Metastatic Melanoma Presenting as a Ventricular Arrhythmia

Babar, Arslan; Lak, Hassan Mehmood; Chawla, Sanchit; Mahalwar, Gauranga; Maroo, Anjli

doi:10.7759/cureus.7634

Cited by 4 publications

(4 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Similar cases to this have been reported in the literature with one describing polymorphic ventricular tachycardia,7 and two recent cases describing monomorphic ventricular tachycardia such as we report here 8 9. Sudden death in the community (presumed secondary to ventricular arrhythmia) has also been reported 10.…”

Section: Discussionsupporting

confidence: 89%

Metastatic melanoma to the heart causing ventricular tachycardia: looking beyond the troponin

et al. 2022

View full text Add to dashboard Cite

A man in his mid-50s presented with palpitations, chest pain and syncope. After initial workup for a non-ST elevation myocardial infarction, a CT scan revealed metastatic melanoma. The malignancy was infiltrating his right ventricle, resulting in recurrent ventricular tachycardia. Although initially hard to manage, his arrhythmias were eventually controlled with medication. Unfortunately, despite an initial response to immunotherapy, he died six months after diagnosis.Cardiac metastases are rare, but melanoma has a high predication for metastasising to the heart and a small number of cases of such metastases causing ventricular arrhythmias have previously been reported. This case shows the importance of concurrent investigations when patients report multiple, seemingly unrelated symptoms as a unifying diagnosis may be uncovered.

show abstract

Section: Discussionsupporting

confidence: 89%

Metastatic melanoma to the heart causing ventricular tachycardia: looking beyond the troponin

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Our systematic literature review identified 1012 articles with 36 studies meeting inclusion criteria (Figure S1 ). 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 All studies received an evidence level of 4 based on the OCEBM Levels of Evidence categorization with a total of 40 individual cases of cardiac metastasis of melanoma identified from these studies.…”

Section: Resultsmentioning

confidence: 99%

“…Our systematic literature review identified 1012 articles with 36 studies meeting inclusion criteria (Figure S1). 19‐50 All studies received an evidence level of 4 based on the OCEBM Levels of Evidence categorization with a total of 40 individual cases of cardiac metastasis of melanoma identified from these studies.…”

Section: Resultsmentioning

confidence: 99%

Metastatic melanoma of the heart: Retrospective cohort study and systematic review of prevalence, clinical characteristics, and outcomes

et al. 2022

View full text Add to dashboard Cite

Background Cardiac metastasis of melanoma is rare and typically diagnosed post‐mortem. Here we perform a retrospective cohort study and systematic review of patients with metastatic melanoma to characterize prevalence, clinical characteristics, and outcomes of cardiac metastasis. Methods We reviewed the electronic medical records of all outpatients with metastatic melanoma who underwent evaluation at the University of Michigan in Ann Arbor from January 2009 to January 2022, identifying patients with a clinical or histopathologic diagnosis of cardiac metastasis. We performed a systematic review of the literature to summarize the clinical characteristics and outcomes of patients with melanoma and cardiac metastasis. Results Overall, 23 of 1254 (1.8%) patients with metastatic melanoma were diagnosed with cardiac metastasis. Cardiac metastasis was reported in the right ventricle (65%), left ventricle (35%), and right atrium (35%). A total of 11 (48%) patients experienced at least one cardiovascular complication after the diagnosis of cardiac metastasis, the most common being arrhythmia (30%), heart failure (22%), and pericardial effusion (17%). Immunotherapy was more commonly used in patients with cardiac metastasis (80% vs 65%; p = 0.005). Mortality at 2‐years post‐diagnosis was higher for patients with cardiac metastasis compared to those without (59% vs 37%; p = 0.034). Progression of malignancy was the underlying cause of death of all patients. Conclusions Cardiac metastasis occurs in <2% of patients with metastatic melanoma, can affect all cardiac structures, and is associated with various cardiovascular complications and high mortality.

show abstract

“…It is admitted that there is intramyocardial invasion with compromise of the right atrium impairing the electrical myocardial conduction system. The maintenance of paroxysmal atrial fibrillation presented in case may be explained by the electrical myocardial alterations due to melanoma [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Heart Dissemination: A Clinical Case of Melanoma

André

Gouveia

et al. 2021

Case Reports in Medicine

View full text Add to dashboard Cite

Introduction. Primitive malignant heart tumours are rare, specific cases. The presence of cardiac metastases, often in the pericardium, besides indicating disseminated oncological disease, represents a diagnostic challenge since they tend to be asymptomatic. Malignant cutaneous melanoma (MCM) is the neoplasm that most often affects the heart. Patients and Methods. The authors describe a case report of a 59-year-old female patient with a history of non-insulin-treated diabetes mellitus, arterial hypertension, dyslipidemia, and remitting cutaneous malignant melanoma who underwent skin excision, lymphadenectomy, and adjuvant chemotherapy in 1996. In April 2014, she resorted to emergency service due to epigastric pain and progressive tiredness. Due to the persistence of the complaints, abdominal ultrasound was performed, which showed a large pericardial effusion, corroborated later by teleradiography and echocardiography. The patient underwent pericardiocentesis, which isolated neoplastic cells. A computed tomography study of the chest, abdomen, and pelvis revealed bilateral and pericardial pleural effusion, as well as alterations suggestive of pericardial and pulmonary metastasis. Later, fine-needle aspiration puncture of the left posterior cervical nodule confirmed histologically malignant melanoma metastasis. Discussion. Given the natural history of melanoma that when metastasized has an overall survival of 15–20% for 5 years, its metastatic spread may occur several years after its surgical excision. Thus, patients with a history of melanoma and heart failure who develop new cardiac symptoms of unknown aetiology should undergo imaging studies such as echocardiography, computed tomography, and magnetic resonance imaging.

show abstract

Metastatic Melanoma Presenting as a Ventricular Arrhythmia

Cited by 4 publications

References 12 publications

Metastatic melanoma to the heart causing ventricular tachycardia: looking beyond the troponin

Metastatic melanoma to the heart causing ventricular tachycardia: looking beyond the troponin

Metastatic melanoma of the heart: Retrospective cohort study and systematic review of prevalence, clinical characteristics, and outcomes

Heart Dissemination: A Clinical Case of Melanoma

Contact Info

Product

Resources

About