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Query: UMLS:C0025202 (melanoma)
 69,561 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The records of 3,795 cases of malignant melanoma treated at the INT (Milan) from 1975 to 1992 were reviewed. Histologic confirmation was obtained in all cases. Thirty-one patients (0.82%) with solitary or multiple skeletal metastases were identified. The review of conventional films, tomograms, CT, MR and bone scintigraphy images enabled us to detect 120 single bone lesions. The X-ray features were divided into two groups according to typical and atypical skeletal lesions. Typical bone metastases are osteolytic (87.5%), with medullary origin (91.6%), and they cannot be distinguished from other osteolytic metastases on the basis of imaging criteria alone. Lesion growth causes cortical erosion and destruction (46.6%), pathologic fractures (22.5%) and soft tissue involvement (12.5%). Lytic areas usually have ill-defined margins. Clear-cut outline is an uncommon finding. Atypical skeletal metastases exhibit a mixed osteolytic-osteoblastic pattern (10%), which is hardly ever completely osteoblastic (2.5%). Other unusual metastatic patterns include intense trabecular rarefaction with no detectable single lesion (3.3%), the presence of a well-defined sclerotic rim and periosteal reaction (12.5%). Atypical growth may cause extensive cortical destruction and periosteal production resembling osteogenic osteosarcoma. The various imaging methods show that conventional radiology has relatively poor sensitivity because of anatomical reasons, while MRI is the most sensitive method to detect skeletal localizations. Treatment changes the radiologic patterns of the lesions: recalcification, sclerotic rim, periosteal reaction are common response patterns. Finally, in spite of the above limitations, conventional radiology remains the method of choice to assess lesion evolution during the follow-up.
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PMID:[The radiodiagnosis of bone metastases from melanoma]. 804 25

A complete ocular examination is essential for the correct diagnosis of a malignant melanoma of the choroid. The single, most important technique is indirect ophthalmoscopy associated with biomicroscopy of the fundus. Fluorescein angiography may provide additional arguments for malignancy, but with this method it is not always possible to differentiate a malignant melanoma from a suspected naevus or even a choroidal metastasis. Fluorescein angiography provides however a detailed and objective document which allows a better follow-up of suspected lesions. As with infrared angiography, choroidal vessels are more readily seen, this technique may prove to be of diagnostic importance. A- and B-scan ultrasonography are essential to precisely measure a choroidal lesion. Especially A-scan may also allow tissue differentiation. Diaphanoscopy is especially useful in the diagnosis of choroidal haemangioma. Even naevi may provide relative or absolute scotomas. The diagnostic importance of perimetry is therefore very limited. CT-scan and especially MRI are helpful in detecting extra-ocular extension. In case of atypical naevi, a close observation for potential growth is advised. Malignant melanomas of the choroid have to be differentiated from other fundus tumours, but also from inflammatory and degenerative conditions.
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PMID:Diagnosis and differential diagnosis of malignant melanomas of the choroid. 804 33

Cerebral metastases of malignant melanoma usually have a characteristic appearance on CT and MRI. They present as multiple small lesions at the junction of grey and white matter. On CT the lesions are slightly hyperdense with moderate contrast enhancement. On MRI, typical T1 and T2 shortening is seen. In our case these findings were due to abundant presence of melanin without associated hemorrhage.
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PMID:Cerebral metastatic malignant melanoma: CT and MR findings with pathological correlation. 811 73

