title: Myocardial metastases from renal cell carcinoma mimicking ischemia on myocardial perfusion scintigraphy.
abstract: A 60-year-old man with history of metastatic renal cell carcinoma and atypical chest pain was referred for dipyridamole Tc-tetrofosmin perfusion scintigraphy (MPS). Two years earlier, the patient was noted to have myocardial metastases on cardiac MRI. On the MPS, perfusion defects were present at stress in multiple vascular territories; resting myocardial uptake was homogeneous. These findings suggested multivessel atherosclerotic heart disease. In fact, retrospective rigid fusion with prior chest CT and cardiac MRI demonstrated that the reversible perfusion defects corresponded to metastatic deposits in the myocardium. This unusual case illustrates how myocardial metastases can mimic ischemia on MPS.
authors.affiliation: From the *Division of Nuclear Medicine, and †Department of Radiology, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Matthieu
authors.initials: M
authors.lastname: Pelletier-Galarneau
authors.forename: Rebecca
authors.initials: R
authors.lastname: Hibbert
authors.forename: Lionel S
authors.initials: LS
authors.lastname: Zuckier
mesh_terms: D002292:Carcinoma, Renal Cell / Q000000981:diagnostic imaging* / Q000556:secondary; D003937:Diagnosis, Differential; D006338:Heart Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging*; D055420:Perfusion Imaging