Key result
Emergency resection of obstructing right atrial melanoma achieves uneventful recovery and 6-month symptom-free survival.
Why the study?
Cardiac metastases of malignant melanoma are rare in living patients and often diagnosed postmortem, with limited data on surgical treatment outcomes.
Case Report (n=1)
No
Surgical excision of symptomatic cardiac metastasis from malignant melanoma can be performed successfully and provide symptom relief.
Supports vigilance for cardiac metastases in long-term melanoma survivors with dyspnea; leaves open optimal management strategies.
Malignant melanoma has a high propensity for cardiac metastasis, with autopsy studies reporting an incidence of 47-64%. However, in living patients, Cardiac Metastases of Malignant Melanoma (CMMM) are rare (<2%) and often diagnosed postmortem. A 46-year-old woman was presented with dyspnea and fatigue. Sixteen years earlier, she had undergone treatment for malignant melanoma of the right forearm. Echocardiography revealed a right atrial mass (6.5×3.7 cm) intermittently obstructing the tricuspid valve and a smaller mass in the right atrial appendage. PET imaging showed no systemic metastases. Due to the risk of tricuspid obstruction and embolization, the patient underwent emergency surgical resection. Histopathology confirmed metastatic malignant melanoma. Postoperative recovery was uneventful, and she was discharged on postoperative day 11 to continue oncology-directed therapy. At six-month follow-up, she remained asymptomatic. CMMM can present decades after primary melanoma treatment. Advances in imaging facilitate earlier detection, yet diagnosis remains challenging. Surgical excision is the preferred treatment in symptomatic cases. Despite historically poor prognosis, survival has improved with modern immunotherapy. This case underscores the importance of lifelong melanoma surveillance and timely surgical intervention in cases of cardiac obstruction.
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Jonjev et al. (2025) conducted a case report in Cardiac Metastasis of Malignant Melanoma (n=1). Surgical resection was evaluated on Postoperative recovery and symptom status. Emergency surgical resection of a right atrial metastatic melanoma mass obstructing the tricuspid valve resulted in an uneventful recovery and the patient remained symptom-free at 6 months.
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