Isolated Myocardial Metastases in a Neuroendocrine Tumor

Cardiac metastases from neuroendocrine tumors (NETs) are rare and usually occur in advanced metastatic disease. We present a 58-year-old man with a well-differentiated terminal ileum NET (grade 1, Ki-67 1%) who underwent 68Ga-DOTATATE PET/CT for staging. The scan demonstrated intense uptake in the primary tumor and 2 incidental myocardial foci. Subsequent cardiac magnetic resonance imaging (CMR) revealed myocardial signal heterogeneity at corresponding locations, supporting the diagnosis of myocardial metastases. This case illustrates isolated myocardial involvement detected at initial staging of a well-differentiated NET and highlights the complementary role of somatostatin receptor-based PET/CT and CMR in detecting cardiac metastases.