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DOI: 10.1055/s-0040-1703495
Value of MRI and 68Ga-DOTANOC-PET-CT in a patient with right ventricular neuroendocrine tumor
Publikationsverlauf
Publikationsdatum:
21. April 2020 (online)
Einleitung Primary cardiac neuroendocrine tumors (NET) are extremely rare. Secondary metastatic disease can develop usually from a gastrointestinal or pulmonary primary.
Anamese A 73-year-old male patient presented at our clinic for further evaluation of a right ventricular tumor. In 1996, he had undergone complete resection of a NET(G1) of the larynx, without lymph node metastasis. At presentation in 2017, cardiac MRI showed a 5.2 cm large, homogenous, contrast-enhancing lesion originating from the right ventricular free wall. On TTE and heart catheterisation, right ventricular and right atrial function was not impaired. 18F-FDG PET-CT showed an oval lesion in the right ventricle with uptake-values up to 7.5 SUV max. After resection, histology showed a NET, G3 with Ki67 27%. A first follow-up 68Ga-DOTANOC-PET-CT 3 months later showed a pericardial/right ventricular lesion with pathological tracer uptake suspicious of metastasis or recurrence. Further 68Ga-DOTANOC-PET-CT and CT examinations in the course of sixteen months revealed a progression of the cardiac mass with extension into the mediastinum and lymph node metastases. Additionally, the tumor infiltrated the superior vena cava, and to avoid obstruction, a wallstent was implanted. After initiation of chemotherapy with carboplatin/etoposide AUC-5, follow-up CT showed regression of the intrathoracic metastasis.
Diskussion This case demonstrates the rare finding of a NET(G3) in the heart found 21 years following a NET(G1) of the larynx. This can either be interpreted as late metastasis with progression from G1 to G3 neoplasm, or regarded as a second primary. 68Ga-DOTANOC-PET-CT has an important role in follow-up and high-impact on management of somatostatin-avid malignancies.
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Quellen
- Bonsen LR, Aalbersberg E, Tesselaar M, Stokkel M. et al. (2016) Cardiac neuroendorine tumour metastases: case reports and review of the literature. Nuclear Medicine CommunicationsVolume 37 , Number 5, 1 May 2016; , pp. 461-465 (05) . https://doi.org/10.1097/MNM.0000000000000464
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Quellen
- Bonsen LR, Aalbersberg E, Tesselaar M, Stokkel M. et al. (2016) Cardiac neuroendorine tumour metastases: case reports and review of the literature. Nuclear Medicine CommunicationsVolume 37 , Number 5, 1 May 2016; , pp. 461-465 (05) . https://doi.org/10.1097/MNM.0000000000000464