Case Session 03: Pericardial Disease (2018)-A Cardiac Mass Missed on CT and Echocardiography: The Added Value of CMR

A Cardiac Mass Missed on CT and Echocardiography: The Added Value of CMR

Video Transcription

Video Summary

A 50-year-old woman presented with progressive shortness of breath. CT and echocardiography suggested a pericardial fluid collection with early tamponade, leading to pericardiocentesis and then a surgical pericardial window after reaccumulation. Surgery unexpectedly revealed a large adherent intrapericardial mass. Cardiac MRI showed an 8 × 4 cm extracardiac mass with vascularity, inflammation, fibrosis, and no fat suppression, helping narrow the differential. Pathology confirmed synovial sarcoma. After resection, follow-up MRI showed no residual tumor but pericarditis, which was treated with steroids. The case highlights the value of CMR for tissue characterization and diagnosis of cardiac/pericardial masses.

Keywords

pericardial mass

synovial sarcoma

cardiac MRI

pericardial tamponade

intrapericardial tumor