CASE REPORT article

Front. Cardiovasc. Med.

Sec. Cardio-Oncology

Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1588106

This article is part of the Research TopicTargets in Cardio-Oncology: Drug Effects and Mechanisms of ActionView all 18 articles

Case of cardiac metastases from melanoma, treated by stereotactic radiotherapy, using a MICRA implant

Provisionally accepted
Mehdi BelbachirMehdi Belbachir1Nicolas DanthezNicolas Danthez1David C. RotzingerDavid C. Rotzinger2Antiochos PanagiotisAntiochos Panagiotis2Etienne PruvotEtienne Pruvot3Veronique ValletVeronique Vallet4Maude GondreMaude Gondre4Grégoire BerthodGrégoire Berthod5Sofiya LatifyanSofiya Latifyan6Rita DemicheliRita Demicheli6Luis SchiappacasseLuis Schiappacasse1,7*
  • 1Department of Radiation Oncology, Lausanne University Hospital (CHUV), Lausanne, Geneva, Switzerland
  • 2Department of Diagnostic and Interventional Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
  • 3Department of Cardiology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
  • 4Institute of Radiophysics, Lausanne University Hospital (CHUV), Lausanne, Switzerland
  • 5Department of Oncology, Valais Hospital, Sion, Switzerland
  • 6Department of Oncology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
  • 7Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland

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Metastatic melanomas with prolonged survival are becoming increasingly common. We present the case of a 47-year-old man with melanoma who developed asymptomatic cardiac metastases, whose prognosis depended on their response to either systemic or focal treatment. Consequently, a CyberKnife radiotherapy treatment was performed using a pacemaker for tracking. Instead of using a pacemaker lead, we report here the successful use of a leadless pacemaker (Micra, Medtronic) as a fiducial reference for the tracking, which proved to be reproducible during all sessions. The planning target treatment volume was 161.58 cm³. The radiotherapy treatment was well tolerated, and followup cardiac CT scans performed at 1 month and 4 months after the treatment showed an approximately 30% reduction in the lesions size. The size reduction was attributed to the focal radiotherapy treatment, as the other metastatic lesions were progressively worsening during the same period. This case report highlights the feasibility of using a leadless pacemaker as a tracking fiducial for the CyberKnife treatment of high-volume cardiac metastatic lesions.

Keywords: SBRT, Cardiac metastasis, Melanoma, case report1, radiotherapy2, cyberknife3, keyword4, keyword5. (Min

Received: 05 Mar 2025; Accepted: 28 Apr 2025.

Copyright: © 2025 Belbachir, Danthez, Rotzinger, Panagiotis, Pruvot, Vallet, Gondre, Berthod, Latifyan, Demicheli and Schiappacasse. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Luis Schiappacasse, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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