After undergoing surgery, she received radiation therapy and chemotherapy; however, she died 31 months after being diagnosed.

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Section: Discussionmentioning

confidence: 99%

Pulmonary Embolism Caused by Intimal Sarcoma of the Pulmonary Artery

et al. 2012

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“…In particular, heterogenous enhancement on MRI after application of gadolinium-diethylene-triamine-pentaacetic acid is characteristic of a vascularized tumor. 7 The usefulness of biopsy via cardiac catheterization to make an accurate preoperative diagnosis has also been reported in the literature. 8 In the present case, a solid mass presented with low signal intensity on T1-weighted image and increased signal intensity on T2-weighted image by MRI and there was no evidence of distal thromboembolism in either of the pulmonary arteries on CT or MRI examination.…”

Section: Discussionmentioning

confidence: 99%

Surgical Treatment for Primary Cardiac Leiomyosarcoma Causing Right Ventricular Outflow Obstruction

Ishikawa

Takanashi

Mihara

et al. 2005

Circ J

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rimary cardiac leiomyosarcoma is extremely rare, constituting less than 0.25% of all cardiac tumors, 1 but it has a lethal prognosis even if surgical resection, with or without adjuvant therapy, is performed. 2,3 Only a few cases of surgical resection of cardiac leiomyosarcoma have been reported. 4 We present a case of surgical resection of a primary cardiac leiomyosarcoma involving the pulmonary valve, which was reconstructed with a bioprosthetic valve and Xenomedica patch. Case ReportA 55-year-man was admitted to another hospital because of dry cough and exertional breathlessness that had rapidly worsened over the previous 1-2 weeks. He had no remarkable medical history. A computed tomographic (CT) examination of the chest revealed a filling defect that almost completely obstructed the main pulmonary arterial trunk.A diagnosis of pulmonary thromboembolism was assumed, and the patient was treated with catheter-directed thrombolysis therapy over 3 days. However, his dyspnea and shortness of breath worsened despite an optimal regimen of thrombolytic and anticoagulation therapy. The patient was referred to us for further evaluation and possible surgical management of the presumed pulmonary thromboembolism.Upon admission, laboratory results showed elevated lactate dehydrogenase (785 U/L) and liver enzymes (AST Circulation Journal Vol.69, January 2005 49 U/L, ALT 95 U/L). Chest X-ray showed mild cardiomegaly with a cardiothoracic ratio of 52%. The patient underwent magnetic resonance imaging (MRI) of the chest, which revealed a solid mass at the pulmonary valve, measuring approximately 50×40×30 mm with low signal intensity on T1-weighted image and increased signal intensity on T2-weighted image, that appeared to be invading the main pulmonary arterial trunk (Fig 1a,b). There was no evidence of distal thromboembolism in either of the pulmonary arteries. Because the mass appeared to be a tumor rather than a thrombus, the possibility of malignancy was raised. Transthoracic echocardiography disclosed a large mass involving the pulmonary valve and extending to the main pulmonary arterial trunk, enlargement of the right ventricle (end-diastolic diameter, 52 mm), and displacement of the ventricular septum toward the left ventricle. The mass almost completely obstructed the main pulmonary arterial trunk (Fig 1c), and right ventricular failure was suspected. The patient was scheduled to undergo surgery for tumor extirpation and histological evaluation of the mass.At surgery, a hard mass was palpated in the slightly dilated main pulmonary arterial trunk. Conventional cardiopulmonary bypass was established with ascending aortic perfusion and bicaval drainage through a median sternotomy. After the heart was arrested, the main pulmonary arterial trunk was incised longitudinally from just above the pulmonary valve to the bifurcation, whereupon a whitish tumor originating from the pulmonary valve was found to have almost completely blocked the lumen of the main pulmonary arterial trunk and invaded its anterior wall. We also o...

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“…Extraluminal extension of the tumour can be a specific finding of PAS. Magnetic resonance imaging (MRI) aids the determination of the extent of masses and the relationship to adjacent structures, and during postoperative follow-up [4]. The degree of contrast enhancement in MRI was shown to correlate with the degree of tumour differentiation, and contrast enhancement might be used to differentiate neoplasm from central pulmonary embolism [5].…”

Section: Fdg-pet In Diagnostic Work-up Of Pulmonary Artery Sarcomasmentioning

confidence: 99%