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Imaging primary cardiac angiosarcoma: case-based illustrations with multimodality imaging and emphasis on the role of positron emission tomography-CT
  1. Ann Mary Jose1,
  2. Gadabanahalli Karthik1,
  3. Pradeep Kumar Shetty2 and
  4. Venkatraman Bhat1
  1. 1 Radiology, Narayana Hrudayalaya Health City Bangalore, Bengaluru, Karnataka, India
  2. 2 Cardiology, Narayana Hrudayalaya Health City Bangalore, Bengaluru, Karnataka, India
  1. Correspondence to Dr Venkatraman Bhat; bvenkatraman{at}


Primary cardiac angiosarcomas are extremely rare, highly aggressive tumours with rapid progression and high metastatic capability. More than 60% of tumours are detected after the onset of a metastatic disease. In the two cases presented, we demonstrate the role of muti-modality imaging in the diagnosis of the lesion and provide valuable input in prognosticating the disease burden. In both cases, the diagnosis was suspected initially by imaging, based on radiological observations, before the final histopathology confirmation was made. Positron emission tomography– (PET-CT) was a critical component of the diagnostic workup for the detection of disease extent and volume of total disease burden. Hence, PET-CT imaging should be performed in all aggressive appearing cardiac tumours. In view of misleading clinical presentation, we suggest that aggressive workup to be performed in suspected patients. Young patients presenting with vague symptoms and those with recurrent, unresolving, unexplained pericardial effusion deserves special consideration.

  • pericardial disease
  • cancer - see oncology
  • chemotherapy
  • pathology
  • radiology

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  • Contributors The following authors were responsible for drafting the text, sourcing and editing clinical images, investigating results, drawing original diagrams and algorithms and critically revising important intellectual content: AM, KGA and VB. The following authors gave final approval of the manuscript: VB.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.