case_images: PMC10761417_01
case_images: Baseline imaging of the left ventricular mass (A) PET/CT indicated multiple masses in the left ventricle, gallbladder, right adrenal gland, and right vertebral column, along with significant lymph node enlargement and widespread bone destruction, all exhibiting markedly increased FDG uptake. (B) Echocardiography showed an additional echogenicity measuring 14 x 17 mm in the proximal segment of the left ventricular septum, with an irregular shape, tissue-like echogenicity, and activity. A detectable filling defect in the septum near the apex is observed, with an irregular shape, approximately 12 x 22 mm in size, broad at the base, highly mobile at the attachment point, and containing a relatively large amount of contrast filling material. (C) CMR showed a mass measuring 1.6 cm x 1.1 cm x 2.1 cm at the left cardiac chamber septum. Long-axis four-chamber myocardial delayed enhancement (MDE) showed that the left ventricular mass appeared non-gadolinium enhancement at baseline.
case_images: fcvm-10-1309613-g001.jpg
case_images: PMC10761417_01_fcvm-10-1309613-g001.jpg
case_images: F1
case_images: In particular, the maximum standardized uptake value for left ventricular masses was 16.5 and 19.7 after delay, consistent with malignancy (Figure 1A). Echocardiography of the cardiac chambers showed a detectable contrast-enhanced mass in the septum near the apex, with an irregular morphology, measuring approximately 12 x 22 mm, with a wide base and high mobility at the point of attachment, and with a relatively large amount of contrast filling detectable within it, which was considered to be malignant (Figure 1B). Long-axis four-chamber myocardial delayed enhancement (MDE) showed nodular shadows in the left cardiac chamber, and the mass had no gadolinium enhancement (Figure 1C).
case_images: Change of the left ventricular mass at baseline and after treatment (A) CMR showed that the baseline size of the mass is 1.6 cm x 1.1 cm x 2.1 cm. (B) CMR showed that after 4 cycles of R-CHOP, the tumor at all sites had almost complete regression. (C) CMR showed no recurrence of cardiac mass in the five years of follow-up. (D) Long-axis four-chamber myocardial delayed enhancement (MDE) showed that the left ventricular mass appeared non-gadolinium enhancement at baseline. (E) After 4 cycles of R-CHOP treatment, long-axis four-chamber MDE showed the left ventricular mass had almost complete regression. (F) MDE showed no recurrence of cardiac mass in the five years of follow-up. (G) PET/CT showed that the maximum standardized uptake value for left ventricular masses was 16.5 and 19.7 after delay. (H) After 4 cycles of R-CHOP treatment, the left ventricle mass had almost complete regression and the FDG uptake of the left ventricular had returned to normal levels. (I) PET/CT showed no recurrence of cardiac mass in the five years of follow-up.
case_images: fcvm-10-1309613-g002.jpg
case_images: PMC10761417_01_fcvm-10-1309613-g002.jpg
case_images: F2
case_images: During the 5-year follow-up, all lesions, including the cardiac mass, remained complete regression, and FDG uptake was reduced to normal (Figure 2).