Key result
18F-FDG PET-CT successfully identified asymptomatic intracardiac melanoma metastases, which were subsequently confirmed and differentiated from tumor thrombus by cardiac MRI.
Why the study?
Cutaneous melanoma can metastasize to the heart and cause severe complications, but cardiac metastases are often asymptomatic and easily missed or misidentified on imaging.
Case Report (n=1)
Multimodality imaging, including 18F-FDG PET-CT and cardiac MRI, is crucial for identifying and differentiating asymptomatic intracardiac melanoma metastases from tumour thrombus.
May support cardiac MRI for characterizing intracardiac melanoma lesions; hypothesis-generating and requires prospective validation.
Cutaneous malignant melanoma is one of the few malignancies that can metastasize to the heart. It is important not to miss cardiac metastases on imaging as they are often clinically asymptomatic, but if present and undiagnosed could lead to significant cardiac compromise, arrhythmias, congestive heart failure, cardiac tamponade or transient ischaemic attacks. Identifying intracardiac metastases on imaging often requires a multimodality approach as they can evade detection due to cardiac motion artefact; be confused with intracardiac thrombus, or be misinterpreted as a normal/anatomical finding. We present an interesting case report of asymptomatic intracardiac melanoma metastases, initially identified on staging 18-fludeoxyglucose positron emission tomography-CT and eventually confirmed on cardiac MRI. The latter was able to differentiate myocardial metastases from tumour thrombus. We also review the relevant literature.
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Sweni et al. (2019) conducted a case report in Intracardiac melanoma metastases (n=1). 18F-FDG PET-CT was evaluated on Detection of intracardiac metastases. 18F-FDG PET-CT successfully identified asymptomatic intracardiac melanoma metastases, which were subsequently confirmed and differentiated from tumor thrombus by cardiac MRI.
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