CTICasesPrimary Pericardial Synovial Sarcoma
Imaging findings
Chest CT shows diffuse thickening and enhancement of the visceral and parietal pericardium (pericarditis), a small pericardial effusion, and mediastinal lymphadenopathy. A large, lobulated mass with internal calcification is present, arising from the pericardium adjacent to the right atrium. Cardiac MRI post-gadolinium confirms intense, heterogeneous enhancement of both the pericardium and the mass.
Key takeaways
Primary cardiac and pericardial sarcomas are extremely rare, aggressive malignancies, with synovial sarcoma representing a subset. Unlike angiosarcomas, which typically arise within the right atrium, pericardial synovial sarcomas present as large, calcified extra-cavitary masses. They carry a very poor prognosis due to high rates of local recurrence and metastasis.
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