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Skeletal Radiology
Published in: Skeletal Radiology 1/2018

01-01-2018 | Case Report

Multiple skeletal muscle metastases revealing a cardiac intimal sarcoma

Authors: Amandine Crombé, Pierre-François Lintingre, François Le Loarer, Denis Lachatre, Benjamin Dallaudière

Published in: Skeletal Radiology | Issue 1/2018

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Abstract

We report the case of a 59-year-old female with progressive bilateral painful swelling of the thighs. MRI revealed multiple intramuscular necrotic masses with similar morphologic patterns. Whole-body CT and 18-FDG PET-CT scans demonstrated additional hypermetabolic muscular masses and a lobulated lesion within the left atrial cavity. As biopsy of a muscular mass was compatible with a poorly differentiated sarcoma with MDM2 oncogene amplification, two diagnoses were discussed: a dedifferentiated liposarcoma with muscle and heart metastases or a primary cardiac sarcoma, mainly a cardiac intimal sarcoma, with muscular metastases, which was finally confirmed by array-comparative genomic hybridization (aCGH) in a sarcoma reference center. This case emphasizes the potential for intimal sarcoma to disseminate in skeletal muscle prior to any other organ and the need for a genomic approach in addition to classical radiopathologic analyses to distinguish primary from secondary locations facing simultaneous tumors of the heart and skeletal muscles with MDM2 amplification.
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Metadata
Title
Multiple skeletal muscle metastases revealing a cardiac intimal sarcoma
Authors
Amandine Crombé
Pierre-François Lintingre
François Le Loarer
Denis Lachatre
Benjamin Dallaudière
Publication date
01-01-2018
Publisher
Springer Berlin Heidelberg
Published in
Skeletal Radiology / Issue 1/2018
Print ISSN: 0364-2348
Electronic ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-017-2768-5

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