A case report of a malignant melanoma in the cardiologic diagnostic workup

TL;DR

This case report describes a patient with melanoma whose heart was found to have a tumor linked to the cancer, highlighting the importance of cardiovascular imaging in cancer care.

Contribution

The paper presents a rare case of cardiac metastasis from melanoma detected during pre-therapy cardiac evaluation.

Findings

Cardiac imaging identified a probable cardiac manifestation of melanoma in an 81-year-old patient.

Cardiovascular imaging is crucial for baseline risk assessment and diagnosing cardiac tumors in cancer patients.

Cardiac metastases are more common than primary heart tumors in cancer patients.

Abstract

Cardiovascular imaging plays an important role in identifying pre-existing cardiac comorbidity prior to the decision on cancer therapy and serves as a reference for detecting changes during treatment and long-term follow-up and also in the further identification of a possible cardiac manifestation of the underlying oncological disease.

We report the case of an 81-year-old patient with a malignant melanoma. The patient initially was presented before the start of adjuvant therapy with serine/threonine-protein kinase B-Raf/mitogen-activated extracellular signal-regulated kinase inhibitors. Cardiologic staged diagnostics using transthoracic echocardiography, transoesophageal echocardiography, and cardiovascular magnetic resonance imaging (CMR) revealed with a high probability a cardiac manifestation of the underlying disease. The echocardiographic and CMR results as well as the diagnostic workup are presented.

Cardiac masses in general have a variety of differential diagnoses. Cardiac metastases are much more common than primary neoplasms in a ratio of about 10:1. Cardiovascular risk stratification is recommended in all patients with cancer before starting potentially cardiotoxic anticancer therapy. Cardiovascular imaging plays an important role for baseline risk stratification but is also the leading diagnostic tool in the differential diagnosis of cardiac tumours and the planning of a potential therapy.

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