E-page Original Images: Pulmonary stenosis due to metastatic malignant melanoma

A 60-year-old male with a history of resected malignant melanoma of neck region and three courses of chemotherapy was presented with exertional dyspnea and near syncope. On cardiovascular examination his heart rate was 90/min and the blood pressure was 90/60 mmHg. Cardiac auscultation revealed a grade 2/6 systolic ejection murmur along the left sternal border. Two-dimensional (2-D) echocardiography showed a 7x3 cm mobile mass in the right ventricle extending into right ventricular outflow tract (Video 1. See video/movie images at www. anakarder.com). Right ventricle was dilated and the mass was found in a narrow pulmonary outflow tract (Fig. 1).