Vnitr Lek 2013, 59(5):407-411

Acute coronary syndrome imitated by malignant melanoma or real acute coronary syndrome?

L. Gužiková^1,*, N. Hučková¹, M. Čaprnda¹, M. Bendžala¹, P. Babál², H. Mrázová²

¹ II. interná klinika Lekárskej fakulty UK a UN Bratislava, Slovenská republika, prednosta doc. MUDr. Ľudovít Gašpar, CSc.

² Ústav patologickej anatómie Lekárskej fakulty UK a UN Bratislava, Slovenská republika, prednosta prof. MUDr. Ľudovít Danihel, PhD.

The article describes the case of 67-year-old woman, hospitalized at our department due to history of syncopes. At the time of admission the patient complained of back pain in the area of exophytic growing tumour. During the diagnostic process routine laboratory tests revealed severe normocytic hypochromic anemia, hypoproteinemia, elevation of inflammatory parameters (leukocytes, C-reactive protein) and imaging methods (ultrasonography, computer-aided tomography) helped to formulate suspicion of disseminated cancerous disease (metastases in spleen, skeleton and lymph nodes). Patient was subsequently operated at the surgical ward, where she had removed the tumour on the back. After the surgery patient's condition was complicated by chest pain accompanied by changes on electrocardiogram and dynamics in cardiospecific markers. We evaluated patient's condition as developing acute coronary syndrome. The patient received conservative treatment of acute coronary syndrome, but despite the provided care she died. However, the autopsy revealed another immediate cause of death - metastases of malignant melanoma of back.

Keywords: back pain; malignant melanoma; acute coronary syndrome

Received: November 14, 2012; Accepted: March 12, 2013; Published: May 1, 2013  Show citation