Role of Imaging Methods in Metastatic Melanoma

Abstract

Melanoma is a malignant neoplasm of the skin deriving from melanocytes. Accounting for less than 5% of all skin cancers, melanoma is associated with approximately 75% of skin cancer-related mortality. Early detection of melanoma with surgical resection remains one of the critical factors determining favorable clinical outcomes for melanoma. Up to now, many imaging methods, such as ultrasound, computed tomography (CT), magnetic resonance imaging, and positron emission tomography/CT, have been used in the diagnosis of melanoma and metastases. This article reviews the application of imaging methods in metastatic melanoma.

Positron emission tomography/ultrasound fusion technique in patients with malignant melanoma

“…Local recurrence or single metastases are subjected to surgical resection, thus reducing tumour load and prolonging overall survival . FDG‐PET/CT is useful to detect tumour dissemination as it was described to be more accurate than CT on its own . However, findings can be unclear: on one hand, CT may provide false‐negative results because of its limitations in depicting muscle lesions and lymph node pathologies; on the other hand, PET often shows non‐specific, non‐malignant increased glucose metabolism due to muscle tonicity and lymphadenitis.…”

“…Multimodal imaging is a valuable tool in follow‐up diagnosis of malignant melanoma (MM). 18 F‐fluorodeoxyglucose positron emission tomography (FDG‐PET)/CT is commonly used to assess tumour recurrence in high‐risk patients, with its diagnostic accuracy considered superior to CT on its own . However, because of its limited soft‐tissue contrast, CT is not the best option to depict muscles and lymph nodes, considering other imaging methods with better performance are available.…”

What is your diagnosis?

“…Vulvar melanoma is a rare variant with a poor prognosis. It should be staged surgically using the American Joint Committee on Cancer (AJCC) staging system, which incorporates the Clark and Breslow scores (4). Desmoplastic melanoma is a rare entity that is more difficult to recognize insofar as the cytomorphology and the immunohistochemical features are non-specific.…”