Department of Radiology and Nuclear Medicine, Fukushima Medical University.
Department of Diagnostic Pathology, Fukushima Medical University.
Fukushima J Med Sci. 2023 Apr 5;69(1):45-49. doi: 10.5387/fms.2022-13. Epub 2023 Feb 11.
Cardiac angiosarcoma is a rare malignant tumor with a poor prognosis, characterized by the high uptake of F-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 F-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 F-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: F-FDG uptake may reflect pathological tumor grade and prognosis in cardiac angiosarcoma.
心脏血管肉瘤是一种罕见的恶性肿瘤，预后不良，其特点是对 F-氟脱氧葡萄糖（FDG）的摄取较高。本病例报告介绍了两例心脏血管肉瘤病例，其 FDG 摄取和预后存在显著差异。
病例 1：一名 40 岁男性因晕厥就诊。超声心动图显示心脏肿瘤 F-FDG 摄取较高（最大标准化摄取值=9.2）。患者接受了心脏导管检查和肿瘤活检。病理结果为高级别血管肉瘤，MIB-1（Ki-67）增殖指数约为 20%。给予全身化疗，但患者在发病后 2 年零 5 个月死亡。
病例 2：一名 65 岁女性在常规超声心动图检查中偶然发现右心房肿瘤。肿瘤 F-FDG 摄取较低（最大标准化摄取值=1.8）。行心脏直视手术，肿瘤完全切除。组织学分析显示为低度血管肉瘤，MIB-1（Ki-67）增殖指数小于 5%。患者接受随访，手术后 2 年未复发。
心脏血管肉瘤中 F-FDG 的摄取可能反映肿瘤的病理分级和预后。
