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False-negative Findings for Cardiac Metastasis from Cervical Cancer on Fluorodeoxyglucose-Positron Emission Tomography/Computed Tomography

Tadaharu Nakasone*, Yusuke Taira, Tomoko Nakamoto, Wataru Kudaka, Yoichi Aoki

Background: Cardiac metastasis of cervical cancer is rare and has a poor prognosis. Some reports suggest that Positron Emission Tomography (PET) is useful in the diagnosis of cardiac metastasis. Case: A-40-year-old woman who had a history of cardiac surgery was treated with concurrent chemo-radiotherapy for stage IIIA cervical cancer (squamous cell carcinoma) and showed good response to treatment one year earlier. At 9 months post-treatment, Computed Tomography (CT) scan showed a thrombus in the left atrium, and the patient was started on warfarin. Three months later, a CT scan showed a mass in the right ventricle. PET scan showed no significant accumulation, and open heart surgery was performed with a preoperative diagnosis of thrombus. However, the postoperative pathological diagnosis was cardiac metastasis. Four months after the heart surgery, the tumor recurred in the right ventricle and embolized in the pulmonary artery, resulting in the patient’s death. Conclusion: In the diagnosis of cardiac metastases, PET may give false-negative results due to concomitant thrombosis.