A Multimodal Approach to Evaluate for Cardiac Metastasis in a Case of Non-Small Cell Lung Cancer.

Autor: Bilani N; Maroone Cancer Center, Cleveland Clinic Florida, Weston, Florida, USA., Elson L; Maroone Cancer Center, Cleveland Clinic Florida, Weston, Florida, USA., Martinez F; Department of Radiology, Cleveland Clinic Florida, Weston, Florida, USA., Sadler D; Heart and Vascular Center, Cleveland Clinic Florida, Weston, Florida, USA., Nahleh Z; Maroone Cancer Center, Cleveland Clinic Florida, Weston, Florida, USA., Elimimian E; Maroone Cancer Center, Cleveland Clinic Florida, Weston, Florida, USA., Alley E; Maroone Cancer Center, Cleveland Clinic Florida, Weston, Florida, USA.
Jazyk: angličtina
Zdroj: Case reports in oncology [Case Rep Oncol] 2020 Mar 05; Vol. 13 (1), pp. 212-218. Date of Electronic Publication: 2020 Mar 05 (Print Publication: 2020).
DOI: 10.1159/000505534
Abstrakt: Malignancies have demonstrated the ability to metastasize to cardiac tissue. However, an optimal diagnostic algorithm for cardiac tumors has not yet been established, due at least in part to the scarcity of symptomatic cases. Several case reports describe how the usage of 18 F-labeled fluorodeoxyglucose positron emission tomography ( 18 F-FDG PET) incidentally revealed cardiac neoplasia. This modality, which indicates uptake sites of the radioisotope 18 F-FDG, allows for whole-body imaging and is often used for preoperative determination of malignant metastasis or for assessing response to therapy over time. However, findings of false positivity are often reported due to increased FDG avidity caused by a range of other, nonmetastatic processes, most notably inflammation and infection. In this case report, an 84-year-old male with stage IV non-small cell lung cancer presented a clinical course, echocardiogram, and 18 F-FDG PET-CT findings that were suggestive of endocardial metastasis. Nine months into therapy, after extensive consultation, the patient finally consented to a more complete workup using cardiac MRI (CMRI), which showed no evidence of cardiac metastasis. This case report supports the utility of CMRI as a means of further interpreting intracardiac, localized FDG uptake foci in PET-CT findings, in order to avoid false positivity and further refine proposed cardiac differential diagnoses in cancer patients.
Competing Interests: The authors have no conflicts of interest to declare.
(Copyright © 2020 by S. Karger AG, Basel.)
Databáze: MEDLINE
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