SIMULTANEOUS ENUCLEATION OF A PULMONARY L ATE METASTASIS AND MYOCARDIAL REVASCULARIZATION

Background: The incidence of late, recurrence of malignant melanoma, i s a well known, but very rare clinical experience. Case Report: We rep ort a case of simultaneous myocardial revascularisation and resection of pulmonary melanoma metastasis. In 1963 an enucleation of the right eye was necessary due to an ocular melanoma. In 1993 the patient suffe red acute left heart failure and a 3-vessel disease with severe reduce d left ventricular function was diagnosed. Chest X-ray examination rev ealed a singular pulmonary lesion in the right lower lobe with a diame ter of 5.5 cm. Myocardial revascularisation and resection of the pulmo nary focus was performed simultaneously without complication. The hist ological examination documented a pulmonary late recurrence of maligna nt melanoma. Up to this time (3 years later) the patient is free of ca rdiac symptoms and there is no evidence of further late recurrence of malignant melanoma. Conclusion: The appreciable number of patients who , after a disease-free interval of 10 to 20 years, develop a late recu rrence of a malignant melanoma, is in particular - as in the present c ase - a choroidal melanoma, is powerful evidence for a need to keep th ese patients unter lifelong surveillance.