Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0278883 (metastatic melanoma)
 6,224 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 57-year-old man with metastatic melanoma developed colitis secondary to ipilimumab, a known immune-related adverse event (irAE). The patient then received pembrolizumab immunotherapy, an anti-programmed-death-receptor-1 (PD-1) antibody. Restaging FDG PET/CT study following 3 cycles of therapy demonstrated diffuse increased FDG uptake throughout the body of the pancreas associated with fat stranding in the peripancreatic region, suggestive of pembrolizumab-induced pancreatitis. Although the patient was clinically asymptomatic, diagnosis was biochemically confirmed with elevated amylase and lipase levels. In the era of immunotherapy, it will be critical to recognize irAEs early to allow prompt initiation of appropriate therapy and reduce the risk of long-term sequelae.
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PMID:Pancreatitis Secondary to Anti-Programmed Death Receptor 1 Immunotherapy Diagnosed by FDG PET/CT. 2628 65

BRAF inhibitors vemurafenib and dabrafenib have become the standard of care for treatment of stage IV metastatic melanoma harboring a BRAF mutation. Panniculitis is a rare but known adverse side effect of these agents and presents with tender erythematous nodules. These nodules may demonstrate uptake on F-FDG PET/CT, which may mimic metastatic disease in patients undergoing treatment. We present a case of BRAF inhibitor-induced panniculitis in a patient with stage IV metastatic melanoma and discuss the imaging findings on F-FDG PET/CT.
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PMID:BRAF Inhibitor-Induced Panniculitis: Appearance on 18F-FDG PET/CT. 2644 89

F-18 FDG PET/CT provides an accurate staging and post-therapeutic evaluation of melanoma based on high metabolic characteristics of its primary and secondary lesions. This functional imaging modality may, however, detect coexisting benign lesions of inflammatory or infectious origin mimicking malignancy thus interfering with the staging of cancer. The authors present a case of ruptured epidermal inclusion cyst exhibiting abnormal radiotracer accumulation on PET/CT in a patient with a history of recurrent metastatic melanoma.
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PMID:Ruptured epidermal cyst mimicking cutaneous melanoma on F-18 FDG PET/CT. 2730 6

FDG PET/CT has high sensitivity and specificity for the detection of distant metastases from cutaneous melanoma. Imaging is recommended for patients with clinical suspicion of metastasis and should be considered for those with confirmed sentinel lymph node metastasis. Metastatic melanoma bears a poor prognosis. Only a complete resection improves survival, which explains the need to detect potentially unresectable disease, and most metastatic patients are ineligible for a curative surgical procedure. Here, FDG PET/CT demonstrated isolated bilateral adrenal metastases from melanoma of unknown primary. The patient underwent curative surgery, with no sign of recurrence at 48 months after surgery.
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PMID:Bilateral Huge Incidentalomas of Isolated Adrenal Metastases From Unknown Primary Melanoma Revealed by 18F-FDG PET/CT. 2777 37

Carcinoma of unknown primary is a type of malignant disease where the primary carcinoma cannot be identified by conventional examination, which presents challenges in diagnosis and therapy. This study aims to evaluate the detailed clinical value and indications of using fluorine-18-2-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (F-18 FDG PET/CT) in a large sample. A total of 449 patients who were selected under strict standards were retrospectively included in this study. F-18 FDG PET/CT accurately detected the primary carcinoma in 115 of 449 patients whose primaries could not be detected by conventional examination (25.6%), with additional 27 false-positive patients. The most common primary site was the lung (34.8%). In addition, except for in metastatic melanoma (1/19, 5.3%) and axillary metastasis patients (2/49, 4.1%), F-18 FDG PET/CT had a comparative performance in detecting primary carcinoma in other pathological types and anatomical locations. The scan is able to guide treatment strategy modifications to some extent (130/449, 29.0%). We strongly recommend the use of F-18 FDG PET/CT in the early phase of examination. It is also recommended as a supplementary radiological method, and certain patients may benefit from its application in cases where regular examination is inconclusive. However, in metastatic melanoma or axillary metastasis patients where the primary site cannot be identified by routine examination, regular application of F-18 FDG PET/CT for the sole purpose of detecting the primary carcinoma should not be encouraged.
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PMID:Advantages and disadvantages of F-18 fluorodeoxyglucose positron emission tomography/computed tomography in carcinoma of unknown primary. 2789 31

