Report an error   

Submitted: 31 August 2011 Modified: 07 July 2017
HERDIN Record #: PCHRD08311102084423

Incidental detection of an anterior mediastinal mass during dipyridamole stress Tc-99m sestamibi myocardial perfusion imaging for coronary artery disease.

1Edward-Bengie L. Magsombol,
2Earl Fidel M. Villareal
Section of Nuclear Cardiology,Heart Institute - St. Luke's Medical Center


Primary anterior mediastinal neoplasms account for 50% of all mediastinal masses with thymomas being the most common. These tumors demonstrate T1-20 1, Tc-99m sestamibi, and Tcc99m tetrofosmin uptake during SPECT myocardial scintigraphy A 60-year-old Filipino with hypertension, dyslipidemia and prior history of ischemic stroke underwent Tc-99m sestamibi SPECT dipyridamole stress. Inhomogeneous tracer uptake of the left ventricle in the inferior and inferolateral region was noted which was attributed to diaphragmatic attenuation. Gated SPECT showed normal myocardial thickening and wall motion. Extracardiac mediastinal activity was visualized on both the resting and stress images. Computed tomography scan demonstrated two (2) well-defined homogeneously enhancing lesions in the left anterior mediastinum most likely a thymoma. Specialists who interpret myocardial scintigrams should be aware of the causes of non-cardiac uptake so that unanticipated focal extracardiac accumulation during myocardial scintigraphy will lead to further investigation to establish the diagnosis of mediastinal tumors.

Publication Type:
Publication Sub Type:
Case report
The Philippine Journal of Nuclear Medicine
Publication Date:
July-December 2010
Heart Institute, St. Luke's Medical Center

LocationCall NumberAvailable FormatAvailability
Philippine Council for Health Research and Development Library Box No. 32 Fulltext pdf (Request Document)
1. Strollo, DC , Rosado de Christenso, ML , Jett, JR . "Primary mediastinal tumors. Part 1" Chest 112, 511-522, 1997
2. Ishibashi, M , Fujimoto, K , Ohzono, H . "Tc99m tetrofosmin uptake in mediastinal tumours" Br J Radiol 69, 1134-1138, 1996
3. Yuzuriha, H , Morimoto, M , Inokawa, K . "Scintiscanning demonstration of thymoma: Comparative study on scintiscans using Tl201,Ga67, Se 75" Jpn J Surg 16, 250-256, 1986
4. Campeau, R , Ey, E , Varma, D . "Thallium-201 uptake in a benign thymoma" Clin Nucl Med 11, 524, 1986
5. Adalet, I , Kocak, M , Ece, T . "Tc99m MIBI and T1-201 uptake in benign thymoma" clin Nucl Med 20, 733-734, 1995
6. Maticke, G , Sokol, J , Jozwiak, J . "Detection of thymomas by SPECT thallium imaging" J Nucl Cardiol 5, 449-450, 1998
7. Paull, DE , Graham, J , Forgett, J , Turissini, T , Saidman, B . "Detection of occult thymoma during exercise Thallium 201, Technetium 99m tetrofosmin imaging for coronary artery disease" Chest 118(2): 550-55, 2000
8. Hawkins, M , Scarsbrook, F , Pavlitchouk, S , Moore, NR , Bradley, KM . "Detection of an occult thymoma on 99Tcm-Tetrofosmin myocardial scintigraphy" Br J Radiol 80, 72-72, 2007
9. Seto, H , Kageyama, M , Shimizu, M , Wu, Y , Kamei, T , Kakishita, M . "Assessment of residual tumor viability in thymic carcinoma by sequential Thallium-201SPECT: Comparison with CT and biopsy findings" J Nuc Med 35, 1659-1661, 1994