Rofo 2020; 192(S 01): S129
DOI: 10.1055/s-0040-1703495
Case-Report
Onkologische Bildgebung/Onkologie
© Georg Thieme Verlag KG Stuttgart · New York

Value of MRI and 68Ga-DOTANOC-PET-CT in a patient with right ventricular neuroendocrine tumor

J Mandl
1   Medizinische Universität Graz, Klinische Abteilung für allgemeine radiologische Diagnostik, Graz
,
J Schmid
2   Medizinische Universität Graz, Klinische Abteilung für Allgemeine Radiologische Diagnostik, Graz
,
B Pernthaler
3   Medizinische Universität Graz, Klinische Abteilung Nuklearmedizin, Graz
,
E Phlank
3   Medizinische Universität Graz, Klinische Abteilung Nuklearmedizin, Graz
,
A Geiger
4   Medizinische Universität Graz, Klinische Abteilung für Onkologie, Graz
,
I Brcic
5   Medizinische Universität Graz, Insitut für Pathologie, Graz
,
P Kump
4   Medizinische Universität Graz, Klinische Abteilung für Onkologie, Graz
,
M Fuchsjäger
6   Medizinische Universität Graz, Klinische Abteilung für allgemeine Radiologische Diagnostik, Graz
,
J Igrec
6   Medizinische Universität Graz, Klinische Abteilung für allgemeine Radiologische Diagnostik, Graz
› Author Affiliations
Further Information

Publication History

Publication Date:
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.

 
  • Quellen

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