Cardiac metastases of melanoma as first manifestation of the disease.

Cardiac metastases are rare, but more common than primary cardiac tumours, and metastatic melanoma involves heart or pericardium in greater than 50% of the cases, although cardiac metastasis are rarely diagnosed ante mortem because of the lack of symptoms. A multimodality approach may help to obtain a more timely diagnosis and in some cases a quicker and better diagnosis can enable a surgical resection to prevent cardiac failure or to reduce the tumour before chemotherapy. We present a case of a patient with cardiac metastasis as first evidence of a malignant melanoma: in this case the patient underwent echocardiography, cardiac magnetic resonance and computed tomography. This case underlines the importance of advanced diagnostic techniques, such as cardiac magnetic resonance, not only for the detection of cardiac masses, but also for a better anatomic definition and tissue characterization, to enable a quick and accurate diagnosis which can be followed by appropriate treatment.