Metastasis to the heart is not as rare as one might expected, with increase incidence over the last decades, which is likely attributable to the improvement of imaging ability to detect myocardial disease ex-vivo and the prolonged survival of cancer patients. The frequency of heart metastases israrein patients with known malignancies, with increase risk on account histological type of primitive tumour and metastatic disease burden. Cardiac involvement from carcinoid is observed in about 50% of patients with carcinoid syndrome, typically with involvement of the right...

A 78-year-old man was referred to Cardiology Department at our hospital for transthoracic echocardiography (TTE) (Movie 1) for evaluation of suspect myocardial antero-septal wall mass with increase of up-take of 18F-Choline at PET-CT exam (Fig.2), performed during follow-up of prostate cancer, surgically treated 2-years before; one lymph-node with suspect features was detected at right common iliac level. Cardiac Magnetic Resonance (CMR)was performed for tissue characterizzation, using 1,5T scanner; ECG -gated cine images were obtained using a segmented steady-state free precessionsequence (b-SSFP - trueFISP); duble and...

Cardiac magnetic resonance (CMR) was performed shortly after TTEand confirmed the presence of a large, well-circumscribed mass in the interventricular septum (cine-RM with SSFP sequences - Fig. 3 - Movie 2). The mass showed hyperintense signal intensity on both T1- and T2-weighted STIR turbo spin echo (TSE) sequences suggestive for fluid/necrotic content also with few and thin intra-lesional septa (Fig. 4A,B). During contrast administration the mass revealed increase signal intensity during first pass of perfusion analysis with predominately peripheral ring-enhancement and mild contrast enhancement along...

This case report shows the added value of multimodality imaging strategy in approaching cardiac masses, in particular in case of heart metastasis from carcinoid tumor with uncommon appearance. In particular, echocardiography allowed a initial evaluation of mass dimension and anatomical features, demonstrating the absence of carcinoid heart disease with no right-sided valvular dysfunction (1); CMR showed unmatched ability for tissue characterization on account high contrast and spatial resolution, guiding the diagnosis towards malignant and secondary nature of the mass; CT with material contrast administration had...

Yao JC, Hassan M, Phan A, et al. One hundred years after “carcinoid”: epidemiology of and prognostic factors for neuroendocrine tumors in 35,825 cases in the United States. J Clin Oncol 2008;26:3063–72. U. H. Pandya, P. A. Pellikka, M. Enriquez-Sarano, W. D. Edwards, H. V. Schaff, and H. M. Connolly, “Metastatic carcinoid tumor to the heart: Echocardiographic-pathologic study of 11 patients,” J. Am. Coll. Cardiol., vol. 40, no. 7, pp. 1328–1332, 2002. J. Davar et al., “Diagnosing and Managing CarcinoidHeartDisease in PatientsWithNeuroendocrine Tumors: An Expert...