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RECURRENT MEDIASTINUM AND LEFT MID-CHEST BREAST CANCER
Authored By: Xiaoni Hong and Henry Royal.
Patient: 70 year old female
History:  70 year old female who presents with chest pain.
Image Size:[small][as-submitted]

Fig. 1
Rest and pharmacologic-stress myocardial perfusion examination findings: 1. Normal rest and pharmacologic-stress myocardial perfusion. 2. Normal left ventricular size and systolic function. 3. Increased uptake on both thallium and Tc-99m sestamibi images in the mediastinum and mid chest wall likely related to the patient's known cancer recurrence.

Fig. 2
Rest and pharmacologic-stress myocardial perfusion examination findings: 1. Normal rest and pharmacologic-stress myocardial perfusion. 2. Normal left ventricular size and systolic function. 3. Increased uptake on both thallium and Tc-99m sestamibi images in the mediastinum and mid chest wall likely related to the patient's known cancer recurrence.

Fig. 3
Chest CT reveals a low attenuation soft tissue lesion within the left chest wall and abutting the sternum. This lesion measures 5.8 cm x 2.9 cm in maximum transaxial dimensions.
Image Size:[small][as-submitted]

Findings: Rest and pharmacologic-stress myocardial perfusion examination findings:
1. Normal rest and pharmacologic-stress myocardial perfusion.
2. Normal left ventricular size and systolic function.
3. Increased uptake on both thallium and Tc-99m sestamibi images in the mediastinum and mid chest wall likely related to the patient's known cancer recurrence.

CT reveals a low attenuation soft tissue lesion within the left chest wall and abutting the sternum. This lesion measures 5.8 cm x 2.9 cm in maximum transaxial dimensions.

Diagnosis: recurrent mediastinum and Left mid-chest breast cancer
General Discussion:

Long history: 70-year-old female with known coronary artery disease and recurrent breast cancer here for evaluation of chest pain. The electrocardiogram during infusion of the pharmacologic agent today was indeterminate for ischemia.

Radiopharmaceutical: 2.5 mCi Tl-201 chloride i.v. and 22.0 mCi Tc-99m sestamibi i.v.


Discussion: Both thallium and Tc-99m sestamibi are also tumor agent. This case  demonstrates ability od thallium and Tc-sestamibi to incidentally detect recurrent breast carcinoma  if a focally Increased activity is seen extracadiac the cardiac, tumor should be concern.

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Additional Details:

Case Number: 97518Owner(s): Xiaoni Hong and Henry RoyalLast Updated: 02-07-2013
Anatomy: Breast   Pathology: Neoplasm
Modality: Nuc MedAccess Level: Readable by all users, writable by NucMed Certifiers
Keywords: minmACR: 01211.12110

Case has been viewed 22 times.
Certified by Henry Royal on 09-17-2009

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