Key result
TEE confirms intense RA 18F-FDG uptake is a prominent crista terminalis masquerading as a tumor.
Why the study?
Physiologic F-18 FDG activity in the crista terminalis can be mistakenly identified as a malignant mass, highlighting the need to understand benign uptake in normal anatomical structures during cardiac imaging.
Case Report (n=1)
Physiologic 18F-FDG uptake in the crista terminalis can mimic a malignant mass in the right atrium, highlighting the importance of multimodality imaging like TEE for accurate diagnosis.
Intense right atrial FDG uptake may represent crista terminalis; TEE confirmation is prudent and systematic evaluation remains lacking.
The crista terminalis is a structure found in the right atrium, traversing along the posterolateral wall between the superior vena cava and the inferior vena cava. In some cases, the physiologic activity of F-18 FDG in crista terminalis can be mistakenly identified as a malignant mass, as was the situation in our case. Therefore, it is essential to have a thorough understanding of benign/physiologic uptake in normal anatomical structures and their variants when interpreting cardiac imaging. In this report, we present the case of a 79-year-old female patient who had recently been diagnosed with breast cancer. An 18F-FDG (fluorodeoxyglucose) PET/CT scan imaging assessment as part of staging revealed intense metabolic activity in the right atrium corresponding to prominent soft tissue. Subsequent assessment using transesophageal echocardiography (TEE) ultimately confirmed the diagnosis of a prominent crista terminalis, which is a normal anatomical variant.
No takes yet. Share an insight, caveat, or question.
Ghesani et al. (2023) conducted a case report in Breast cancer (n=1). 18F-FDG PET/CT and Transesophageal echocardiography was evaluated. Transesophageal echocardiography confirmed that intense 18F-FDG uptake in the right atrium was a prominent crista terminalis, a normal anatomical variant masquerading as a tumor.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: