Uveal melanoma metastasising to the heart after 39 years

Ocular melanoma most often arises in the uvea and has several distinguishing characteristics from cutaneous melanoma including: dominant liver metastases, poor response to systemic therapy and late metastasis.1 We present a case of ocular melanoma, presenting after 39 years with liver and cardiac metastases (CM) to the right atrium and left ventricle. This is the longest time to CM from ocular or cutaneous melanoma that we could find in the English literature. ### Case A 68-year-old male presented with progressive shortness of breath over months. He had a history of ocular melanoma diagnosed 39 years prior and treated with enucleation of his left eye. Medical records were not available, but the patient recalled the lesion was a spindle B tumour. The patient had no known cardiac disease. A short systolic ejection murmur …