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Cardiac Sarcoma
Suhny Abbara, MD, FACR, FSCCT; Christopher M. Walker, MD; Brett W. Carter, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Definitions

              • Most common primary cardiac malignancy
              • Restricted to heart and pericardium
              • Cardiac tumors that arise from one of connective tissues (mesodermal cell origin) of heart
            • Types of Cardiac Sarcoma

              • Angiosarcoma, undifferentiated sarcomas, malignant fibrous histiocytoma (MFH), osteosarcoma, leiomyosarcoma, myxofibrosarcoma, synovial sarcoma, rhabdomyosarcoma

            IMAGING

            • General Features

              • Radiographic Findings

                • CT Findings

                  • MR Findings

                    • Ultrasonographic Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Staging, Grading, & Classification

                              • Gross Pathologic & Surgical Features

                                • Microscopic Features

                                  CLINICAL ISSUES

                                  • Presentation

                                    • Demographics

                                      • Natural History & Prognosis

                                        • Treatment

                                          DIAGNOSTIC CHECKLIST

                                          • Consider

                                            Selected References

                                            1. Caspar T et al: Magnetic resonance evaluation of cardiac thrombi and masses by T1 and T2 mapping: an observational study. Int J Cardiovasc Imaging. 33(4):551-9, 2017
                                            2. Tüdös Z et al: "Sun ray" appearance in a case of cardiac angiosarcoma: a comparison of MRI and PET/CT. Magn Reson Med Sci. 16(2):176-80, 2017
                                            3. Hudzik B et al: Malignant tumors of the heart. Cancer Epidemiol. 39(5):665-72, 2015
                                            4. Trimble CR et al: Primary cardiac osteosarcoma: airp best cases in radiologic-pathologic correlation. Radiographics. 35(5):1352-7, 2015
                                            5. Esposito A et al: CMR in the assessment of cardiac masses: primary malignant tumors. JACC Cardiovasc Imaging. 7(10):1057-61, 2014
                                            6. Look Hong NJ et al: Cardiac angiosarcoma management and outcomes: 20-year single-institution experience. Ann Surg Oncol. 19(8):2707-15, 2012
                                            7. Bendel EC et al: Imaging sarcomas of the great vessels and heart. Semin Ultrasound CT MR. 32(5):377-404, 2011
                                            8. Buckley O et al: Cardiac masses, part 2: key imaging features for diagnosis and surgical planning. AJR Am J Roentgenol. 197(5):W842-51, 2011
                                            9. Hashimoto W et al: Primary cardiac osteosarcoma with imaging that revealed no calcification. Gen Thorac Cardiovasc Surg. 59(3):184-6, 2011
                                            10. Randhawa K et al: Magnetic resonance imaging of cardiac tumors: part 2, malignant tumors and tumor-like conditions. Curr Probl Diagn Radiol. 40(4):169-79, 2011
                                            11. Serdaroglu G et al: A rare cause of recurrent stroke in childhood: left atrial rhabdomyosarcoma. Acta Paediatr. 100(10):e189-91, 2011
                                            12. Fresneau B et al: [Malignant primary cardiac tumors in childhood and adolescence.] Arch Pediatr. 17(5):495-501, 2010
                                            13. O'Donnell DH et al: Cardiac tumors: optimal cardiac MR sequences and spectrum of imaging appearances. AJR Am J Roentgenol. 193(2):377-87, 2009
                                            14. Truong PT et al: Treatment and outcomes in adult patients with primary cardiac sarcoma: the British Columbia Cancer Agency experience. Ann Surg Oncol. 16(12):3358-65, 2009
                                            15. Murinello A et al: Cardiac angiosarcoma--a review. Rev Port Cardiol. 26(5):577-84, 2007
                                            16. Sparrow PJ et al: MR imaging of cardiac tumors. Radiographics. 25(5):1255-76, 2005
                                            17. Best AK et al: Best cases from the AFIP: cardiac angiosarcoma. Radiographics. 23 Spec No:S141-5, 2003
                                            18. Chiles C et al: Metastatic involvement of the heart and pericardium: CT and MR imaging. Radiographics. 21(2):439-49, 2001
                                            19. Araoz PA et al: CT and MR imaging of benign primary cardiac neoplasms with echocardiographic correlation. Radiographics. 20(5):1303-19, 2000
                                            20. Grebenc ML et al: Primary cardiac and pericardial neoplasms: radiologic-pathologic correlation. Radiographics. 20(4):1073-103; quiz 1110-1, 1112, 2000
                                            Related Anatomy
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                                            Related Differential Diagnoses
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                                            References
                                            Tables

