PETCT in Melanoma by Michael S. Hofman & Rodney J. Hicks

Author:Michael S. Hofman & Rodney J. Hicks
Language: eng
Format: epub
Publisher: Springer International Publishing, Cham

4.4 Computerised Tomography (CT)

CT is the preferred modality for assessment of melanoma metastases to lungs and abdominal organs. Pulmonary metastases from melanoma are usually multiple and may vary in size from miliary to large (Fig. 4.2) [8] and are a relatively common site of metastasis. Isolated pleural effusion is, however, uncommon [9]. Hepatic metastases are often hypervascular (Fig. 4.3) enhancing in the arterial phase and hypo- or isodense in portal venous phase, a pattern which helps distinguish them from other metastases. Metastases to the spleen, pancreas and kidneys are rare and may be solid or cystic [7] but are otherwise non-specific in appearance. Adrenal metastases may be bilateral, and metastases to the gall bladder may be small flat nodules or polypoid and pedunculate (Fig. 4.4). Metastatic lesions to the small bowel may cause wall thickening or manifest as small nodules, which may be missed without use of oral contrast but may sometimes be detected due to resultant intussusception (Fig. 4.5) or small bowel obstruction. Masses resulting from metastases to ovaries are usually difficult to distinguish from other ovarian masses on CT, and the uncommon occurrence of melanoma metastases to the vagina and uterus may be occult on CT, especially when small.

Fig. 4.2Lung window image of CT chest demonstrating bilateral, multiple, pulmonary metastases from melanoma

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