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英文誌(2004-)

Journal of Medical Ultrasonics

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1996 - Vol.23

Vol.23 No.01

Case Report(症例報告)

(0029 - 0033)

右心内転移をきたした悪性黒色腫の1例

Malignant Melanoma Metastasizing to the Right Heart: A Case Report

山田 博胤1, 大木 崇1, 井内 新1, 田畑 智継1, 真鍋 和代1, 福田 和代1, 佐々木 美和1, 福田 信夫2, 伊東 進1

Hirotsugu YAMADA1, Takashi OKI1, Arata IUCHI1, Tomotsugu TABATA1, Kazuyo MANABE1, Kazuyo FUKUDA1, Miwa SASAKI1, Nobuo FUKUDA2, Susumu ITO1

1徳島大学第2内科, 2国立善通寺病院

1Second Department of Internal Medicine Tokushima University School of Medicine, 2Zentsuji National Hospital

キーワード : Cardiac metastasis, Malignant melanoma, Transesophageal echocardiography

A 42-year-old woman with systemic dissemination of malignant melanoma that had originated in the left toe was admitted to the hospital with complaints of precordial discomfort and abdominal fullness. Computed tomographic and serial echocardiographic studies suggested a diagnosis of intracardiac metastasis of malignant melanoma. The transthoracic echocardiogram showed a solid mass in the right ventricular cavity, and a huge immobile mass occupied almost the entire right ventricular cavity in the transesophageal echocardiogram. Furthermore, a mobile mass attached to the tricuspid valve appeared in the right atrial cavity at systole, and the mass echo prolapsed into the right ventricular cavity during diastole. Obstruction of the right ventricular inflow tract was also observed by two-dimensional and transthoracic continuous-wave Doppler echocardiography. The patient underwent partial resection of the tumor, which was identified histologically as a malignant melanoma with thrombi. This case indicates that transesophageal echocardiography can provide important information regarding hemodynamic and structural abnormalities of intracardiac metastatic malignant melanoma.