Synchronous tonsil, gallbladder, and cardiac metastases without any other visceral metastases of malignant melanoma.
BACKGROUND
Malignant melanoma is a highly unpredictable tumor that has capacity to metastasize to any organ. A better understanding is needed of the clinicopathologic features of metastatic melanoma and, in particular, of its rare manifestations.


METHODS
A 33-year-old woman with a past medical history of malignant melanoma presented with symptoms of throat discomfort and bleeding. On physical examination, a dark pigmented lesion was observed on the right tonsil. Tonsillectomy was performed, and melanoma was diagnosed. Computed tomography of the thorax and abdomen revealed a filling defect in the right atrium and a 4-cm gallbladder mass. Echocardiography revealed a right atrial mass. No further metastasis was detected by whole body (18)F-fluorodeoxyglucose positron emission tomography. Each metastasis was completely resected with clear margins. The pathologic diagnosis of the resected masses was malignant melanoma. 3 weeks after the final surgery, temozolomide was started. The patient has been followed up for 9 months after diagnosis of the first recurrence, and no new metastases have been detected.


CONCLUSIONS
We report a case with synchronous tonsil, gallbladder, and heart metastases without any other common sites of metastasis of melanoma. The patient was successfully treated with aggressive surgery followed by temozolomide.
Cicin
Irfan
I
Department of Medical Oncology, Faculty of Medicine, Trakya University, Edirne, Turkey. irfancicin@hotmail.com
Usta
Ufuk
U
Sezer
Atakan
A
Canbaz
Suat
S
Uzunoglu
Sernaz
S
Karagol
Hakan
H
Genchellac
Hakan
H
Karasalihoglu
Ahmet Rifat
AR
D000328:Adult; D005260:Female; D005706:Gallbladder Neoplasms / Q000175:diagnosis / Q000556:secondary*; D006338:Heart Neoplasms / Q000175:diagnosis / Q000556:secondary*; D006801:Humans; D008545:Melanoma / Q000175:diagnosis / Q000556:secondary*; D009382:Neoplasms, Unknown Primary / Q000175:diagnosis*; D014067:Tonsillar Neoplasms / Q000175:diagnosis / Q000556:secondary*; D014781:Viscera