Malignant melanomas of the choroid are the most frequent symptomatic eye tumours in adults. They often have a pathognomonic appearance, being collar-button or mushroom shaped due to rupture of Bruch's membrane by the tumoral mass. The ultrasonographic image of collar-button melanoma is well known: the head of the tumour is hyperechogenic and its base hypoechogenic. According to some authors, this is caused by difference in blood supply between the two parts. At MRI strongly pigmented melanomas emit a high-intensity signal on T1-weighted sequences and a low-intensity signal on T2-weighted sequences, but these characteristic features are inconstant. We present a case of collar-button melanoma explored by ultrasonography, colour Doppler Flow Imaging (CDFI) ultrasound and MRI, then enucleated. Flows and signals were different in front of, or behind the rupture of Bruch's membrane: ultrasounds showed a hyperechogenic image at the head and a hypoechogenic image at the base; on T2-weighted MRI sections intensity was greater in the head than in the base (head: 69 ms, base 180 ms) on CDFI, no flow was detectable in the head and very high flows were seen in the base of the tumour. Comparisons of these images with pathological findings, where there was no difference between head and base in melanin concentration and in cellular type (mixed or mainly epithelioid), led us to believe that the differences observed in images were essentially due to differences in blood supply between the two parts of the tumour constricted by the sides of the ruptured Bruch's membrane.
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PMID:[Collar-button choroidal melanoma. Anatomo-radiologic correlations]. 816 14

A retrospective comparison was made between 99mTc-MDP bone scans and corresponding spine MR images in 35 patients who had complementary studies within 2 mo. Bone scans were performed with planar imaging of the entire body and MRI was performed with a 1.5 tesla signal scanner using standard techniques with T1- and T2-weighted images. There were 18 male and 17 female patients diagnosed with cancer prior to these studies. Cancer diagnoses included 14 prostate, 12 breast, 1 bladder, 2 renal, 2 lung, 1 each of esophagus, melanoma, myeloma and adenocarcinoma of unknown primary cancer. Of the regions compared, 69 were positive for bony metastases by MRI and 63 regions by bone scans. Thirty-eight regions were concordantly positive and 56 regions concordantly negative. No patients with entirely positive bone scans were negative by MRI, but one patient was entirely positive by MRI but negative by a bone scan. At least one region was discordantly read in 21 patients. Distribution of positive regions was similar on bone scan and MRI. The greatest number and proportion of discordant readings occurred in the lumbar regions and more frequently in patients with prostate cancer. Considering its widespread availability and the ease of performing a whole-body survey for metastasis, radionuclide bone scanning remains the study of choice for initial evaluation of patients with cancer. However, MRI is an excellent complementary technique when bone scan findings are inadequate for answering clinical questions. MRI appears to be quite sensitive and probably more specific for metastasis in certain locations of the spine.
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PMID:Comparison of radionuclide bone scans and magnetic resonance imaging in detecting spinal metastases. 825 11

Twenty-six cases of various brain metastases were treated with Gamma-knife. Their primary sites were: lung in 13, colon in 5, breast in 2, kidney in 2, liver in 1, ovary in 1, and a malignant melanoma. The origin of one case was not verified. There were 11 single and 15 multiple metastases. In total 70 tumors were involved. Following localization with MRI and dose planning using a computer system, radiosurgery was carried out. Tumors were treated with the maximum dose between 24 and 50Gy, and with the marginal dose between 12 and 25Gy. Early follow-up results demonstrated favorable responses chiefly by tumor shrinkage, central tumor necrosis or by decreased peritumoral edema. In fact after radiosurgery, the rates of tumor shrinkage were 55.7%, 61.8% and 66.7% at 3, 6 and 9 months respectively. The tumor control rates, including regressed and stable tumors, were 98.6%, 97.1 and 85.7 at 3, 6 and 9 month intervals respectively. Meanwhile, 14 cases were neurologically improved, and another 4 showed either no perceivable change. Neurological deterioration occurred in 4 cases by progression of brain metastasis in 2 and by perifocal edema after radiosurgery. Recurrent brain metastases occurring after radiosurgery were treated with a repetition of Gamma-knife surgery in 4 cases, resulting in good tumor control. In conclusion most of the brain metastasis can be well controlled by radiosurgery for relatively long period of time.
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PMID:[Gamma-radiosurgery of metastatic brain tumors]. 825 87

