Fırat UYGUR, Hakan TANRIVERDİ, BÜLENT ALTINSOY, Fatma ERBAY, Ziyaeddin AKTOP, Meltem TOR

Cardiac metastasis of small cell lung cancer diagnosed with PET/CT and echocardiography

Malign tümörlerin kardiyak metastazları kalbin primer tümörlerinden daha sık görülür. Primer akciğer kanserlerinde kalbin ve perikardın lokal invazyonu sık görülür ancak lokal invazyon olmadan myokard tutulumu nadirdir. FDG PET/BT malign tümörlerin tanısal değerlendirmesinde ve evrelemesinde yaygın olarak kullanılmaktadır, ancak myokardın FDG tutulumu oldukça yoğun ve heterojendir. Bronkoskopik biyopsi ile küçük hücreli akciğer kanseri tanısı alan 55 yaşında erkek hastanın PET BT incelemesinde myokartta yoğun FDG tutulumu saptandı. Transtorasik ekokardiyografide her iki ventrikül apeksinde kitle benzeri lezyon tespit edildi. Klinik, radyolojik ve ekokardiyografik bulgularla küçük hücreli akciğer kanserinin kardiyak metastazı olarak kabul edildi ve histopatolojik incelemeye gerek görülmedi. Malign tümörlerin kardiyak metastazlarının lokal invazyon olmadan da görülebileceği ve PET BT nin kardiyak metastaz tanısında kullanılabileceğini göstermek için bu vakayı sunmak istedik.

PET/BT ve ekokardiografi ile tanı konan küçük hücreli akciğer kanserinin kardiyak metastazı

Cardiac metastases of malignant tumors occur more frequently than primary tumors of the heart. Local invasion of the pericardium and heart is commonly seen in primary lung cancer, but myocardial metastasis without local invasion rarely occurs. 18-F fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) is widely used in the diagnostic evaluation and staging of different malignant tumors, but the FDG uptake of myocardium is intense and heterogeneous. A-55-year old male smoker was diagnosed with small cell lung cancer (SCLC) by bronchoscopic biopsy, and FDG PET/CT showed high FDG uptake in myocardium. Transthoracic echocardiagraphy revealed mass like lesions in the apical regions of both ventricules. After systematic evaluation of imaging studies, the mass was diagnosed as intracardiac metastasis of SCLC and histopathologic examination. This case shows that intracardiac metastases of malignant tumors can be seen without local invasion, and FDG PET/CT can be a useful diagnostic tool in evaluation of intracardiac metastasis

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