Solitary Pulmonary Metastasis of Choroidal Malignant Melanoma:

Harada, Suzuka; Kuwahara, Takeichiro; Kido, Masayoshi; Kajiki, Akira; Ishikura, Y; Koide, Osamu

doi:10.1055/s-2007-1021558

Cited by 5 publications

(3 citation statements)

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“…We conclude that the yield of a chest X‐ray, widely used as the primary imaging test in North America, is very low once abdominal imaging is part of the screening program. We have consequently abandoned chest X‐ray as a follow‐up examination despite rare cases of solitary pulmonary metastases from uveal melanoma 31–33…”

Section: Discussionmentioning

confidence: 99%

Screening for metastatic malignant melanoma of the uvea revisited

Eskelin

Pyrhönen

Summanen

et al. 1999

Cancer

141

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BACKGROUND The purpose of the current study was to assess the value of routine imaging and liver function tests in detecting metastases from malignant melanoma of the uvea. METHODS Forty‐six consecutive patients diagnosed with metastatic uveal melanoma between 1985 and 1996 who had participated in a screening program that included annual liver function tests (LFT), chest X‐ray, and abdominal ultrasonography (US) were eligible for this retrospective cohort study. Main outcome measures were the sensitivity of screening tests, presence of symptoms, recurrence free interval, and metastatic burden. RESULTS Metastases were diagnosed in 74% of patients (95% confidence interval [95% CI], 59–86) at screening and in 26% (95% CI, 14–41) when the patient consulted a physician because of symptoms that developed before the next scheduled visit. Of all the patients, 59% (95% CI, 43–73) were asymptomatic, and 80% (95% CI, 66–91) had only hepatic metastases. The median recurrence free interval, greatest dimension of the largest metastasis, and metastatic burden of the two groups did not differ. US was diagnostic in 78% (95% CI, 64–89), at least 1 LFT test was abnormal in 70% of patients (95% CI, 54–82), and a chest X‐ray was abnormal in 2% of patients (95% CI, 0–12). LFTs and US did not reveal hepatic metastases in 33% and 4% of patients, respectively. The sensitivity of individual LFTs ranged from 0.27 to 0.67, and their specificity from 0.90 to 0.96, with lactate dehydrogenase being the most sensitive LFT used. CONCLUSIONS The authors believe that annual screening with LFTs and abdominal US will identify 59% of patients while they are still asymptomatic and that semiannual screening will detect >95% of such patients. Chest X‐ray has a very low yield and is recommended only at baseline to exclude metastatic disease to the eye and if pulmonary symptoms develop. Cancer 1999;85:1151–9. © 1999 American Cancer Society.

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Section: Discussionmentioning

confidence: 99%

Screening for metastatic malignant melanoma of the uvea revisited

Eskelin

Pyrhönen

Summanen

et al. 1999

Cancer

141

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“…These figures compare favorably with programs that used liver imaging only if symptoms, abnormal physical examination, or LFTs indicated them. In the largest and most recent such series, 9 of 145 patients, 30% (95% CI, 23-39) were asymptomatic, metastases involved only the liver in 56% (95% CI, 47-67), and the frequency of a positive chest X-ray was 24% (95% CI, [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32]. The frequency of pulmonary metastases in earlier, smaller series likewise ranged from 17% to 28%.…”

Section: Discussionmentioning

confidence: 99%

“…We have consequently abandoned chest X-ray as a follow-up examination despite rare cases of solitary pulmonary metastases from uveal melanoma. [31][32][33] We still consider chest X-ray mandatory in the initial work-up of patients with uveal melanoma to exclude the possibility that the uveal tumor is a metastasis, considering the fact that, due to advances in nonsurgical management of primary uveal melano-mas, they usually are diagnosed clinically and that both lung carcinoma and pulmonary metastases are common in patients with metastatic carcinoma of the eye. 34 It is also useful in examining patients who develop pulmonary symptoms and as a staging examination once metastases have been detected elsewhere.…”

Section: Discussionmentioning

confidence: 99%

Screening for metastatic malignant melanoma of the uvea revisited

Eskelin

Pyrhönen

Summanen

et al. 1999

Cancer

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Clinical, Pathologic, and Imaging Features and Biological Markers of Uveal Melanoma

Rashid¹,

Grossniklaus²

2013

Methods in Molecular Biology

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Uveal melanoma has unique clinical and pathologic features including virtually exclusive metastasis to the liver in high-risk cases. In this chapter, the clinical findings in uveal melanoma and diagnostic methods including imaging tests and serum markers are described. Additionally, the histopathologic features including the modified Callender classification and immunohistochemical findings of uveal melanoma are described.

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Solitary Pulmonary Metastasis of Choroidal Malignant Melanoma:

Cited by 5 publications

References 0 publications

Screening for metastatic malignant melanoma of the uvea revisited

Screening for metastatic malignant melanoma of the uvea revisited

Screening for metastatic malignant melanoma of the uvea revisited

Clinical, Pathologic, and Imaging Features and Biological Markers of Uveal Melanoma

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