Intravascular metastatic melanoma: A difficult diagnosis

Ghattas, Samer; Howle, Julie R.; Wang, Wei; Kefford, Richard; Gruenewald, Simon M.

doi:10.1111/ajd.12033

Cited by 7 publications

(6 citation statements)

References 5 publications

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“…Although melanoma is an aggressive form of skin cancer with the propensity for lymphatic spread to lymph nodes and haematogenous spread to distant organs, tumour thrombi are rarely reported. Sites of reported venous involvement by metastatic melanoma include the superior vena cava, the inferior vena cava, and the pulmonary, portal, renal, femoral and great saphenous veins 2‐11 . Similarly to our case, most cases presented a number of years after the initial primary cutaneous melanoma.…”

Section: Discussionsupporting

confidence: 75%

“…Sites of reported venous involvement by metastatic melanoma include the superior vena cava, the inferior vena cava, and the pulmonary, portal, renal, femoral and great saphenous veins. [2][3][4][5][6][7][8][9][10][11] Similarly to our case, most cases presented a number of years after the initial primary cutaneous melanoma. One case presented as an extension into the inferior vena cava from a primary adrenal melanoma.…”

Section: Discussionsupporting

confidence: 68%

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Metastatic melanoma presenting as intravenous tumour thrombus

et al. 2020

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Tumour thrombus is a complication that occurs when a malignancy invades into the vasculature, occluding its lumen. Here, we present a rare case of melanoma tumour thrombus of the great saphenous vein of the left thigh, which was diagnosed on 18 F-fluorodeoxyglucose positron emission tomography/computed tomography and ultrasound-guided biopsy, and responded well to immunotherapy with pembrolizumab.

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Section: Discussionsupporting

confidence: 75%

Section: Discussionsupporting

confidence: 68%

Metastatic melanoma presenting as intravenous tumour thrombus

et al. 2020

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“…Ghattas et al reported a case of melanoma of the left axilla with intravascular metastasis to the lower SVC which was also hypermetabolic on PET/CT, but with no central catheter present [4]. Bland non-catheter-related thrombus often has a lower SUV max compared to tumor thrombus.…”

Section: Discussionmentioning

confidence: 99%

Cardiac Magnetic Resonance for Evaluating Catheter Related FDG Avidity

Jeong

Gage

Berman

et al. 2016

Case Reports in Radiology

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A 53-year-old female with a history of metastatic left arm melanoma presented for F(18) fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) which showed a moderately FDG avid focus at her port catheter tip near the cavoatrial junction. Although catheter tip related FDG avidity has previously been suggested to be bland thrombus or infection, melanoma can metastasize to unusual locations including the superior vena cava. In addition, the patient had an elevated risk of anticoagulation due to a history of hemorrhagic brain metastases. Therefore, confirmatory cardiac magnetic resonance (CMR) was obtained and findings were consistent with bland catheter-related thrombus.

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“…Furthermore, intraluminal metastasis to the SVC from DASCs has not been reported previously. To date, only a limited number of cases of malignant neoplasms of the skin ( 12 , 13 ), prostate ( 14 ), lung ( 15 ), thyroid ( 16 ), thymus ( 17 ) and colon ( 18 ) with intraluminal metastases to the SVC have been reported ( Table I ). We hypothesize that metastases to the large vessels are extremely rare due to the high volume and speed of blood flow, and the thick sub-endothelial layer, which prevent invasion by tumor cells.…”

Section: Discussionmentioning

confidence: 99%

Intraluminal superior vena cava metastasis from adenosquamous carcinoma of the duodenum: A case report

et al. 2015

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In 2013, a 76-year-old male with a cardiac pacemaker was diagnosed with adenosquamous carcinoma of the duodenum. Subsequently, a pancreatoduodenectomy and lymph node dissection were performed, and 12 cycles of adjuvant chemotherapy (modified FOLFOX6 regimen), which consisted of fluorouracil, leucovorin and oxaliplatin, were administered via a central venous catheter. At 5 months after the completion of adjuvant chemotherapy, the patient experienced the sudden onset of severe pain at the back right of the ear, edema of the right side of the face and right jugular vein dilatation. Computed tomography (CT) revealed filling defects in the superior vena cava (SVC) and right brachiocephalic vein, indicating catheter-induced venous thrombosis. Although the catheter was removed and anti-coagulation therapy, aspiration of the thrombosis and ballooning dilatation were performed immediately, the patient's symptoms were not ameliorated. Notably, histological examination following thrombus aspiration revealed metastatic cancer cells, and fluorodeoxyglucose-positron emission tomography/CT identified metabolically active nodules in the SVC at locations consistent with the initial duodenal tumors detected by CT and in the first thoracic vertebrae. The tumor thrombus rapidly increased in size and resulted in worsening dyspnea. Subsequently, radiotherapy was performed, followed by chemotherapy, which relieved the systemic symptoms and suppressed the tumor growth. Adenosquamous carcinoma of the duodenum is extremely rare, and to the best of our knowledge, intraluminal SVC metastasis as a result of adenosquamous carcinoma of the duodenum has not been reported previously. The placement of a cardiac pacemaker, central venous catheter and tumor cells possessing high metastatic potential are hypothesized to have contributed to this rare case of metastasis.

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Intravascular metastatic melanoma: A difficult diagnosis

Cited by 7 publications

References 5 publications

Metastatic melanoma presenting as intravenous tumour thrombus

Metastatic melanoma presenting as intravenous tumour thrombus

Cardiac Magnetic Resonance for Evaluating Catheter Related FDG Avidity

Intraluminal superior vena cava metastasis from adenosquamous carcinoma of the duodenum: A case report

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