Synchronous tonsil, gallbladder, and cardiac metastases without any other visceral metastases of malignant melanoma

Onkologie. 2009 Apr;32(4):197-9. doi: 10.1159/000201126. Epub 2009 Mar 6.


Background: Malignant melanoma is a highly unpredictable tumor that has capacity to metastasize to any organ. A better understanding is needed of the clinicopathologic features of metastatic melanoma and, in particular, of its rare manifestations.

Case report: A 33-year-old woman with a past medical history of malignant melanoma presented with symptoms of throat discomfort and bleeding. On physical examination, a dark pigmented lesion was observed on the right tonsil. Tonsillectomy was performed, and melanoma was diagnosed. Computed tomography of the thorax and abdomen revealed a filling defect in the right atrium and a 4-cm gallbladder mass. Echocardiography revealed a right atrial mass. No further metastasis was detected by whole body (18)F-fluorodeoxyglucose positron emission tomography. Each metastasis was completely resected with clear margins. The pathologic diagnosis of the resected masses was malignant melanoma. 3 weeks after the final surgery, temozolomide was started. The patient has been followed up for 9 months after diagnosis of the first recurrence, and no new metastases have been detected.

Conclusion: We report a case with synchronous tonsil, gallbladder, and heart metastases without any other common sites of metastasis of melanoma. The patient was successfully treated with aggressive surgery followed by temozolomide.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Female
  • Gallbladder Neoplasms / diagnosis
  • Gallbladder Neoplasms / secondary*
  • Heart Neoplasms / diagnosis
  • Heart Neoplasms / secondary*
  • Humans
  • Melanoma / diagnosis
  • Melanoma / secondary*
  • Neoplasms, Unknown Primary / diagnosis*
  • Tonsillar Neoplasms / diagnosis
  • Tonsillar Neoplasms / secondary*
  • Viscera