Detection of an occult thymoma on⁹⁹Tc^m-Tetrofosmin myocardial scintigraphy

Abstract

Thymoma is an uncommon tumour, which is often asymptomatic and may be detected coincidentally on cross-sectional imaging performed for other reasons. We report a case of thymoma detected on myocardial scintigraphy performed for suspected coronary artery disease. Extracardiac pathology may be suggested by abnormal non-cardiac tracer uptake on myocardial scintigraphy. An awareness of the potential causes of this is essential to allow potentially life threatening non-cardiac disorders to be recognized and treated promptly.

Two Invasive Thymomas Incidentally Found during Coronary Artery Bypass Graft Surgery

“…Since the thymoma may be asymptomatic or accompanied by nonspecific signs, it is not uncommon to find thymic tumors coincidentally on imaging studies for investigating other disorders [4]; moreover, some thymic tumors may be discovered intraoperatively and are not detected in radiography before surgery especially when we do not keep it as a differential diagnosis in our minds [6–10]. There are few reports in which thymomas were found incidentally during cardiac surgery and had not been detected in imaging prior to surgery [9, 10].…”

“…There are few reports in which thymic mass was discovered incidentally during cardiovascular workups prior to coronary artery bypass grafting (CABG)/stenting or intraoperatively [6–10]. …”

Imaging of Thymic Epithelial Neoplasms

“…Several case reports document the identification of previously unsuspected thymic neoplasms in patients imaged for other reasons [34]. Thallium 201 ( 201 Tl) scintigraphy has been used in the past to differentiate between normal thymus and lymphoid follicular thymic hyperplasia in patients with myasthenia gravis using single photon emission CT (SPECT) imaging, but it is rarely used clinically.…”

Unusual incidental findings by SPECT myocardial perfusion imaging and CT in the same patient

“…3,4 They may present with chest pain or shortness of breath. Up to 50% of patients have symptoms suggestive of Myasthenia Gravis including weakness, diplopia, ptosis, or dysphagia.…”