Surgical Treatment of an Endovascular Metastatic Melanoma of The Superior Vena cava

Abstract

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 for the evaluation of an superior vena cava syndrome. The thoracic CT scan and the phlebography showed obstruction of the superior vena cava by an endovascular tumor. Abdominal, pelvis and cranial CT scans did not reveal any other metastatic localization. Surgery with extracorporeal circulation was performed. The mass was resected and histopathologic examination confirmed the endovascular metastatic melanoma. There was no heart metastasis. The patient was then given a polychemotherapy. She was still alive after 18 months of follow-up after the initial metastasis. To our knowledge, no similar case has previously been reported and surgical treatment, as for isolated heart metastatic melanoma, may be considered for vascular metastasis, as in our case.

Superior vena cava syndrome: endovascular management

“…Furthermore, recurrence rates after conservative treatment vary from 10 to 50% 2021 Surgical reconstruction with grafts was reserved for cases of failure with conservative treatment 22…”

Intravascular metastatic melanoma of the vena saphena magna

“…Venous metastases of melanoma are very uncommon. One case of metastatic melanoma of the superior vena cava 1 and a few cases of involvement of the cavernous sinus in primary choroid melanoma 2 have been reported. Three cases of angiotropic melanoma have been described 3,4 .…”

Melatonin-Associated Facial Swelling in an Oncology Patient: Case Report and Review of Swelling of the Face in Individuals With Head and Neck Cancer

“…Superior vena cava syndrome presents clinically with facial edema, shortness of breath, and headache [ 2 ]. While intrathoracic tumors are the most common causes of superior vena cava syndrome, metastatic melanoma has been shown to obstruct the superior vena cava and produce these symptoms [ 2 - 4 ].…”