Asymptomatic Malignant Melanoma Presenting as a Cardiac Mass

Following a health fair screening echocardiogram and notification of a concerning finding, a repeat echocardiogram identified a large right atrial mass crossing the tricuspid valve into the right ventricle in an asymptomatic patient. Subsequent MRIs confirmed the cardiac mass and identified multiple liver masses. Four weeks later, the patient returned with exertional dyspnea and lower extremity edema. Coronary arteriography showed a right atrial mass perfused by right coronary arterial branches with a tumor blush. The tumor was surgically excised with pathological confirmation of a malignant melanoma. At 4 months, the patient was asymptomatic and stable after commencement on chemotherapy.