Rare Extramedullary Cardiac Involvement of Recurrent Multiple Myeloma Suspected on 18F-FDG and Confirmed on 18F-Fluorocholine.

ABSTRACT

A man experienced pain in the right hemithorax 6 months after a first-line therapy for multiple myeloma (MM). FDG PET/CT showed a large extramedullary extent in the right hemithorax, which was biopsy proven. During the second-line treatment, FDG PET/CT showed no response as well as a suspected myocardium spread, a rare extramedullary location in MM. F-Fluorocholine PET/CT and then MRI confirmed myocardium lesions. This case confirms that F-fluorocholine PET/CT is able to detect MM recurrence and may be used to complete FDG PET/CT in difficult cases such as suspicion of cardiac MM.