Author + information
- Received October 22, 2010
- Revision received November 9, 2010
- Accepted November 18, 2010
- Published online August 30, 2011.
- Keyvan Karimi Galougahi, MD⁎,†,
- Michael Harden, MBBS‡,
- Richard Maher, MBBS, BSc§,
- Anthony Gill, MBBS∥,
- Ravinay Bhindi, MBBS, PhD⁎,†,
- Stuart M. Grieve, MBBS, DPhil†,¶,
- Peter Brady, MBBS‡ and
- Gemma A. Figtree, MBBS, DPhil⁎,†
Metastasis of melanoma to the heart bears a poor prognosis but is often asymptomatic. A 73-year-old man with a history of malignant melanoma and pulmonary metastasis was referred for the assessment of a cardiac mass detected on surveillance computed tomography (A). Review of a previous positron emission tomography scan showed a hypermetabolic focus in this region (B). Echocardiography revealed a large echodense right ventricular (RV) mass (C, Online Video 1). Cardiac magnetic resonance imaging demonstrated the mass infiltrating the RV free wall adjacent to the tricuspid annulus (D, Online Videos 2 and 3). Both the mass and the pulmonary metastases demonstrated T1 hyperintensity (E) consistent with melanin content and heterogeneous enhancement on late-gadolinium images (F, G). Given the threat of embolization, surgery was scheduled. The RV infiltration necessitated a palliative debulking approach (friable tissue) (H). Histopathology confirmed metastatic melanoma (I). This case highlights the key role of cardiac magnetic resonance imaging in characterization of cardiac masses and surgical planning.
This work was supported by the North Shore Heart Research Foundation, Sydney, Australia, and Sydney Medical Foundation, Australia.
- Received October 22, 2010.
- Revision received November 9, 2010.
- Accepted November 18, 2010.
- American College of Cardiology Foundation