A 60-year-old man with history of metastatic renal cell carcinoma and atypical chest pain was referred for dipyridamole Tc-tetrofosmin perfusion scintigraphy (MPS).
Two years earlier, the patient was noted to have myocardial metastases on cardiac MRI. On the MPS, perfusion defects were present at stress in multiple vascular territories; resting myocardial uptake was homogeneous. These findings suggested multivessel atherosclerotic heart disease. In fact, retrospective rigid fusion with prior chest CT and cardiac MRI demonstrated that the reversible perfusion defects corresponded to metastatic deposits in the myocardium. This unusual case illustrates how myocardial metastases can mimic ischemia on MPS.
Written by:
Pelletier-Galarneau M, Hibbert R, Zuckier LS. Are you the author?
Division of Nuclear Medicine; and Department of Radiology, University of Ottawa, Ottawa, Ontario, Canada.
Reference: Clin Nucl Med. 2014 May 28. Epub ahead of print.
PubMed Abstract
PMID: 24873803
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