Prolonged survival after surgery for cardiac metastasis from malignant melanoma.

Malignant melanoma often involves the heart in patients with advanced tumor disease but isolated cardiac metastasis is rare. We describe successful removal of isolated metastasis in the right ventricular outflow tract of a 64-year-old woman with exertional dyspnea and prior history of melanoma. She remains asymptomatic for 3 years after surgery while median survival is about 3 months after diagnosis without treatment. This report should promote early surgery in order to relieve symptoms and improve survival. <Learning objective: Metastatic melanoma has an ominous prognosis, particularly in case of widespread disease and cardiac localization. When isolated metastasis of the heart is present the optimal treatment remains controversial, either chemotherapy, surgery, or both. As shown in this case, long-term favorable outcomes can be obtained when isolated surgery of obstructive cardiac metastasis is performed, even incomplete.>.