CTICasesExtensive Pericardial Metastasis from Small Lung Adenocarcinoma
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Imaging findings
CT revealed a small (T1a) adenocarcinoma in the left upper lobe. Accompanying imaging showed extensive pericardial metastasis, characterized by marked nodular and beaded thickening of the pericardium. PET imaging confirmed the high metabolic activity ('red-hot') of the pericardial lesions. Lesions were also present elsewhere in the body.
Key takeaways
This case illustrates that even small primary lung adenocarcinomas (T1a) can lead to aggressive and widespread metastatic disease, including exuberant pericardial metastasis. The extent of metastatic disease does not always correlate with the size of the primary tumor. Pericardial thickening with nodularity and high SUV on PET scan is highly suspicious for pericardial metastasis.
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