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Purpose The uptake of 18F-FDG is higher in most malignancies than in benign tumors. This study aimed to investigate the diagnostic value of 18F-FDG PET/CT in vertebral vascular tumors. Materials and methods We retrospectively collected PET/CT and clinical data of patients with vertebral vascular tumors and analyzed the location, number, and bone destruction and FDG uptake features of the lesion. We measured SUVmax and maximum diameter and analyzed the correlations between SUVmax and the pathological results, size, and CT features. Results Twenty-one pathology-proven vertebral vascular tumors were included: 2 angiosarcomas (SUVmax, 11.6 and 32.3), 1 epithelioid hemangioendothelioma (SUVmax, 5.7), 1 epithelioid hemangioma (SUVmax, 8.5), and 17 aggressive hemangiomas. Twelve cases of typical hemangiomas were included as controls. The SUVmax and diameter of the aggressive hemangiomas were higher than those of the typical hemangiomas. The mean SUVmax of aggressive hemangiomas with cortical destruction was higher than that of those without cortical destruction (t = −2.566, P = 0.022). Radioactive distribution in aggressive hemangiomas was homogeneous and heterogeneous in nine and eight cases, respectively. In six aggressive hemangiomas, the FDG uptake of residual and marginal sclerosing bone was higher than that of the osteolytic destruction area and/or paravertebral soft tissue. Six aggressive hemangiomas involved the spinal canal, without clear visualization on PET/CT. Conclusion 18F-FDG uptake of vertebral malignant vascular tumors is higher than that of hemangiomas. The FDG uptake of hemangiomas varies and may be related to concurrent cortical destruction. 18F-FDG PET/CT shows limitations in evaluating the spinal canal involvement of aggressive hemangioma.

Tumors arising from or secondarily involving the vena cava (VC) are broad-spectrum diseases, ranging from benign to malignant. The benign tumors include myxoma, leiomyomatosis and leiomyoma. The primary malignant tumors of the VC are rare, and of these rare entities, leiomyosarcoma is the most frequently encountered. The direct extension of a tumor arising from an adjacent organ such as hepatocellular carcinoma or renal cell carcinoma is more common than primary malignant tumor in the inferior VC. In this article, the authors review the spectrum of VC pathologic processes and the relevant findings from magnetic resonance imaging, ultrasonography, and computed tomography.

Objective To describe MR imaging features of presumed vascular plexi in the periscapular (PSC) and retroclavicular (RC) locations. Materials/methods 443 consecutive MR studies performed as “brachial plexus” protocol (axialT1-W and sagittal STIR) were reviewed for presence, size and characteristics of PSC and RC plexi. Results Presumed PSC and RC vascular plexi were present in 10%. Both plexi more commonly occurred on the left side. Percutaneous biopsy (n = 1) yielded no vascular neoplasm. Conclusion RC and PSC vascular plexi are commonly encountered on routine brachial plexus MR imaging and may represent variant vascular networks, as they are frequently found on the contralateral asymptomatic side.

Though generally considered benign, angiomyolipomas can invade through the renal vein into the inferior vena cava, putting patients at risk of catastrophic pulmonary fat embolization. Venous invasion is thus an indication for surgical resection but is thought to increase the risk of adverse operative outcomes including intraoperative hemorrhage and embolization of fat and/or tumor thrombus. We report a novel approach to mitigating these complications illustrated in the case of a 43-year-old woman with IVC-invasive renal AML who underwent successful radical nephrectomy after concurrent pre-operative renal artery embolization and placement of a retrievable suprarenal IVC filter.

We herein report an unusual case of invasive thymoma with venous intraluminal extension. The thymoma extended into the superior vena cava, the left brachiocephalic vein, and the proximal portion of the left jugular and subclavian veins intraluminally. It was suggested that the tumor had a discrete intravascular growth via the thymic vein into the left brachiocephalic vein and extended into the proximal portion of the left jugular and subclavian veins in the opposite direction of the venous stream.

