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Chest, Vol 84, 195-198, Copyright © 1983 by American College of Chest Physicians

ARTICLES

Intracavitary cardiac melanoma diagnosed by endomyocardial left ventricular biopsy

PC Hanley, C Shub, JB Seward and LE Wold

A patient was evaluated for a persistent pericardial effusion and on two-dimensional echocardiography was found to have an intracavitary left ventricular mass. Twenty-two years earlier, a melanoma of the ethmoid sinus had been excised. An electrocardiogram revealed impressive T-wave abnormalities and pathologic Q waves, initially suggestive of "myocardial infarction." However, the coronary arteries were normal at angiography. At catheterization, the left ventricular mass was biopsied, using a transvenous catheter-directed technique, and proved to be a metastatic melanoma. This procedure obviated the need for diagnostic thoracotomy. We believe that this is a unique application of the use of catheter-directed biopsy to make a histologic diagnosis of a left ventricular neoplasm.


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