A case of double cancers with myocardial metastasis mimicking acute myocardial infarction both on an electrocardiogram and on Tc-99m-MIBI myocardial SPECT
- 43 Downloads
We report a rare case of double cancers with myocardial metastasis presenting acute myocardial infarction (AMI)-like findings both on an electrocardiogram (ECG) and on Tc-99m-MIBI myocardial SPECT. The ECG showed abnormal Q-waves and ST-segment elecvation in leads V1−V4, and Tc-99m-MIBI SPECT showed a photon deficient area in the anteroseptum. These findings were suggestive of AMI, but the patient had been simultaneously suffering from two adenocarcinomas, which were lung cancer and gastric cancer, and consecutive ultrasonic 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 difficult to distinguish between myocardial infarction and myocardial metastasis with myocardial perfusion SPECT. It is necessary to consider the possibility of myocardial metastasis when a patient with malignancy presents AMI-like findings.
Key wordsmyocardial metastasis AMI-like findings ECG Tc-99m-MIBI
- 7.Nezuo S, Tohara M, Katsume H, Arakawa M, Sawayama T, Koresawa S, et al. Metastatic cardiac tumor (Original title in Japanese).Naika 1974; 34: 312–316.Google Scholar
- 8.Okada S, Kawanishi K, Ofuji T. A case of metastatic cardiac tumor (Original title in Japanese).Shinzo 1972; 4: 74–79.Google Scholar
- 9.Mikasa K, Katada H, Ito S, Yoneda N, Sawaki M, Mikami R, et al. Transmyocardial metastasis of a lung cancer showing a recent myocardial infarction-like ECG: Report of a case with autopsy findings.Haigan 1985; 25: 93–98.Google Scholar
- 13.Dazai Y, Katoh I, Sueda S, Katoh T, Yoshida R, Fujii M, et al. Report of a case of lung cancer with metastasis to the myocardium which showed electrocardiographic findings similar to acute myocardial infarction and intramyocardial mass on echocardiography.Kokyu To Junkan 1989; 37: 461–465.PubMedGoogle Scholar