Identification of multiple cardiac metastases from nonsmall-cell lung cancer by 18F-FDG PET/CT A case report

Introduction: Multiple cardiac metastases from nonsmall-cell lung cancer are extremely rare. Multiple cardiac metastases detected by F-18-fluorodeoxyglucose positron-emission tomography/computed tomography (F-18-FDG PET/CT) have not been previously reported. Patient concerns: A 53-year-old man was admitted to the hospital with left back pain for 1 month. Diagnoses: A contrast-enhanced computed tomography (CECT) scan showed a moderately enhancing mass with a necrotic area in the upper left lobe of the lung and a filling defect in the interventricular septum. Two-dimensional transthoracic echocardiography identified a mass attaching to the endocardial surface of interventricular septum. F-18-FDG PET/CT showed multiple intense F-18-FDG uptakes in the cardiac region. Nonsmall-cell lung cancer was confirmed by histopathologic examination of the mass in the upper left lobe of the lung. Intervention: The patient was treated with Gemcitabine chemotherapy. Outcomes: After 18 months of follow-up, the patient achieved stable disease status according to the Response Evaluation Criteria In Solid Tumors guidelines. Lessons: Our case demonstrates that F-18-FDG PET/CT is a sensitive and feasible imaging modality to diagnosis multiple cardiac metastases.