Aim To evaluate the value of magnetic resonance imaging-detected extramural vascular invasion (MR-EMVI) in predicting regional lymph node metastasis (RLNM) in patients with rectal cancer. Methods A total of 183 patients were included. A set of clinical and imaging factors including MR-EMVI were evaluated using univariate and multivariate analyses to determine the risk factors for RLNM. Results Among the clinical and imaging factors evaluated, MR-EMVI, pathologic EMVI, nodal size, and diffusion-weighted imaging-detected positive nodes were independent predictors of RLNM. Conclusions MR-EMVI may be an independent predictor of RLNM in patients with rectal cancer.

A patient was diagnosed with chronic hepatitis C at the age of 63 years. He achieved eradication of HCV via interferon (IFN). Eight years after, a hepatocellular carcinoma (HCC) was detected and treated through transarterial embolization and percutaneous ethanol injection therapy. After about 1 year, a large hypovascular tumor was detected. This tumor was surgically resected and diagnosed as an HCC with sarcomatous change. This is the first case of an HCC with sarcomatous change arising after a sustained response to IFN therapy.

Presented is a case of epithelioid hemangioma (EH) of bone occurring in the radial styloid of a 17-year-old boy. EH is a benign vascular tumor whose name and classification have changed over the years, adding potential confusion to an already existing diagnostic challenge. Overlapping imaging and histopathologic features with malignant vascular neoplasms and occasional aggressive clinical features have resulted in misdiagnoses and inappropriate treatment. The goal of this case report is to raise awareness of EH and related vascular neoplasms.

This article describes a case of organizing hematoma with features of papillary endothelial hyperplasia arising at the site of a right cerebellar juvenile pilocytic astrocytoma previously treated with surgery and involved-field radiation therapy. CTA demonstrated a mass with abnormal vascularity in the treatment bed. MRI demonstrated the evolution of the lesion from a cystic mass with a heterogeneously enhancing nodule with blood products into a nearly solid-enhancing mass with abundant areas of susceptibility effect and surrounding vasogenic edema. These imaging features warrant considering papillary endothelial hyperplasia in the differential diagnosis for a mass that develops after radiotherapy.

Intravascular papillary endothelial hyperplasia was a rare benign vascular proliferative process as a result of papillary proliferation of the endothelial cells within the vessels. To our knowledge, we reported the second case occurring in the madibule, and the first reported in 1984 in the literature. We discussed manifestations of multislice computed tomography and panoramic radiography about the lesion and relevant literature was reviewed.

Intravenous leiomyomatosis is a rare growth pattern of benign uterine leiomyomas. Approximately 300 cases of intravenous leiomyomatosis have been reported in the English literature; however, there have only been a few in radiology journals. Even more rare is its extension through the inferior vena cava and heart chambers. Radiologic diagnosis can be challenging, as it is often difficult to differentiate it from other entities. We present a case of a 45-year-old woman with a cardiac extension of an intravenous leiomyomatosis and discuss the cross-sectional imaging appearance of this entity as well as the differential diagnosis.

Pulmonary embolism is the most frequent diagnosis for a filling defect in the pulmonary artery, but a tumor in the arteriae pulmonalis should be contained in the differential diagnosis. Primary pulmonary artery myxoma is extremely rare, and only a few cases have been reported. The early diagnosis of this disease is difficult, but it is feasible with modern radiographic methods, which play an important role in the presentation of the origin and extension of the tumor. Here, we review one case with computed tomographic (CT) and pulmonary CT angiographic findings to emphasize the significance of the imaging method in its diagnosis.

Intravenous lipoleiomyomatosis (LPL) is a rare benign tumor composed of fat and smooth muscle. Intravenous LPL is a rare subtype of intravenous leiomyomatosis (IVL), of which only four cases have been reported. We report a case of intravenous LPL that extended into the inferior vena cava and right atrium. The imaging findings in this case were reported. A review of the world literature revealed no previous description of the imaging findings in a case of intravenous LPL. We discussed the reported imaging findings of typical IVL and briefly discussed relevant clinical features of intravenous LPL and IVL.

