Fig. 8

Local extension. a Axial FDG-PET/CT image in a patient with melanoma shows multiple hypermetabolic nodules on the cardiac surface (arrow). There is also pericardial effusion. b MRI was performed to better characterize the extent of these lesion, particularly to see whether there was myocardial involvement. Four-chamber delayed enhancement MRI shows the multiple pericardial masses extending to the myocardium. Diffuse heterogeneous myocardial enhancement (arrows) is seen, indicating diffuse infiltration