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Marketou ME, Kapsoritakis N, Bourogianni O, Patrianakos A, Kochiadakis G, Plevritaki A, Papadaki S, Zervakis S, Parthenakis F, Koukouraki S. Hybrid imaging of neuroendocrine tumors in the heart: Union is strength. J Nucl Cardiol 2023; 30:298-312. [PMID: 34622428 DOI: 10.1007/s12350-021-02804-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 08/22/2021] [Indexed: 11/28/2022]
Abstract
Cardiac neuroendocrine tumors (NETs) are particularly rare tumors that can lead to a very poor clinical outcome, partly because of metastases but mainly because of manifestations of the hormonal activity they exhibit. Prompt diagnosis is important in order to start the most effective treatment for their removal or management, with the fewest complications. They are often difficult to diagnose, especially in their early stages. One of the reasons for this is that the heart is an organ with a high rate of metabolism and is located in close proximity to other high-metabolism organs. In addition, the anatomic location and their small size render their diagnosis extremely challenging. In recent years, hybrid imaging methods have revolutionized the diagnostic approach to oncology patients and have established a place in the diagnosis of cardiac NETs, because they provide both anatomical and functional information at the same time. Positron emission tomography/computed tomography (PET/CT), PET/magnetic resonance imaging (PET/MRI) and single-photon emission computed tomography/CT (SPECT/CT) are widely used in clinical practice because of the very important metabolic information, the high sensitivity and specificity. However, prospective studies are needed to confirm the true clinical and prognostic value of various hybrid imaging diagnostic techniques in cardiac NETs.
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Affiliation(s)
- Maria E Marketou
- Cardiology Department, Heraklion University Hospital, P.O. Box 1352, Stavrakia, Heraklion, Greece.
| | - Nikolaos Kapsoritakis
- Department of Nuclear Medicine, School of Medicine, University of Crete, Heraklion, Greece
| | - Olga Bourogianni
- Department of Nuclear Medicine, School of Medicine, University of Crete, Heraklion, Greece
| | - Alexandros Patrianakos
- Cardiology Department, Heraklion University Hospital, P.O. Box 1352, Stavrakia, Heraklion, Greece
| | - George Kochiadakis
- Cardiology Department, Heraklion University Hospital, P.O. Box 1352, Stavrakia, Heraklion, Greece
| | - Anthoula Plevritaki
- Cardiology Department, Heraklion University Hospital, P.O. Box 1352, Stavrakia, Heraklion, Greece
| | - Sophia Papadaki
- Cardiology Department, Heraklion University Hospital, P.O. Box 1352, Stavrakia, Heraklion, Greece
| | - Stelios Zervakis
- Cardiology Department, Heraklion University Hospital, P.O. Box 1352, Stavrakia, Heraklion, Greece
| | - Fragiskos Parthenakis
- Cardiology Department, Heraklion University Hospital, P.O. Box 1352, Stavrakia, Heraklion, Greece
| | - Sophia Koukouraki
- Department of Nuclear Medicine, School of Medicine, University of Crete, Heraklion, Greece
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Nan X, Dharmawardhane A. Rare case of concurrent suprasternal and cardiac metastasis from small bowel neuroendocrine tumour. J Surg Case Rep 2022; 2022:rjac308. [PMID: 35769309 PMCID: PMC9218994 DOI: 10.1093/jscr/rjac308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Accepted: 06/01/2022] [Indexed: 11/13/2022] Open
Abstract
Neuroendocrine tumours (NETs) are rare tumours derived from the neuroendocrine cell system, arising across a wide range of organs, most commonly the gastrointestinal tract and bronchopulmonary symptoms. Although NETs can metastasis widely throughout the body, cardiac metastasis is rare with an incidence of 2–4% and usually presents in the presence of extensive metastasis elsewhere. Suprasternal metastasis to the neck is exceedingly rare with <20 cases reported in the literature. We report the case of a 71-year-old female with concurrent cardiac and suprasternal metastasis at diagnosis of terminal ileal NET.
