CTICasesPrimary Pericardial Angiosarcoma
Imaging findings
Contrast-enhanced chest CT demonstrates a large, hemorrhagic-appearing pericardial effusion associated with irregular, nodular thickening and avid contrast enhancement of the pericardium, extending into the transverse sinus and superior pericardial recess. PET/CT shows intense hypermetabolism of the pericardial masses, and biopsy confirms angiosarcoma.
Key takeaways
Primary cardiac angiosarcomas are rare, highly aggressive malignant vascular tumors that typically arise in the right atrium. However, they can occasionally arise primarily from the pericardium, presenting as a hemorrhagic pericardial effusion and nodular pericardial thickening that can mimic pericardial mesothelioma. Diagnosis is difficult and carries a dismal prognosis, requiring multimodality therapy.
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