Intracavitary cardiac melanoma diagnosed by endomyocardial left ventricular biopsy.
A patient was evaluated for a persistent pericardial effusion and on two-dimensional echocardiography was found to have an intracavitary left ventricular mass. Twenty-two years earlier, a melanoma of the ethmoid sinus had been excised. An electrocardiogram revealed impressive T-wave abnormalities and pathologic Q waves, initially suggestive of "myocardial infarction." However, the coronary arteries were normal at angiography. At catheterization, the left ventricular mass was biopsied, using a transvenous catheter-directed technique, and proved to be a metastatic melanoma. This procedure obviated the need for diagnostic thoracotomy. We believe that this is a unique application of the use of catheter-directed biopsy to make a histologic diagnosis of a left ventricular neoplasm.
D001706:Biopsy; D004452:Echocardiography / Q000379:methods; D004562:Electrocardiography; D004699:Endocardium / Q000473:pathology*; D005260:Female; D006338:Heart Neoplasms / Q000150:complications / Q000473:pathology* / Q000556:secondary; D006352:Heart Ventricles / Q000473:pathology; D006801:Humans; D008545:Melanoma / Q000150:complications / Q000473:pathology* / Q000556:secondary; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D009669:Nose Neoplasms / Q000473:pathology; D010490:Pericardial Effusion / Q000209:etiology