"Potential presenting signs and symptoms may greatly vary, influenced by the location of tumour deposit(s) 3,5:"
"high temporal resolution (30–50 ms)"
"T1: hypointense"
"T2: hyperintense"
"For FDG PET assessment of cardiac metastases, patient preparation is critical to suppress the physiological myocardial glucose uptake, which would otherwise obscure focal tumour uptake. Patients should follow a very low-carbohydrate, high-fat diet for at least 24 - 72 hours prior to the scan, ending with a water fast for at least 4-12 hours. This will allow the myocardial metabolism to shift toward free fatty acids and reduce background FDG uptake. Adequate dietary preparation can achieve >80% suppression of normal myocardial uptake, significantly improving detection of pathological uptake 18."
"18F-FDG PET-CT with state-of-the-art CT may aid in differentiation between benign and malignant cardiac tumours. Likely the best present imaging modality to assess the widespread nature of the causative primary malignancy 4."
"Caveat emptor! Calculating a priori probability of synchronous primary cardiac neoplasm in these rare primaries might provide the end of the calculator on Occam's desk."
"multiple masses or nodules with a heterogeneous enhancement pattern, best diagnostic clue"
"The latter finding may alert to the need for pericardiocentesis."
"The latter finding may alert to the need for pericardiocentesis."
Expected headings
"Gross pathology"
"Histopathology"
"Transthoracic echocardiography (TTE)"
"Transoesophageal ultrasound (TOE)"
"Cross-sectional imaging"
"MRI"
"CT"
"Virtually any primary malignancy may metastasise to the heart; however, the most common metastases are:"
"endocardial (5%) - usually ventricular; right ventricle (more common), associated with tumours with endovascular growth potential"
"Encountering a high-grade, undifferentiated tumour may necessitate extensive use of immunohistochemical stains, a preliminary panel of which should include keratinic, melanocytic and lymphoid markers (cf. list of most common primaries) 3,5."
"cardiomegaly (e.g. indicating pericardial effusion and/or cardiac congestion)"