Management of cardiac metastases of melanoma in the era of immunotherapy: a case series

Cardiac metastasis from melanoma is a rare but clinically significant condition often underdiagnosed because of its asymptomatic nature. This retrospective case series examines six patients with metastatic melanoma treated at the University Hospital of Bordeaux who were incidentally found to have cardiac metastases during follow-up. The patients were treated with immune checkpoint inhibitors (ICIs) either alone or combined with surgical excision of cardiac lesions. Outcomes were mixed, with three (50%) patients achieving a complete response, one (16.7%) a partial response, and two (33.3%) experiencing disease progression. Cardiac metastasectomy, when combined with ICI, showed promising results in selected patients, highlighting a potential survival benefit and enhanced tumor control with a multimodal approach. This series emphasizes the importance of considering cardiac metastases in differential diagnosis and underscores the role of imaging in early detection. While ICI therapy shows effectiveness, further studies are needed to refine treatment strategies and improve outcomes for patients with cardiac involvement.