Ozyuncu Nil, Sahin Menekse, Altin Timucin, Karaoguz Remzi, Guldal Muharrem, Akyurek Omer
Department of Cardiology, Faculty of Medicine, Ankara University, Sihhiye, Ankara 06002, Turkey.
Europace. 2006 Jul;8(7):545-8. doi: 10.1093/europace/eul058.
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.
恶性黑色素瘤具有侵袭性生物学行为，心脏受累率高。尸检研究表明，黑色素瘤转移可累及任何器官，心脏转移很常见。本报告描述了一例广泛恶性黑色素瘤患者，临床表现为完全性房室传导阻滞。胸部CT和经胸超声心动图显示一个累及传导系统的肿块。通过VDD永久起搏（心房同步心室起搏），维持了血流动力学稳定，患者仍在接受化学免疫治疗并处于随访中。在对患者记录的回顾性分析中，我们发现房室传导延迟至少已经进展了7个月。恶性黑色素瘤的心脏转移是常见发现，可在无明显临床表现的情况下发生。因此，临床医生应警惕转移性黑色素瘤患者心脏体征和症状的出现，并应进行详细的心脏检查以排除肿瘤的心脏转移。
