Cardiac melanoma – a rare echocardiographic finding in emergency room settings

Abstract Melanoma is a rare and aggressive type of cancer that can metastasize to any organ of the body, including the heart. The most common symptoms are shortness of breath (36.4%) and tachycardia (24.2%). Given that these are the most common cardiovascular and pulmonary disease symptoms, cardiac metastases are mostly diagnosed on autopsy. We report a case of a 67-year-old female who was previously diagnosed with BRAF-mutated skin melanoma pT3aN0M0 of the chest which was surgically excised and received treatment with targeted therapy. The chest X-ray showed bilateral opacification of the lung field consistent with pulmonary edema. During echocardiography a mass was revealed in the left ventricle. The treatment strategy in cardiac metastases is usually based on histology. In case of melanoma targeted therapy and immunotherapy are indicated, while surgical resection is reserved for selected cases, usually to palliate symptoms of heart failure and outflow tract obstruction.