We evaluated 67Ga SPECT in the differentiation of mass-like lesions in the orbital and ocular areas. A two-headed SPECT system equipped with parallel-hole collimator was used. 67Ga SPECT demonstrated three dimensionally the extent of tumors found by CT and MRI. 67Ga SPECT was especially useful in the assessment of localized lesions in and around the lacrimal gland. In a total of 43 patients studied, the overall accuracy of 67Ga SPECT in diagnosing orbital and ocular lesions was 72%. Sixteen of 21 malignant lesions (76%) showed true positive findings and 15 of 22 benign lesions (68%) showed true negative findings. All seven malignant lymphoma lesions showed true positive findings. One of four cases of malignant melanoma was not visualized. This lesion was less than 15 mm in diameter. None of the three cases of retinoblastoma was visualized, regardless of tumor size. Four of seven cases of pseudotumor or pseudolymphoma showed false positive findings. The differentiation of pseudotumor and pseudolymphoma from malignant lymphoma seemed to be difficult. We conclude that 67Ga SPECT is useful in the differentiation of lesions in the orbital and ocular areas and that evaluation of the extent of malignant lesions can be improved by comparing the findings obtained by morphological diagnostic modalities.
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PMID:[67Ga SPECT in the evaluation of orbital and ocular mass-like lesions]. 833 11

Uveal melanomas are unique among the malignant tumors of the eye investigated by MRI in that both T1 and T2 are relatively shortened due to the paramagnetic effect of melanin. Bearing in mind this property, we conducted a comparative study between MRI and CT in 11 patients with histologically proven choroidal malignant melanoma. The results of this study confirm that MRI is far superior to CT in both differential diagnosis and in determining the extent of the tumor which is crucial if conservative treatment is to be undertaken.
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PMID:[Malignant melanoma of the choroid in vivo. Comparative biometry using RX scanner and MRI]. 849 59

Twelve cases of uveal melanoma (T3N0M0:11 patients, T4N0M0:1 patient) treated with Gamma Knife stereotactic radiosurgery are reported. Our protocol includes preoperative ocular and systemic assessments with complete ocular examination, ophthalmoscopy, fundus photography, fluorangiography, standardized echography, CT and MRI, chest X-rays, liver echography and blood tests. The follow-up program is mainly based on echographic evaluation of tumor thickness and size. The procedures include fixation of the eye, application of the stereotactic Leksell frame G, CT/MRI localization of the melanoma, dose planning and treatment with the Gamma Knife (B type). A mean surface dose of 55 +/- 10 Gy was administered at the 60-90% isodose curve using 4- to 14-mm collimators and a number of shots ranging from 1 to 6. A significant reduction (10-41%) in echographic thickness of the tumor was shown in 6 cases with a follow-up of 3-12 months. In 4 patients, the tumor size was still unchanged after 1-10 months. The single high-dose radiation delivered to the target and the high spatial accuracy are the main advantages of stereotactic radiosurgery for the treatment of posterior uveal melanomas. A longer followup is needed to further validate this new application of Gamma Knife radiosurgery.
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PMID:Stereotactic radiosurgery of uveal melanomas: preliminary results with Gamma Knife treatment. 858 42

A case of cervical juxtamedullary meningeal melanocytoma is presented along with results of careful neuroradiological and pathological examinations. The authors review the previous literature and discuss the problems related to the intriguing diagnosis of this very rare entity. CT and MRI show variable appearances due to different degrees of melanization and do not reliably allow us to distinguish meningeal melanocytomas from other pigmented tumors. Pathological examination of the tumor is critical for diagnosis, but it absolutely must comprise electron microscopy and immunohistochemistry. Immunohistochemical and ultrastructural criteria are thus proposed to distinguish meningeal melanocytoma from pigmented meningioma or schwannoma and malignant melanoma (primary or secondary).
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PMID:Spinal meningeal melanocytoma. Case report and analysis of diagnostic criteria. 873 64


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