A case of double cancers with myocardial metastasis mimicking acute myocardial infarction both on an electrocardiogram and on Tc-99m-MIBI myocardial SPECT
S. Konishi et al., A case of double cancers with myocardial metastasis mimicking acute myocardial infarction both on an electrocardiogram and on Tc-99m-MIBI myocardial SPECT, ANN NUCL M, 15(4), 2001, pp. 381-385
We report a rare case of double cancers with myocardial metastasis presenti
ng acute myocardial infarction (AMI)-like findings both on an electrocardio
gram (ECG) and on Tc-99m-MIBI myocardial SPECT. The ECG showed abnormal Q-w
aves and ST-segment elevation in leads V-1-V-4, and Tc-99m-MIBI SPECT showe
d a photon deficient area in the anteroseptum. These findings were suggesti
ve of AMI, but the patient had been simultaneously suffering from two adeno
carcinomas, which were lung cancer and gastric cancer, and consecutive ultr
asonic cardiography (UCG) demonstrated a growing mass lesion in the septal
aspect of the left ventricle. After a month he died of severe heart failure
. The histological diagnosis of a specimen of the: cardiac mass lesion was
invasive adenocarcinoma infiltrating to the heart, which revealed that the
myocardial metastasis had mimicked AMI. This case shows that it is difficul
t to distinguish between myocardial infarction and myocardial metastasis wi
th myocardial perfusion SPECT. It is necessary to consider the possibility
of myocardial metastasis when a patient with malignancy presents AMI-like f
indings.