JACC Case Rep. 2025 Dec 11:106306. doi: 10.1016/j.jaccas.2025.106306. Online ahead of print.
ABSTRACT
BACKGROUND: Merkel cell carcinoma (MCC) is an aggressive neuroendocrine malignancy with high metastatic potential. Cardiac involvement is rare and usually occurs late in the disease course.
FIRST-IN-HUMAN/EARLY REPORTS SUMMARY: A 76-year-old man with recurrent MCC was found to have a large epicardial mass encasing the right coronary artery. Surgical and external percutaneous biopsy approaches were considered high risk.
DISCUSSION: A transcatheter biopsy was performed using multimodality imaging. Intracardiac echocardiography enabled real-time visualization, while transesophageal echocardiography provided higher resolution to confirm accurate forceps positioning. Diagnostic tissue was successfully obtained, confirming recurrent MCC and informing subsequent oncologic therapy.
NOVELTY: This appears to be the first description of transcatheter biopsy of an epicardial mass guided by both intracardiac and transesophageal echocardiography.
TAKE-HOME MESSAGES: Multimodality imaging can facilitate safe biopsy of select cardiac masses. Tissue confirmation remains important when management decisions depend on histology.
PMID:41379044 | DOI:10.1016/j.jaccas.2025.106306