Cardiac metastasis from medullary thyroid carcinoma: insights from multimodal molecular imaging and magnetic resonance imaging

Myocardial metastases are relatively uncommon and are frequently diagnosed postmortem especially in patients with aggressive cancers and systemic dissemination. The imaging phenotype of myocardial metastases of neuroendocrine medullary thyroid carcinoma (MTC) is not exhaustively detailed. Herein, we illustrate the results of cardiac morphofunctional imaging in a 49-year-old woman with sporadic MTC addressed to our institution after total thyroidectomy and multiple neck metastatic lymphadenectomy for dysphagia and increasing serum calcitonin (4840 ng/mL) and carcinoembryonic antigen (35 ng/mL) values. 6-L-18F-fluorodihydroxyphenylalanine (18F-FDOPA) positron emission tomography/computed tomography (PET/CT) established a voluminous and symptomatic left para-pharyngeal nodal metastasis and revealed additional cervical and mediastinal hypermetabolic lymphadenopathies (Panel A...