PMC3017878_01
MRI and histologic finding of cardiac osteosarcoma and its femoral metastasis.. A. Axial double inversion-recovery T1-weighted image with fat saturation (TR/TE, 960/8.6 msec) showed well-demarcated mass of mildly heterogeneous and high signal intensity without evidence of invasion into surrounding structures. B, C. Axial triple inversion-recovery T2-weighted image with fat saturation (TR/TE, 960/100 msec) and four chamber view of cine image (3211/1605 msec) showed heterogeneous signal intensity of mass. D. Axial image of delayed contrast-enhanced MRI (TR/TE, 4457/1427 msec) showed heterogeneous enhancement. E. Mass measured about 5.0 x 3.7 x 2.3 cm and had focal hemorrhage and necrosis on gross specimen. F. Photomicrograph showed atypical spindle cells with abundant collagen material and displayed focal immature osteoid production (Hematoxylin & Eosin stain, x 40). G. T1-weighted coronal image (TR/TE, 651/20 msec) showed mass that was isointense to muscle at right femoral neck. Peripheral rim with low signal intensity was seen. H. T2-weighted axial image (TR/TE, 4053/100 msec) showed heterogeneously high signal intensity lesion with peripheral hypointense rim at right femoral neck. I. Gadolinium-enhanced T1-weighted coronal image with fat suppression (TR/TE, 540/17 msec) was performed and lesion showed heterogeneous enhancement within central portion of non-enhancement. J. Atypical spindle cells with abundant collagen material were seen on photomicrograph (Hematoxylin & Eosin stain, x 40).
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The mass showed mildly heterogeneous and high signal intensity (SI) on double inversion-recovery T1-weighted images (T1WI), with fat saturation (Fig. 1A). In addition, triple inversion recovery T2-weighted images (T2WI) with fat saturation and cine-cardiac images showed heterogeneously high SI (Fig. 1B, C). On delayed contrast-enhancement MR images, the mass was heterogeneously enhanced (Fig. 1D). The patient underwent surgical removal of the mass, which was found to be smooth, well-encapsulated with focal necrosis and hemorrhage (Fig. 1E). In addition, the presence of minimal osteoid deposition foci confirmed the tumor as a fibroblastic osteosarcoma (Fig. 1F). T1WI (Fig. 1G) and showed a heterogeneously high SI on T2WI (Fig. 1H). The mass was well-demarcated, with a peripheral low SI rim on both T1WI and T2WI. Gadolinium-enhanced T1WI showed heterogeneous enhancement with central non-enhancing portions (Fig. 1I). A biopsy and following histological analysis confirmed the lesions as metastases from the previously resected cardiac tumor on the basis of histologic similarity between them (Fig. 1J).