Ipilimumab (YERVOY) is a monoclonal CTLA-4-antibody with anti-tumor-immunogenic effect and is used to treat malignant melanoma. In this case study, we present [18F]Fluorodeoxyglucose Positron Emission Tomography (FDG-PET) images of a 37-year-old woman with metastatic melanoma, who was previously treated with interferon-alpha therapy and dacarbazine and still progressed. After four cycles of ipilimumab, there was a complete remission of the disease with no evidence of vital, FDG-positive tumor tissue. The follow-up for a total of 1 year confirmed the therapeutic success. This report demonstrates that FDG-PET/CT is a reliable imaging method for response monitoring in metastatic melanoma treated with ipilimumab.
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PMID:[18F]Fluorodeoxyglucose Positron Emission Tomography Reveals a Complete Remission of Refractory Metastatic Melanoma after Therapy with Ipilimumab. 2824 93

Intra-articular melanoma metastases are rare. We present a case of a 65-year-old woman with metastatic melanoma in the right ankle joint. F-FDG PET/CT was performed from the vertex to the toes, which demonstrated FDG-avid inguinal lymphadenopathy and an intensely FDG-avid soft tissue mass adjacent to the neck of the talus within the right ankle joint. The intra-articular mass was subsequently resected and histologically confirmed as metastatic melanoma. This case emphasizes the value of the contemporaneous CT in these studies for accurate anatomical localization in diagnostically challenging clinical scenarios.
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PMID:Intra-articular Melanoma Metastasis in the Ankle Joint. 2880 55

Combination therapies for the treatment of metastatic melanoma are a matter of debate nowadays. We report on a stage IV metastatic melanoma patient with the BRAF V600 mutation and a large tumor burden initially treated with two cycles of ipilimumab. Due to dramatic disease progression, demonstrated on interim 18F-FDG PET/CT, vemurafenib was added in the patient's therapeutical scheme. After completion of the concurrent ipilimumab and vemurafenib administration, a third 18F-FDG PET/CT showed an impressive metabolic remission of the metastatic disease, reflecting the potential role of the modality in treatment response evaluation of melanoma patients receiving combination therapies.
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PMID:Metastatic melanoma response to combination therapy with ipilimumab and vemurafenib. 2917 65

Spontaneous complete and partial regression of metastatic melanoma is poorly understood, and is a rare phenomenon with less than 80 cases reported since 1866. Several correlations have been noted such as systemic or local infections, operative trauma, hormonal influences, nutrition and immunologic factors. We present FDG PET and CT findings in a patient with multiple pulmonary metastases of melanoma, one of which underwent regression following biopsy. We suggest immune system modulation, triggered by biopsy, could have played a role, although the precise mechanism remains unknown.
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PMID:Spontaneous regression of a metastatic melanoma pulmonary deposit following biopsy. 2998 70

Immune checkpoint inhibitors (ICI) have revolutionized therapy of metastatic melanoma. The first ICI was ipilimumab, a cytotoxic T lymphocyte-associated Ag 4 (CLTA-4) inhibitor with response rates of approximately 11% and disease control of 22%. The programmed cell death 1 (PD-1) inhibitors, such as pembrolizumab and nivolumab, led to longer progression-free survival and overall survival rates with fewer side effects. Molecular imaging techniques, such as positron emission tomography-computed tomography (PET-CT) with 2-deoxy-2-(18F)fluoro-D-glucose (18F-FDG) are in use for staging and therapy monitoring of metastatic melanoma. However, classical radiological imaging criteria such as RECIST and WHO are not appropriate for the assessment of ICI response. New immune-related criteria have been defined such as iRECIST or irRC, which refer to radiological imaging modalities. Until now only a few studies report on immunotherapy response assessment based on 18F-FDG PET-CT. The classical criteria used for therapy monitoring with 18F-FDG PET, such as the EORTC criteria, are not suitable for ICI monitoring. In this focussed review, we present different criteria proposed for ICI monitoring with 18F-FDG and their limitations. One goal is to early identify non-responders to tailor immunotherapy. Another question is pseudoprogression and how to interpret the 18F-FDG images for response assessment. Finally, the definition of 18F-FDG criteria which can be used to identify progress is crucial and discussed in the review. The recent presented PET-based immune-related criteria, the so-called PERCIMT (PET Response Evaluation Criteria for IMmunoTherapy) are presented. Furthermore, new tracers are discussed.
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PMID:Monitoring of patients with metastatic melanoma treated with immune checkpoint inhibitors using PET-CT. 3012 22


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