Incidental detection of a pulmonary adenocarcinoma on low-dose computed tomography used for attenuation correction in myocardial perfusion imaging with SPECT.

A 68-year-old patient with known 3-vessel coronary artery disease, a history of aortocoronary bypass surgery, and presently without chest pain, was referred to myocardial perfusion imaging for preoperative risk assessment as infrarenal aortic aneurysm repair was planned. Single photon emission computed tomography (CT) revealed normal myocardial perfusion at adenosine-stress and at rest. However, the CT scan used for attenuation correction (AC) demonstrated a large tumor in the right upper lung as an incidental finding, and the patient was referred for staging with F-18 fluorodeoxyglucose positron emission tomography/CT and subsequently to thoracic surgery. The lesion was resected and diagnosed to be an adenocarcinoma (stage pT2, cN0, cM0). When last seen, the patient was recovering well from surgery.