Vaginal mucosal melanoma recurrence with intracardiac metastasis treated with immunotherapy

• In depth review of treatment regime and disease control. • Multidisciplinary specialist input. • Clear description of factors influencing care and outcomes. Vaginal mucosal melanoma (VMM) is highly malignant tumour with limited cases reported worldwide. There are no guidelines in place to inform best therapy; instead, management is guided by previous studies and outcomes. There have been no reported cases of vaginal mucosal melanoma metastasizing to the heart. This case follows 54-year-old, otherwise well woman with VMM metastasizing to the heart. It outlines diagnosis, multi-specialty input, chosen treatments and progress of recovery and successful disease control. Primary surgical resection and adjuvant immunotherapy were best indicated and depicted best survival outcomes for this case. Multidisciplinary expert care is essential in clinical decision making. Immunotherapy significant improved survival, and side effects were able to be managed with good response.