PMC6704372_01
A-Contrast enhanced CT in coronal view showing 12.4 x 14.0 cm heterogeneous right thoracic mass with areas of necrosis causing mass effect and leftward deviation of the mediastinum. B- Contrast enhanced CT in transverse view showing 12.4 x 12.5 cm heterogeneous right thoracic mass with areas of necrosis causing mass effect and leftward deviation of the mediastinum. C- Contrast enhanced CT showing the right thoracic mass stable size with increased areas of necrosis after serial TAE. D-Contrast enhanced CT demonstrating enhancing lesion in the liver pre embolization. E- Contrast enhanced CT demonstrating near complete remission of the liver lesion post serial TAE.
gr1.jpg
PMC6704372_01_gr1.jpg
fig1
CD34, CD99, and bcl2 and negative for keratin, CD31, factor VIII, desmin, S-100 and melanA, consistent with the diagnosis of hemangiopericytoma. Contrast enhanced CT scan of the chest, abdomen and pelvis revealed a large 12.4 x 14.0 x 12.5 cm heterogeneous mass on the anterior inferior aspect of the right hemithorax, numerous draining veins into the left atrium, and leftward deviation of the mediastinum caused by mass effect (Fig. 1-A,B). The liver demonstrated numerous enhancing lesions, the largest measuring 5.6 x 4.6 cm in the left hepatic lobe (Fig. 1-D). Six months following the last TAE, CT showed near complete remission of liver lesions (Fig. 1E), and only minimal increase in the size of the right thoracic mass craniocaudally, measuring 19.5 cm as compared to previously 17.7 cm. Increased size was attributed to increased necrotic fluid within the mass (Fig. 1C).
A-Angiography demonstrating microcatheter advancement through the left gastric artery above the diaphragm supplying feeder vessels to the thoracic mass. B-Angiographic image taken during embolization of the right internal thoracic artery as one of the extensive tumor vascular supply of the right thoracic mass.
gr2.jpg
PMC6704372_01_gr2.jpg
fig2
During the procedure, successful bland embolization to segments IVa and IVb left hepatic artery branches, the right hepatic artery, a branch of the inferior phrenic artery, the inferior epigastric artery and the right internal thoracic artery (Fig. 2-B) followed by Gelfoam embolization were performed.