Cardiac metastasis of malignant melanoma: a rare cause of complete atrioventricular block.
Malignant melanoma has an aggressive biological behaviour and a high rate of cardiac involvement. As shown from post-mortem studies, metastases of melanoma can involve any organ and cardiac metastases are frequent. This report describes a case of widespread malignant melanoma in a patient with clinical presentation of complete atrioventricular (AV) block. Thorax CT and transthoracic echocardiography revealed a mass involving the conduction system. By VDD permanent pacing (atrial synchronous ventricular pacing), haemodynamic stability was maintained and the patient remains under follow-up receiving chemo-immunotherapy. In the retrospective analysis of the patient's records, we realized that the AV conduction delay had been progressing for at least 7 months. Cardiac metastasis of malignant melanoma is a common finding and can proceed in the absence of overt clinical manifestations. Therefore, the clinician should be alert to the development of cardiac signs and symptoms in a metastatic melanoma patient and should perform a detailed cardiac examination to exclude cardiac metastasis of the tumour.
Ozyuncu
Nil
N
Department of Cardiology, Faculty of Medicine, Ankara University, Sihhiye, Ankara 06002, Turkey. nilozyuncu@yahoo.com
Sahin
Menekse
M
Altin
Timucin
T
Karaoguz
Remzi
R
Guldal
Muharrem
M
Akyurek
Omer
O
D001283:Atrioventricular Node / Q000473:pathology* / Q000503:physiopathology; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D006327:Heart Block / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy*; D006338:Heart Neoplasms / Q000150:complications / Q000556:secondary*; D006801:Humans; D008297:Male; D008545:Melanoma / Q000150:complications / Q000556:secondary*; D008875:Middle Aged; D012878:Skin Neoplasms / Q000473:pathology*