Small direct right ventricular cardiac metastasis of osteosarcoma in a 10-year-old boy affirmed by cardiac MRI

Verena Linder, MD; Torsten Fritscher, MD; Matthias Hammon, MD; Michael Schroth, MD; Wolfgang Schmidt, MD; Michael Uder, MD; Oliver Rompel, MD

Radiology Case Reports (Jun 2020)

Small direct right ventricular cardiac metastasis of osteosarcoma in a 10-year-old boy affirmed by cardiac MRI

Verena Linder, MD,
Torsten Fritscher, MD,
Matthias Hammon, MD,
Michael Schroth, MD,
Wolfgang Schmidt, MD,
Michael Uder, MD,
Oliver Rompel, MD

Affiliations

Verena Linder, MD: Department of Pediatrics and Adolescent Medicine, Cnopf Children's Hospital, St. Johannis Mühlgasse 19, Nürnberg 90419, Germany; Corresponding author.
Torsten Fritscher, MD: Department of Radiology and Nuclear Medicine, Paracelsus Medical University, Nürnberg, Germany
Matthias Hammon, MD: Department of Radiology, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
Michael Schroth, MD: Department of Pediatrics and Adolescent Medicine, Cnopf Children's Hospital, St. Johannis Mühlgasse 19, Nürnberg 90419, Germany
Wolfgang Schmidt, MD: Department of Pediatrics and Adolescent Medicine, Cnopf Children's Hospital, St. Johannis Mühlgasse 19, Nürnberg 90419, Germany
Michael Uder, MD: Department of Radiology, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
Oliver Rompel, MD: Department of Radiology, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany

Journal volume & issue: Vol. 15, no. 6
pp. 761 – 764

Abstract

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Background: Metastatic osteosarcoma with direct cardiac involvement is an exceptionally rare finding. Reliable detection of cardiac metastases is known to be crucial for patients therapy and prognosis. Case Summary: In a 10-year-old boy affected by osteosarcoma of the left femur, a baseline Fluorine-18-fluorodeoxy-glucose positron emission tomography/computed tomography (18F-FDG PET/CT) was performed to assess the full extent of disease. Whole-body scan detected numerous bone metastases together with a single pulmonary metastasis. Moreover, increased tracer uptake was observed in the intracavitary right cardiac ventricle in the position of a subtle spot of calcification. Because of nondetectability of a cavitary lesion on echocardiography, cardiac magnetic resonance imaging (CMRI) examination was performed to evaluate cardiac 18F-FDG PET/CT finding. CMRI revealed a small nodule in the right ventricle attached to the trabeculae, highly suspicious of a direct cardiac metastasis. After 4 cycles of chemotherapy, complete regression of tracer uptake of the lesion was observed on a follow-up 18F-FDG PET/CT scan. Conclusion: CMRI is able to detect even small, clinically asymptomatic cardiac metastases in young patients affected by osteosarcoma.

Published in Radiology Case Reports

ISSN: 1930-0433 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Medicine (General): Medical physics. Medical radiology. Nuclear medicine
Website: https://www.sciencedirect.com/journal/radiology-case-reports

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