DIFFUSE INFILTRATIVE METASTATIC NEUROENDOCRINE TUMOR PRESENTING WITH DYNAMIC OUTFLOW OBSTRUCTION: ROLE OF MULTIMODALITY IMAGING
Recommended Citation
Sabra M, Nguyen F, Ananthasubramaniam K. DIFFUSE INFILTRATIVE METASTATIC NEUROENDOCRINE TUMOR PRESENTING WITH DYNAMIC OUTFLOW OBSTRUCTION: ROLE OF MULTIMODALITY IMAGING. J Am Coll Cardiol 2025; 85(12):4599.
Document Type
Conference Proceeding
Publication Date
4-1-2025
Publication Title
J Am Coll Cardiol
Keywords
case report, clinical article, conference abstract, diagnosis, echocardiography, heart failure, heart left ventricle outflow tract obstruction, heart metastasis, human, hypertrophic cardiomyopathy, male, metastasis, neuroendocrine tumor, positron emission tomography, radionuclide therapy, single photon emission computed tomography
Abstract
Background: Neuroendocrine tumors (NET) are rare, slow-growing tumors with an incidence of 2.25 per 100,000, and cardiac metastasis is an exceptionally rare complication. Case 66-year-old male with metastatic somatostatin receptor positive NET presented to cardiology clinic for evaluation prior to starting radionuclide therapy. He underwent a transthoracic echocardiogram (TTE) that showed severe asymmetric septal hypertrophy (2.5 cm) and dynamic LVOT obstruction (Fig. E,F). Additionally, increased backscatter and focal echogenic areas and masses were noted (Fig. A,B). Subsequently, he underwent a whole body FDG PET scan that showed patchy increased uptake in the left ventricle and right ventricle suspicious for cardiac metastasis (Fig. C,D). The patient was referred for radionuclide therapy. Decision-making Cardiac metastasis is rare, typically seen in advanced, widespread tumors. NET with cardiac metastasis are usually asymptomatic from a cardiac perspective, although some cases present with heart failure. Left ventricle metastasis occurs in 53% of cases. While TTE can be challenging to detect metastasis, our case highlights the crucial role of multimodality imaging (TTE and SPECT) in identifying obstructive physiology and cardiac metastasis. Conclusion Multimodality imaging using TTE and FDG PET is a valuable tool for the surveillance and detection of cardiac metastases in NET. [Formula presented]
Volume
85
Issue
12
First Page
4599
