[67Ga-citrate SPECT imaging of the isolated right ventricle heart metastatic malignant melanoma in a patient with chest pain].

AIM

To present a rare case report about a woman with a right heart ventricle malignant melanoma metastasis who presented with chest pain and that was successfully detected by 67Ga-citrate single photon emission computer tomography (SPECT).

MATERIAL AND METHOD

A 73-years-old woman with a past history of excision of a malignant melanoma from the right calf, 6 years later, was admitted to hospital with chest pain. The examination excluded myocardial ischemia. The chest CT and MR imaging detected a large tumour mass in the right heart ventricle. The CT and MR finding was evaluated as a suspect benign, mesenchymal intracardiac tumour. The 67Ga-citrate scintigraphy for restaging of malignant melanoma was performed. The double-head gamma camera VariCam (Elscint) with infrared body countouring and the large field of view was used. The gamma camera was fitted with medium-energy, parallel-hole collimators. Images were evaluated by processing system Xpert-Pro (Elscint).

RESULTS

The whole body planar scintigraphy from anterior and posterior view was negative without pathological uptake of 67Ga-citrate, but the subsequent chest SPECT revealed oval focus (4 x 5 x 4 cm) of the pathological uptake in the right heart ventricle. The SPECT slices and whole body planar scans were evaluated as the suspect isolated metastasis of a malignant melanoma in the right ventricle (it was proven by biopsy) without others metastases. The woman underwent percutaneous transcatheter biopsy from the right heart ventricle and malignant melanoma metastasis was proven.

CONCLUSION

The chest SPECT improved the sensitivity of 67Ga-citrate scintigraphy. The suspect malignant character of cardiac involvement was proven by 67Ga-citrate scintigraphy.