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Case Report
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| A case of myocardial metastasis from lung adenocarcinoma presenting as cerebral infarction | ||||||
| Kentaro Suina1, Satoshi Hirano1, Junko Hirashima1, Kazutaka Shimizu2, Sosuke Takeuchi2, Miyako Morooka3, Kazuo Kubota3, Tateki Ito4, Yuichiro Takeda1, Haruhito Sugiyama1, Nobuyuki Kobayashi1, Koichiro Kudo1 | ||||||
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1Departments of Respiratory Medicine and National Center for Global Health and Medicine.
2Departments of Neurology, National Center for Global Health and Medicine. 3Departments of Division of Nuclear Medicine, National Center for Global Health and Medicine. 4Departments of Pathology Division of Clinical Laboratory, National Center for Global Health and Medicine. | ||||||
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| Suina K, Hirano S, Hirashima J, Shimizu K, Takeuchi S, Morooka M, Kubota K, Ito T, Takeda Y, Sugiyama H, Kobayashi N, Kudo K. A case of myocardial metastasis from lung adenocarcinoma presenting as cerebral infarction. International Journal of Case Reports and Images 2012;3(10):28–31. |
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Abstract
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Introduction:
Myocardial metastasis from lung cancer is rarely found in antemortem settings. Herein we present a case of myocardial metastasis from lung adenocarcinoma presenting as cerebral infarction.
Case Report: A 78-year-old Japanese female (non-smoker) who had been diagnosed with poorly differentiated lung adenocarcinoma suddenly complained of weakness in the left hand on a regular follow-up visit. Brain non-contrast-enhanced computed tomography (CT) scan showed no abnormality. Electrocardiography (ECG) showed abnormal Q waves, ST-segment elevation, and inverted T waves in leads II, III, and aVF that had not been demonstrated previously. The results of brain CT scan and symptoms were strongly suggestive of cerebral infarction. Brain magnetic resonance imaging (MRI) with diffusion-weighted imaging performed 5 days after admission showed a small, acute infarct on a knob on the precentral gyrus. Transthoracic echocardiography performed to detect cardiac sources of embolism revealed an intracardiac mass. Cardiac 18F-fluoro-deoxy-glucose positron emission tomography (18F-FDG PET)/CT scan demonstrated increased uptake in the mass. After the patient died, autopsy revealed many metastatic lesions of various sizes accompanied by thrombi on the surface of the ventricular myocardium. Conclusion: Cardiac 18F-FDG PET/CT was useful for diagnosing myocardial metastasis in our patient. The possibility of cardiac metastases should be considered in patients with lung cancer in the event of sudden cerebral infarction. | |
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Key Words:
Myocardial metastasis, Lung cancer, Cerebral infarction, Cardiac PET/CT
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Author Contributions:
Kentaro Suina – Substantial contributions to conception and design, Acquisition of data, Drafting the article, revising it critically for important intellectual content, Final approval of the version to be published Satoshi Hirano – Substantial contributions to conception and design, Acquisition of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Junko Hirashima – Substantial contributions to conception and design, Acquisition of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Kazutaka Shimizu – Substantial contributions to conception and design, Acquisition of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Sosuke Takeuchi – Substantial contributions to conception and design, Acquisition of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Miyako Morooka – Substantial contributions to conception and design, Acquisition of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Kazuo Kubota – Substantial contributions to conception and design, Acquisition of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Tateki Ito – Substantial contributions to conception and design, acquisition of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Yuichiro Takeda – Substantial contributions to conception and design, Acquisition of data, Drafting the article, revising it critically for important intellectual content, Final approval of the version to be published Haruhito Sugiyama – Substantial contributions to conception and design, Acquisition of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Nobuyuki Kobayashi – Substantial contributions to conception and design, Acquisition of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Koichiro Kudo – Substantial contributions to conception and design, Acquisition of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published |
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Guarantor of submission:
The corresponding author is the guarantor of submission. |
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Source of support:
None |
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Conflict of interest:
Authors declare no conflict of interest. |
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Copyright:
© Kentaro Suina et al. 2012; This article is distributed the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any means provided the original authors and original publisher are properly credited. (Please see Copyright Policy for more information.) |
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