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Affiliation(s)
- Xinyi Nan
- Surgical & Critical Care Division , Gold Coast Health & Hospital Services, Gold Coast, Queensland, Australia
| | - Anoj Dharmawardhane
- Department of Surgery , Darling Downs Hospital & Health Services, Toowoomba, Queensland, Australia
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3
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Buffet C, Leboulleux S, Kraeber-Bodéré F, Bodet-Milin C, Cabanes L, Dohan A, Leprince P, Schlumberger M, Huillard O, Groussin L. Cardiac Metastasis from Medullary Thyroid Cancers with Long-Term Survival under Vandetanib. Eur Thyroid J 2021; 10:517-522. [PMID: 34956923 PMCID: PMC8647102 DOI: 10.1159/000517716] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 06/07/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Cardiac metastases from thyroid cancers are uncommon with a poor prognosis. There is a lack of long-term follow-up studies. CASES We report 2 cases of cardiac metastasis from medullary thyroid cancer (MTC). Both patients presented limited metastatic disease apart from a cardiac metastasis. The initial diagnosis was challenging and was facilitated by functional imaging with an immuno-PET-CT using an anti-CEA bispecific antibody and a 68Ga-labeled peptide. Both patients were treated with the multitarget kinase inhibitor vandetanib with prolonged stability. The first patient was alive at the last follow-up, 14 years after the diagnosis of cardiac metastasis. The second patient required surgical excision of the cardiac mass because of disease progression under vandetanib. CONCLUSION These cases illustrate long-term survival and effectiveness of clinical management of 2 patients who developed cardiac metastases from MTC, in the current era of personalized medicine with targeted therapy.
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Affiliation(s)
- Camille Buffet
- Department of Thyroid Pathologies and Endocrine Tumors, AP-HP, Pitié-Salpêtrière Hospital, Groupe de Recherche Clinique n°16 Tumeurs Thyroïdiennes, Sorbonne Université, Paris, France
- UMR9019, Genome Integrity and Cancers, CNRS, Villejuif, France
| | - Sophie Leboulleux
- Department of Nuclear Medicine and Endocrine Oncology, Gustave Roussy Institut, Villejuif, France
| | - Françoise Kraeber-Bodéré
- Nuclear Medicine Department, Université de Nantes, CHU de Nantes, CNRS, Inserm, CRCINA, Nantes, France
- CHU Nantes/ICO, Saint-Herblain, France
| | - Caroline Bodet-Milin
- Nuclear Medicine Department, Université de Nantes, CHU de Nantes, CNRS, Inserm, CRCINA, Nantes, France
- CHU Nantes/ICO, Saint-Herblain, France
| | - Laure Cabanes
- Department of Cardiology, APHP, Cochin Hospital, Paris, France
- Université de Paris, Paris, France
| | - Anthony Dohan
- Radiology Department, Université de Paris, Paris, France
- Department of Radiology, AP-HP, Hôpital Cochin, Paris, France
| | - Pascal Leprince
- Department of Thoracic and Cardiovascular Surgery, Sorbonne Université, AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Martin Schlumberger
- UMR9019, Genome Integrity and Cancers, CNRS, Villejuif, France
- Department of Nuclear Medicine and Endocrine Oncology, Gustave Roussy Institute, Villejuif, France
| | - Olivier Huillard
- Université de Paris, Sorbonne Paris Cité, Paris, France
- Department of Medical Oncology, AP-HP, Hôpital Cochin, Paris, France
| | - Lionel Groussin
- INSERM Unité 1016, CNRS UMR 8104, Institut Cochin, Paris, France
- Université de Paris, Paris, France
- Department of Endocrinology, AP-HP, Hôpital Cochin, Paris, France
- *Lionel Groussin,
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Mikail N, Pisani A, El Hatimi S, Hentic O, Lebtahi R, Poitier B, Braham W, Deschamps L, Ehmer C, Ben Driss A, Alkhoder S, Ou P. Early Diagnosis and Treatment of Myocardial Neuroendocrine Tumor Metastasis: The Cornerstone Role of Multimodality Imaging. Circ Cardiovasc Imaging 2021; 14:e011857. [PMID: 33794650 DOI: 10.1161/circimaging.120.011857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Nidaa Mikail
- Department of Nuclear Medicine, Beaujon Hospital, APHP, Clichy, France (N.M., R.L.)
