Interesting ImagesRare Extramedullary Cardiac Involvement of Recurrent Multiple Myeloma Suspected on 18F-FDG and Confirmed on 18F-FluorocholineZhang-Yin, Jules MD∗; Garderet, Laurent MD†; Martino, Suella MD†; Montravers, Françoise MD, PhD∗; Talbot, Jean-Noël MD, PhD∗Author Information From the ∗Department of Nuclear Medicine, Hôpital Tenon AP-HP & Sorbonne Université †Department of Hematology, Hôpital Pitié Salpêtrière AP-HP & Sorbonne Université, Paris, France. Received for publication June 4, 2020; revision accepted June 20, 2020. Conflicts of interest and sources of funding: none declared. Correspondence to: Jules Zhang-Yin, MD, Department of Nuclear Medicine, Hôpital Tenon AP-HP & Sorbonne Université, 4 Rue de la Chine, 75020, Paris, France. E-mail: email@example.com. Clinical Nuclear Medicine: November 2020 - Volume 45 - Issue 11 - p 916-918 doi: 10.1097/RLU.0000000000003234 Buy Metrics Abstract A man experienced pain in the right hemithorax 6 months after a first-line therapy for multiple myeloma (MM). FDG PET/CT showed a large extramedullary extent in the right hemithorax, which was biopsy proven. During the second-line treatment, FDG PET/CT showed no response as well as a suspected myocardium spread, a rare extramedullary location in MM. 18F-Fluorocholine PET/CT and then MRI confirmed myocardium lesions. This case confirms that 18F-fluorocholine PET/CT is able to detect MM recurrence and may be used to complete FDG PET/CT in difficult cases such as suspicion of cardiac MM. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.