open access

Vol 12, No 3 (2016)
Case report
Published online: 2016-08-31
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Heart metastasis in the course of melanoma

Aleksandra E. Danieluk, Joanna H. Mańdziuk, Marek Z. Wojtukiewicz, Ewa Sierko
Oncol Clin Pract 2016;12(3):97-101.

open access

Vol 12, No 3 (2016)
CASE REPORT
Published online: 2016-08-31

Abstract

Introduction. The majority of melanoma patients develop distant metastases, the most common locations being the liver, the bones, and the brain. Moreover, it is a neoplasm that involves the heart in an unusually high number of cases compared to other neoplasms. However, there is a wide disproportion between metastasis rate to the heart in autopsy studies and antemortem diagnoses.

Case report. A 78-year-old female patient presented with a nevus in the lumbar area, diagnosed as malignant melanoma. Six months after the procedure, bilateral metastases in inguinal lymph nodes and recrudescence in the post-procedural scar were surgically removed. Radiotherapy covering the area of affected lymph nodes was carried out. During the next two months, regional recurrence of melanoma and metastases to the lungs and liver were observed. Due to the cancer progression the patient underwent three courses of DTIC chemotherapy; however, new lesions in skin and subcutaneous tissue were discovered, so second-line chemotherapy with ipilimumab was commenced. An echocardiography performed at the time showed no abnormalities. Three months later an ECG showed negative T wave in V2–V4, and CT revealed progression in size of the existing lesions and a new lesion located in the heart, infiltrating the interventricular septum. The patient was referred to hospice care.

Conclusions. Since heart metastases are rarely diagnosed antemortem, raising awareness of possible cardiac involvement in the course of melanoma progression among physicians and radiologists is vital. It can lead to more diagnoses of cardiac metastases and therefore provide optimal care for the patients.

Abstract

Introduction. The majority of melanoma patients develop distant metastases, the most common locations being the liver, the bones, and the brain. Moreover, it is a neoplasm that involves the heart in an unusually high number of cases compared to other neoplasms. However, there is a wide disproportion between metastasis rate to the heart in autopsy studies and antemortem diagnoses.

Case report. A 78-year-old female patient presented with a nevus in the lumbar area, diagnosed as malignant melanoma. Six months after the procedure, bilateral metastases in inguinal lymph nodes and recrudescence in the post-procedural scar were surgically removed. Radiotherapy covering the area of affected lymph nodes was carried out. During the next two months, regional recurrence of melanoma and metastases to the lungs and liver were observed. Due to the cancer progression the patient underwent three courses of DTIC chemotherapy; however, new lesions in skin and subcutaneous tissue were discovered, so second-line chemotherapy with ipilimumab was commenced. An echocardiography performed at the time showed no abnormalities. Three months later an ECG showed negative T wave in V2–V4, and CT revealed progression in size of the existing lesions and a new lesion located in the heart, infiltrating the interventricular septum. The patient was referred to hospice care.

Conclusions. Since heart metastases are rarely diagnosed antemortem, raising awareness of possible cardiac involvement in the course of melanoma progression among physicians and radiologists is vital. It can lead to more diagnoses of cardiac metastases and therefore provide optimal care for the patients.

Get Citation

Keywords

melanoma, heart metastasis, rare site of metastasis

About this article
Title

Heart metastasis in the course of melanoma

Journal

Oncology in Clinical Practice

Issue

Vol 12, No 3 (2016)

Article type

Case report

Pages

97-101

Published online

2016-08-31

Bibliographic record

Oncol Clin Pract 2016;12(3):97-101.

Keywords

melanoma
heart metastasis
rare site of metastasis

Authors

Aleksandra E. Danieluk
Joanna H. Mańdziuk
Marek Z. Wojtukiewicz
Ewa Sierko

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