CTICasesCardiac Angiosarcoma
Imaging findings
CT chest shows a hyperdense, avidly enhancing, necrotizing mass arising from the right ventricular outflow tract (RVOT) and interdigitating between the main pulmonary artery and the ascending aorta. PET-CT shows intense FDG avidity (SUV max 16.7), and perfusion imaging shows rapid enhancement equal to the cardiac blood pool.
Key takeaways
Angiosarcoma is the most common primary malignant cardiac tumor, classically arising in the right atrium or RVOT. It is an extremely aggressive, hypervascular tumor that is highly FDG-avid on PET-CT. Distinguishing it from benign vascular neoplasms (like hemangioma) is crucial as angiosarcoma requires urgent surgery and/or chemotherapy.
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