Cardiac metastasis of malignant melanoma: a case report

Abstract

The heart is regularly involved in metastatic neoplasms with cardiac metastases being found in up to 20 % of autopsies. We present a case about a 42-year-old Caucasian female with a fatal metastatic melanoma to the heart. The five- year survival rate for stage IV melanoma (melanoma with metastases to other organs) is 15 to 20 %. If patients with malignant melanoma present with new onset of cardiac symptoms, clinicians should always be aware of the possibility of cardiac metastases and perform further investigations.

Fig. 1

a Transversal angiography CT image after intravenous iodised contrast fluid without ECG triggering shows an inhomogeneous enhancing mass in the right atrium that protrudes through the tricuspid valve towards the right ventricle. Pericardial and bilateral pleural effusion is also seen. b Coronal angiography CT image. There is retrograde flow of contrast fluid towards the liver veins and inferior caval vein; signs of right-sided failure of the heart are present

Fig. 2

a Transversal T1 weighted black-blood ECG-triggered image before the infusion of gadolinium shows a relatively high signal intensity of a mass in the right atrium, compared with that of the muscles. Artefacts can be seen due to the large amount of pleural fluid. b Transversal T1 weighted SE echo planar imaging (EPI) ECG-triggered image after gadolinium shows strong enhancing of the mass in the right atrium, highly suspicious for atrial metastasis of the melanoma. There is a large amount of pleural effusion