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Case report: Metastatic melanoma masquerading as apical hypertrophic cardiomyopathy

BACKGROUND: Cardiac tumors are usually metastatic. Melanoma is the tumor with the highest rate of cardiac metastasis. Clinicians need to be aware of the metastatic involvement of the left ventricular apex as a differential diagnosis of apical hypertrophic cardiomyopathy. CASE SUMMARY: A 74-year-old...

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Autores principales: Ashraf, Muddasir, Jahangir, Arshad, Jan, M. Fuad, Muthukumar, Lakshmi, Neitzel, Gary, Tajik, A. Jamil
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9780589/
https://www.ncbi.nlm.nih.gov/pubmed/36568563
http://dx.doi.org/10.3389/fcvm.2022.993631
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author Ashraf, Muddasir
Jahangir, Arshad
Jan, M. Fuad
Muthukumar, Lakshmi
Neitzel, Gary
Tajik, A. Jamil
author_facet Ashraf, Muddasir
Jahangir, Arshad
Jan, M. Fuad
Muthukumar, Lakshmi
Neitzel, Gary
Tajik, A. Jamil
author_sort Ashraf, Muddasir
collection PubMed
description BACKGROUND: Cardiac tumors are usually metastatic. Melanoma is the tumor with the highest rate of cardiac metastasis. Clinicians need to be aware of the metastatic involvement of the left ventricular apex as a differential diagnosis of apical hypertrophic cardiomyopathy. CASE SUMMARY: A 74-year-old woman presented for evaluation of fatigue. The initial electrocardiogram and echocardiogram showed features of apical hypertrophic cardiomyopathy. The patient reported a lesion on her right forearm that had been present for many years, leading to its biopsy, which showed melanoma. Further evaluation with a chest-computed tomography (CT) scan showed left lung nodules and nodular thickening of the left ventricular apex. Positron emission tomography showed an increased uptake of fluorodeoxyglucose in the left lung nodule and left ventricular apex, suggestive of metastatic spread of the melanoma. A CT-guided biopsy of the left lung nodule revealed melanoma. The patient was treated with ipilimumab initially, followed by paclitaxel with poor response to treatment, and later passed under hospice care. CONCLUSION: Metastatic tumors involving the left ventricular apex should be considered in the differential diagnosis of apical hypertrophic cardiomyopathy, especially in patients with a history of melanoma, and advanced cardiac imaging, including cardiac magnetic resonance imaging, CT, and/or positron emission tomography (PET) may help with narrowing down the differential diagnosis.
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spelling pubmed-97805892022-12-24 Case report: Metastatic melanoma masquerading as apical hypertrophic cardiomyopathy Ashraf, Muddasir Jahangir, Arshad Jan, M. Fuad Muthukumar, Lakshmi Neitzel, Gary Tajik, A. Jamil Front Cardiovasc Med Cardiovascular Medicine BACKGROUND: Cardiac tumors are usually metastatic. Melanoma is the tumor with the highest rate of cardiac metastasis. Clinicians need to be aware of the metastatic involvement of the left ventricular apex as a differential diagnosis of apical hypertrophic cardiomyopathy. CASE SUMMARY: A 74-year-old woman presented for evaluation of fatigue. The initial electrocardiogram and echocardiogram showed features of apical hypertrophic cardiomyopathy. The patient reported a lesion on her right forearm that had been present for many years, leading to its biopsy, which showed melanoma. Further evaluation with a chest-computed tomography (CT) scan showed left lung nodules and nodular thickening of the left ventricular apex. Positron emission tomography showed an increased uptake of fluorodeoxyglucose in the left lung nodule and left ventricular apex, suggestive of metastatic spread of the melanoma. A CT-guided biopsy of the left lung nodule revealed melanoma. The patient was treated with ipilimumab initially, followed by paclitaxel with poor response to treatment, and later passed under hospice care. CONCLUSION: Metastatic tumors involving the left ventricular apex should be considered in the differential diagnosis of apical hypertrophic cardiomyopathy, especially in patients with a history of melanoma, and advanced cardiac imaging, including cardiac magnetic resonance imaging, CT, and/or positron emission tomography (PET) may help with narrowing down the differential diagnosis. Frontiers Media S.A. 2022-12-09 /pmc/articles/PMC9780589/ /pubmed/36568563 http://dx.doi.org/10.3389/fcvm.2022.993631 Text en Copyright © 2022 Ashraf, Jahangir, Jan, Muthukumar, Neitzel and Tajik. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Cardiovascular Medicine
Ashraf, Muddasir
Jahangir, Arshad
Jan, M. Fuad
Muthukumar, Lakshmi
Neitzel, Gary
Tajik, A. Jamil
Case report: Metastatic melanoma masquerading as apical hypertrophic cardiomyopathy
title Case report: Metastatic melanoma masquerading as apical hypertrophic cardiomyopathy
title_full Case report: Metastatic melanoma masquerading as apical hypertrophic cardiomyopathy
title_fullStr Case report: Metastatic melanoma masquerading as apical hypertrophic cardiomyopathy
title_full_unstemmed Case report: Metastatic melanoma masquerading as apical hypertrophic cardiomyopathy
title_short Case report: Metastatic melanoma masquerading as apical hypertrophic cardiomyopathy
title_sort case report: metastatic melanoma masquerading as apical hypertrophic cardiomyopathy
topic Cardiovascular Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9780589/
https://www.ncbi.nlm.nih.gov/pubmed/36568563
http://dx.doi.org/10.3389/fcvm.2022.993631
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