Diagnosis of right atrial metastatic melanoma by transesophageal echocardiographic-guided transvenous biopsy

• Published in: Mayo Clinic proceedings Vol. 71; no. 12; p. 1167
• Main Authors: Malouf, J F, Thompson, R C, Maples, W J, Wolfe, J T
• Format: Journal Article
• Language: English
• Published: England 01-12-1996
• Subjects: Aged; Biopsy - methods; Echocardiography, Transesophageal; Heart Atria - diagnostic imaging; Heart Neoplasms - diagnosis; Heart Neoplasms - diagnostic imaging; Heart Neoplasms - secondary; Humans; Male; Melanoma - diagnosis; Melanoma - diagnostic imaging; Melanoma - secondary
• ISSN: 0025-6196
• DOI: 10.4065/71.12.1167

Traditionally, tissue diagnosis of malignant melanoma metastatic to the heart necessitated thoracotomy or was done at autopsy. More recently, right or left ventricular endomyocardial biopsy under fluoroscopic guidance has been used to confirm metastatic involvement of the heart by various neoplasms including malignant melanoma; results have been excellent, and morbidity has been low. High-quality images of intracardiac masses with excellent anatomic details can be obtained by transesophageal echocardiography. Herein we describe a 73-year-old man with a history of malignant melanoma in whom cardiac metastatic involvement was documented by percutaneous transesophageal echocardiographic-guided transvenous biopsy of a right atrial mass; thus, the need for a more invasive approach to tissue documentation was avoided.