Right atrial metastatic melanoma in a patient with transient ischemic attacks
G Prabhakar1, A Vasilakis, R C Hill
1Department of Surgery, West Virginia University School of Medicine, Morgantown 26506, USA.
Abstract:
A 65-year-old-man was admitted for evaluation of a transient ischemic attack. A 4.5 x 5.3-cm right atrial mass and a patent foramen ovale were identified by echocardiography. A 0.5-cm lesion was identified in the left temporal lobe of the brain by magnetic resonance imaging. Positron emission tomography was used to differentiate a tumor from an infarct in the brain. The cardiac and the brain lesions were successfully resected. Histopathologic study of the atrial and cerebral tissue demonstrated that these were metastases from a previously excised scalp desmoplastic malignant melanoma. The patient remains well at 14 months' follow-up.
Insights
A transient ischemic attack patient had a right atrial mass and brain lesion. Both were metastases from a scalp melanoma, successfully resected, with the patient well at 14 months.
Area of Science:
- Cardiology
- Neurology
- Oncology
Background:
- A 65-year-old male presented with transient ischemic attack symptoms.
- Echocardiography revealed a significant right atrial mass and a patent foramen ovale.
- Magnetic resonance imaging identified a left temporal lobe brain lesion.
Observation:
- Positron emission tomography was utilized to distinguish between tumor and infarct.
- Surgical resection of both the cardiac and cerebral lesions was performed.
- Histopathology confirmed metastatic disease in both locations.
Findings:
- The atrial and cerebral lesions were metastases from a previously excised scalp desmoplastic malignant melanoma.
- The patient experienced a successful resection and recovery.
Implications:
- This case highlights the importance of considering metastatic disease in patients presenting with cardiac and neurological symptoms.
- Early diagnosis and surgical intervention can lead to favorable outcomes even in advanced metastatic melanoma.
- Multidisciplinary collaboration between cardiology, neurology, and oncology is crucial for managing such complex cases.
