case_images: PMC10507320_01
case_images: Transthoracic echocardiography revealed the presence of a mobile, polylobate shaped mass with mid-to-high echogenicity in the RVOT (A), another lesion in the RPA (B).
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case_images: Mild tricuspid regurgitation, systolic pulmonary artery pressure of 53 mmHg, and a left ventricular ejection fraction of 60% were also noted (Figures 1A, B).
case_images: Cardiac computed tomography demonstrated a mixed-density lesion with irregular margins in the RVOT (A), along with another mass in the RPA that was completely occluded (B, C). Postoperative CT imaging showing re-establishment of RPA blood flow (D).
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case_images: Importantly, no pericardial effusion was detected (Figures 2A-C). Notably, she exhibited a satisfactory recovery without any signs of recurrence during the 20-month follow-up period (Figure 2D).
case_images: Cardiac positron emission tomography exhibited low-density mass lesions with multiple calcifications in the RVOT (A-D) and the RPA (E-H). Notably, there were no apparent increase in glucose metabolism.
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case_images: Notably, there was no observed increase in glucose metabolism (Figure 3).
case_images: Histological examination revealed the presence of cytologic atypia in the endocardium of the right ventricle, particularly in a large core. The nuclei exhibit varying shapes, including round, oval, and spindle-shaped. Abundant fibrous hyperplasia is observed, while the number of cells is limited (A). The localized lesions demonstrate spindle cell proliferation, with the presence of multinucleate myxomatous cells (B). Ao, aorta; LA, left atrium; LPA, left pulmonary artery; LV, left ventricular; MPA, main pulmonary artery; ROVT, right ventricular outflow tract; RPA, right pulmonary artery; RV, right ventricle; T, tumor.
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case_images: Upon evaluation, the right ventricular mass was diagnosed as a low-grade myxofibrosarcoma, consistent with the masses on the pulmonary arteries (Figures 4A, B).