| | - Angelo Pisani
- Department of Cardiac Surgery (A.P., B.P., W.B., S.A.), Bichat Hospital, APHP, Paris, France
| | - Safwane El Hatimi
- Department of Cardiovascular Imaging, Bichat Hospital, APHP, Paris Diderot University, Inserm 1148, France (S.E.H., C.E., A.B.D., P.O.)
| | - Olivia Hentic
- Department of Gastroenterology-Pancreatology, ENETS Centre of Excellence, Beaujon University Hospital (APHP), and Université de Paris, Clichy, France (O.H.)
| | - Rachida Lebtahi
- Department of Nuclear Medicine, Beaujon Hospital, APHP, Clichy, France (N.M., R.L.)
| | - Bastien Poitier
- Department of Cardiac Surgery (A.P., B.P., W.B., S.A.), Bichat Hospital, APHP, Paris, France
| | - Wael Braham
- Department of Cardiac Surgery (A.P., B.P., W.B., S.A.), Bichat Hospital, APHP, Paris, France
| | - Lydia Deschamps
- Department of Pathology (L.D.), Bichat Hospital, APHP, Paris, France
| | - Carsten Ehmer
- Department of Cardiovascular Imaging, Bichat Hospital, APHP, Paris Diderot University, Inserm 1148, France (S.E.H., C.E., A.B.D., P.O.)
| | - Ahmed Ben Driss
- Department of Cardiovascular Imaging, Bichat Hospital, APHP, Paris Diderot University, Inserm 1148, France (S.E.H., C.E., A.B.D., P.O.)
| | - Soleiman Alkhoder
- Department of Cardiac Surgery (A.P., B.P., W.B., S.A.), Bichat Hospital, APHP, Paris, France
| | - Phalla Ou
- Department of Cardiovascular Imaging, Bichat Hospital, APHP, Paris Diderot University, Inserm 1148, France (S.E.H., C.E., A.B.D., P.O.)
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Georgiopoulos G, Mitropoulou P, Masci PG, Schwitter J. A concealed carcinoid cardiac metastasis uncovered by comprehensive cardiovascular magnetic resonance-based tissue characterization: a case report. Eur Heart J Case Rep 2021; 4:1-5. [PMID: 33442650 PMCID: PMC7793190 DOI: 10.1093/ehjcr/ytaa354] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 05/11/2020] [Accepted: 09/08/2020] [Indexed: 02/03/2023]
Abstract
Background Cardiac metastases of carcinoid tumours are extremely rare, and their diagnosis poses a significant challenge. A variety of techniques has been reported in the literature for this purpose, ranging from echocardiogram to the Indium-111 Octreotide, positron emission tomography using specific tracers, and biopsy. Occasionally, the diagnosis is only made post-mortem. Recently, CMR (cardiovascular magnetic resonance) has been added to the diagnostic toolkit. This case report describes the CMR sequences that can be used to characterize cardiac metastases of carcinoid tumours. Case summary A 55-year-old woman with an antecedent history of resected carcinoid tumour of the ileocecal junction underwent whole-body In-111 Octreoscan single-photon emission computed tomography in the context of her follow-up. This raised the suspicion of pericardial involvement, which prompted a CMR study. Comprehensive CMR findings were consistent with isolated carcinoid tumour metastasis embedded within the anterior papillary muscle. We describe the CMR sequences that were used to characterize the metastasis. Discussion The rarity of cardiac metastasis of carcinoid tumour makes its diagnosis challenging and warrants a high level of clinical suspicion. Cardiovascular magnetic resonance imaging proves to be an indispensable tool in the tissue characterization of such tumours.
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Affiliation(s)
- Georgios Georgiopoulos
- School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas Hospital, Westminster Bridge Road, London SE1 7EH, UK.,Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Leoforos Vasilissis Sofias 80, Athens 11528, Greece
| | - Panagiota Mitropoulou
- Department of Cardiology, Queen Alexandra Hospital, Southwick Hill Road, Cosham, Portsmouth PO6 3LY, UK
| | - Pier Giorgio Masci
- School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas Hospital, Westminster Bridge Road, London SE1 7EH, UK
| | - Juerg Schwitter
- Centre of Cardiac Magnetic Resonance, Lausanne University Hospital, Rue du Bugnon 46, Lausanne 1011, Switzerland
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