Purpose: To review imaging findings of extrapulmonary metastasis from osteosarcoma and to evaluate them for any consistent pattern and correlation between imaging findings. Materials and methods: This study was retrospectively conducted in 13 patients with extrapulmonary metastasis of pathologically confirmed osteosarcoma. We evaluated the radioisotope (RI) scans (n=16), ultrasonography (USG) (n=4), computed tomography (CT) scans (n=10), MRIs (n=6), clinical records, and pathological reports for assessment of imaging findings and correlation between radiologic findings and RI uptake of the lesions. Points evaluated were the following: uptake on RI scans, presence of mineralization on CT, and MRI, size, enhancement pattern, attenuation on CT, signal intensity (SI) on MRI, and echogenicity on USG. Results: Extrapulmonary metastatic sites were diverse, including another bone other than the primary site (n=6), lymph node (n=4), pleura (n=2), liver (n=2), pancreas (n=1), kidney (n=1), peritoneum (n=1), muscle (n=1), and subcutaneous fat layer (n=1). One patient had tumor growth within the pulmonary artery and jejunum. Among 21 metastatic sites in 13 patients, bone scan was performed in 16 cases and RI uptake was detected in 10 lesions. Calcification was detected in eight lesions on radiologic imaging, including plain radiography, USG, CT, and MRI. Two lesions showed RI uptake without definite calcification or ossification on MRI and plain radiography, respectively. We analyzed the enhancement pattern and mass size in 18 metastatic sites and these factors had poor correlation with uptake on RI scans. Conclusion: The sites and imaging findings of extrapulmonary metastasis of osteosarcoma were variable. All the lesions with mineralization were detectable on RI scans prior to radiologic imaging. RI scan has a limited role in the evaluation of metastatic lesions without mineralization.

Primary leiomyosarcoma of the pulmonary artery is a rare malignancy arising from the multipotential mesenchymal cell of the intima of the pulmonary artery. Due to its rarity and nonspecific clinical symptoms, the correct diagnosis and proper management are often delayed. Furthermore, it is frequently misdiagnosed as pulmonary embolism, mediastinal mass, pulmonary stenosis and lung cancer. Therefore, it is important to consider primary leiomyosarcoma of the pulmonary artery a possibility when a persistent filling defect is present in the pulmonary artery and there is no response to optimal anticoagulation treatment. Radiologic findings such as a unilateral mass continuously filling the pulmonary artery, inhomogenous enhancement, vascular distension, extravascular invasion into adjacent structure or uptake in the area of tumor on the FDG-PET can be helpful when differentiating pulmonary artery sarcoma (PAS) from chronic thromboembolism.

Objective To determine if minute hepatic venous invasion in hepatocellular carcinoma (HCC) can be diagnosed radiologically. Materials and methods CT hepatic arteriography (CTHA) and CT arterioportography (CTAP) of 95 cases with HCCs were examined. Histopathology after surgery has been the gold standard in all patients. Based on the presence of microscopic portal venous invasion (MPVI) and microscopic hepatic venous invasion (MHVI), the cases were classified into four groups as follows: Group vp0vv0, negative MPVI and MHVI; Group vp1vv0, positive MPVI and negative MHVI; Group vp0vv1, negative MPVI and positive MHVI; Group vp1vv1, positive MPVI and MHVI. An area showing low attenuation on CTAP and high attenuation on CTHA around the tumor was defined as an area of peritumoral hemodynamic change (APTHC). The shape and size of APTHC were compared between Groups vp0vv1 and vp0vv0 or between Groups vp1vv1 and vp1vv0. The ratio of APTHC volume to tumor volume (RAT) was employed as an indicator of APTHC size. Each comparison was also made independently when tumor diameter was limited to either less than 3 cm or 3 cm or more. Results Three types of APTHC were identified: wedge-shaped, belt-shaped or irregular, and linear. No significant difference in the frequency of each type of APTHC was observed between Groups vp0vv1 and vp0vv0 or between Groups vp1vv1 and vp1vv0. There was no significant difference in RAT between Groups vp0vv1 and vp0vv0 or between Groups vp1vv1 and vp1vv0, unrelated to tumor size. Conclusions The presence of minute hepatic venous invasion in HCC is difficult to determine even on combined CTHA and CTAP.