Ibrutinib, an oral small-molecule targeted drug, has been the first Bruton tyrosine kinase (BTK) inhibitor in the world to be approved for the market. It works by regulating cell proliferation, apoptosis and migration, and has been proven to exhibit high efficacy and good safety in the treatment of B-cell lymphomas, including chronic lymphocytic leukemia or small lymphocytic lymphoma and mantle cell lymphoma. However, some patients inevitably have drug resistance and disease recurrence, resulting in a poor prognosis. This article serves as a clinical reference by summarizing the related literature on ibrutinib resistance inhibitors.

Primary angiosarcoma is extremely rare malignant tumor that has no typical symptoms and progress rapidly with poor prognosis. It is mesenchymal in origin and observed most frequently in the right atrium, cases in the pericardium is much more rare. Only few can detected in the early-stage allowing complete radical resection with a mean survival of 3 months to 1 year. There is few pericardial angiosarcoma reported among these years. The present study reports a case of a 44-year-old woman with primary pericardial angiosarcoma, who underwent a wide range of imaging methods, including transthoracic echocardiography, contrast-enhanced computed tomography (CT) and positron emission tomography-magnetic resonance imaging (PET-MRI). The patient recovered well after operation in two years and died due to the recrudescence and pulmonary metastases in April, 2020. We report the case for its rarity and revealing the early detection of primary pericardial angiosarcoma with imaging examinations is critical for prognosis. Finally a literature review is done.