                                            Tables

                                            KEY FACTS

                                            • Terminology

                                              • Imaging

                                                • Top Differential Diagnoses

                                                  • Pathology

                                                    • Clinical Issues

                                                      TERMINOLOGY

                                                      • Definitions

                                                        • Most common primary cardiac malignancy
                                                        • Restricted to heart and pericardium
                                                        • Cardiac tumors that arise from one of connective tissues (mesodermal cell origin) of heart
                                                      • Types of Cardiac Sarcoma

                                                        • Angiosarcoma, undifferentiated sarcomas, malignant fibrous histiocytoma (MFH), osteosarcoma, leiomyosarcoma, myxofibrosarcoma, synovial sarcoma, rhabdomyosarcoma

                                                      IMAGING

                                                      • General Features

                                                        • Radiographic Findings

                                                          • CT Findings

                                                            • MR Findings

                                                              • Ultrasonographic Findings

                                                                • Imaging Recommendations

                                                                  DIFFERENTIAL DIAGNOSIS

                                                                    PATHOLOGY

                                                                    • General Features

                                                                      • Staging, Grading, & Classification

                                                                        • Gross Pathologic & Surgical Features

                                                                          • Microscopic Features

                                                                            CLINICAL ISSUES

                                                                            • Presentation

                                                                              • Demographics

                                                                                • Natural History & Prognosis

                                                                                  • Treatment

                                                                                    DIAGNOSTIC CHECKLIST

                                                                                    • Consider

                                                                                      Selected References

                                                                                      1. Caspar T et al: Magnetic resonance evaluation of cardiac thrombi and masses by T1 and T2 mapping: an observational study. Int J Cardiovasc Imaging. 33(4):551-9, 2017
                                                                                      2. Tüdös Z et al: "Sun ray" appearance in a case of cardiac angiosarcoma: a comparison of MRI and PET/CT. Magn Reson Med Sci. 16(2):176-80, 2017
                                                                                      3. Hudzik B et al: Malignant tumors of the heart. Cancer Epidemiol. 39(5):665-72, 2015
                                                                                      4. Trimble CR et al: Primary cardiac osteosarcoma: airp best cases in radiologic-pathologic correlation. Radiographics. 35(5):1352-7, 2015
                                                                                      5. Esposito A et al: CMR in the assessment of cardiac masses: primary malignant tumors. JACC Cardiovasc Imaging. 7(10):1057-61, 2014
                                                                                      6. Look Hong NJ et al: Cardiac angiosarcoma management and outcomes: 20-year single-institution experience. Ann Surg Oncol. 19(8):2707-15, 2012
                                                                                      7. Bendel EC et al: Imaging sarcomas of the great vessels and heart. Semin Ultrasound CT MR. 32(5):377-404, 2011
                                                                                      8. Buckley O et al: Cardiac masses, part 2: key imaging features for diagnosis and surgical planning. AJR Am J Roentgenol. 197(5):W842-51, 2011
                                                                                      9. Hashimoto W et al: Primary cardiac osteosarcoma with imaging that revealed no calcification. Gen Thorac Cardiovasc Surg. 59(3):184-6, 2011
                                                                                      10. Randhawa K et al: Magnetic resonance imaging of cardiac tumors: part 2, malignant tumors and tumor-like conditions. Curr Probl Diagn Radiol. 40(4):169-79, 2011
                                                                                      11. Serdaroglu G et al: A rare cause of recurrent stroke in childhood: left atrial rhabdomyosarcoma. Acta Paediatr. 100(10):e189-91, 2011
                                                                                      12. Fresneau B et al: [Malignant primary cardiac tumors in childhood and adolescence.] Arch Pediatr. 17(5):495-501, 2010
                                                                                      13. O'Donnell DH et al: Cardiac tumors: optimal cardiac MR sequences and spectrum of imaging appearances. AJR Am J Roentgenol. 193(2):377-87, 2009
                                                                                      14. Truong PT et al: Treatment and outcomes in adult patients with primary cardiac sarcoma: the British Columbia Cancer Agency experience. Ann Surg Oncol. 16(12):3358-65, 2009
                                                                                      15. Murinello A et al: Cardiac angiosarcoma--a review. Rev Port Cardiol. 26(5):577-84, 2007
                                                                                      16. Sparrow PJ et al: MR imaging of cardiac tumors. Radiographics. 25(5):1255-76, 2005
                                                                                      17. Best AK et al: Best cases from the AFIP: cardiac angiosarcoma. Radiographics. 23 Spec No:S141-5, 2003
                                                                                      18. Chiles C et al: Metastatic involvement of the heart and pericardium: CT and MR imaging. Radiographics. 21(2):439-49, 2001
                                                                                      19. Araoz PA et al: CT and MR imaging of benign primary cardiac neoplasms with echocardiographic correlation. Radiographics. 20(5):1303-19, 2000
                                                                                      20. Grebenc ML et al: Primary cardiac and pericardial neoplasms: radiologic-pathologic correlation. Radiographics. 20(4):1073-103; quiz 1110-1, 1112, 2000