PDF
ePub
Citation
Print
A 41-year-old female with history of benign carcinoid tumor status post nephrectomy presents with left upper quadrant abdominal pain. Computed tomography (CT) demonstrated a large retroperitoneal mass with biopsy revealing a low-grade neuroendocrine tumor. A Gallium-68 DOTATATE positron emission tomography (PET)/CT scan confirmed the retroperitoneal mass, as well as multifocal radiotracer uptake in the heart (Figure 1A). Transthoracic echocardiogram demonstrated a large echogenic mass along the inferolateral wall with minimal ultrasound contrast uptake (Figure 1B-1D). Cardiac magnetic resonance imaging (MRI) demonstrated multiple high T2 signal masses in the left and right ventricular wall with minimal gadolinium enhancement (Figure 1E and 1F). The patient subsequently underwent resection of the mass.
Myocardial metastases with neuroendocrine tumor are rare and most frequently manifest as carcinoid heart disease with right-sided valvular dysfunction.1) However, metastases can occur in other locations including intra-myocardial. Although, echocardiography is the imaging modality of choice for assessment of valvular heart disease, it may be less reliable for identification of smaller metastases. A multi-modality approach using cardiac MRI2) and Ga68-DOTATATE PET/CT imaging1) may allow for better detection of metastases.
XML Download