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

• Published in: FUKUSHIMA JOURNAL OF MEDICAL SCIENCE Vol. 69; no. 1; pp. 2022-13 - 49
• Main Authors: Yamakuni, Ryo, Ishii, Shiro, Yamada, Shoki, Hara, Junko, Suenaga, Hiroki, Sugawara, Shigeyasu, Sekino, Hirofumi, Yamaki, Takayoshi, Ishida, Keiichi, Hashimoto, Yuko, Ito, Hiroshi
• Format: Journal Article
• Language: English
• Published: Japan THE FUKUSHIMA SOCIETY OF MEDICAL SCIENCE 01-01-2023; The Fukushima Society of Medical Science
• Subjects: Adult; Aged; Cardiac angiosarcoma; Case Report; FDG-PET; Female; Fluorodeoxyglucose F18; Heart Neoplasms - pathology; Hemangiosarcoma; Humans; Ki-67 Antigen; Male; MIB-1 index; Positron Emission Tomography Computed Tomography; Positron-Emission Tomography; Prognosis; Radiopharmaceuticals; FDG-PET; MIB-1 index; Cardiac angiosarcoma
• ISSN: 0016-2590; 2185-4610
• DOI: 10.5387/fms.2022-13

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.