Surgical treatment of an endovascular metastatic melanoma of the superior vena cava

A 42-year-old woman, who had undergone excision of a melanoma of her right forearm 3 years before (Breslow's index 4.4 mm), was admitted To hospital f ar the evaluation of an superior vena cava syndrome. The thoracic CT scan a nd the phlebography showed obstruction of the superior vena cava by an endo vascular tumor. Abdominal, pelvis and cranial CT scans did not reveal any o ther metastatic localization. Surgery with extracorporeal circulation was p erformed. The mass was resected and histopathologic examination confirmed t he endovascular metastatic melanoma. There was no heart metastasis. The pat ient was then given a polychemotherapy. She was still alive after 18 months of follow-up after the initial metastasis. To our knowledge, no similar ca se has previously been reported and surgical treatment, as far isolated hea rt metastatic melanoma, may be considered for vascular metastasis, as in ou r case.