Cardiac and acoustic metastases in relapsing melanoma

Herein we report the case of a 45-year-old woman with known history of malignant melanoma, complaining recent onset of bilateral hearing problems initially addressed to acoustic neuroma. Dedicated (18)F-FDG PET/CT and MR imaging documented the presence of 3 areas of pathologic uptake in the V-VII-VIII cranial nerves, other 2 in the neck and in the medullary sheath, and another unexpected lesion in the interventricular septum. All lesions showed intense (18)F-FDG uptake, high precontrast T1-weighted signal, contrast enhancement in T1-weighted sequences with gadolinium, and hypervascularization/high signal in T2-weighted images: these features were considered in keeping with diffused malignant melanoma metastatization.