PACING
Cardiac metastasis of malignant melanoma: a rare cause of complete atrioventricular block
Department of Cardiology, Faculty of Medicine, Ankara University, Sihhiye, Ankara 06002, Turkey
Malignant melanoma has an aggressive biological behaviour and a high rate of cardiac involvement. As shown from post-mortem studies, metastases of melanoma can involve any organ and cardiac metastases are frequent. This report describes a case of widespread malignant melanoma in a patient with clinical presentation of complete atrioventricular (AV) block. Thorax CT and transthoracic echocardiography revealed a mass involving the conduction system. By VDD permanent pacing (atrial synchronous ventricular pacing), haemodynamic stability was maintained and the patient remains under follow-up receiving chemo-immunotherapy. In the retrospective analysis of the patient's records, we realized that the AV conduction delay had been progressing for at least 7 months. Cardiac metastasis of malignant melanoma is a common finding and can proceed in the absence of overt clinical manifestations. Therefore, the clinician should be alert to the development of cardiac signs and symptoms in a metastatic melanoma patient and should perform a detailed cardiac examination to exclude cardiac metastasis of the tumour.
Key Words: Malignant melanoma, Cardiac metastasis, Complete AV block
* Corresponding author. Tel: +90 312 3103333 2523; fax: +90 312 3098582. E-mail address: nilozyuncu{at}yahoo.com