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Zhou J, Zhao Y. Rare Findings of Gallbladder Metastasis From Cutaneous Melanoma on 18 F-FDG PET/CT Imaging. Clin Nucl Med 2024; 49:253-254. [PMID: 38181300 DOI: 10.1097/rlu.0000000000005035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2024]
Abstract
ABSTRACT We present the imaging findings of a 77-year-old man with a history of malignant cutis melanoma that metastasized to the gallbladder. A restaging 18 F-FDG PET/CT scan showed uneven thickening and elevated 18 F-FDG uptake in the gallbladder wall. Subsequently, the patient underwent laparoscopic cholecystectomy, and histopathologic findings confirmed the diagnosis of metastatic melanoma of the gallbladder.
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Affiliation(s)
- Jing Zhou
- From the Department of Medical Imaging, Chongqing University Fuling Hospital, Chongqing, China
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Ensle F, Schaab JA, Dimitriou F, Huellner MW, Maurer A. Internal Thoracic Vein Tumor Thrombus From Sternal Melanoma Metastasis on 18 F-FDG PET/CT. Clin Nucl Med 2023; 48:540-541. [PMID: 37019114 DOI: 10.1097/rlu.0000000000004644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
Abstract
ABSTRACT We present 18 F-FDG PET/CT findings of an internal thoracic vein tumor thrombus from melanoma in a 76-year-old woman. Restaging 18 F-FDG PET/CT shows a progressive disease with an internal thoracic vein tumor thrombus from a sternal bone metastasis. Although cutaneous malignant melanoma may metastasize to any body part, a direct tumor invasion of veins and the formation of a tumor thrombus represent an extremely rare complication.
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Affiliation(s)
- Falko Ensle
- From the Institute of Diagnostic and Interventional Radiology
| | | | - Florentia Dimitriou
- Department of Dermatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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Cocco G, Delli Pizzi A, Basilico R, Fabiani S, Taraschi AL, Pascucci L, Boccatonda A, Catalano O, Schiavone C. Imaging of gallbladder metastasis. Insights Imaging 2021; 12:100. [PMID: 34259932 PMCID: PMC8280258 DOI: 10.1186/s13244-021-01049-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 06/13/2021] [Indexed: 12/29/2022] Open
Abstract
Gallbladder metastasis (GM) is a rare condition, often with a late diagnosis or detected upon autopsy. There is no extensive literature on the imaging diagnosis of GM. Here we present a comprehensive review of the literature with the aim of helping to interpret the clinical findings and imaging features of such patients. Few studies on GM are reported in literature. GM by melanoma accounts for about 55.6% of cases. The remaining cases origin from breast cancer (13.6%), hepatocellular carcinoma (13.6%), renal cell carcinoma (6.8%), lung cancer (4.5%), lymphoma (3.5%) and gastric cancer (2.4%). The most common clinical presentation of GM is abdominal pain from cholecystitis due to obstruction of the cystic duct. The main ultrasound (US), computed tomography (CT) and magnetic resonance imaging (MRI) findings that clinicians and radiologists should consider in their everyday medical activity were discussed. The diagnosis of GM was often achieved through a combination of more than one imaging modality. In more than 90% of cases, the diagnosis of GM is often late and combined with other organs involvement in the terminal stage of the malignancy. The knowledge of the clinical features and different imaging techniques through careful evaluation of the gallbladder can help to achieve early diagnosis and avoid misdiagnosis or false negative results.
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Affiliation(s)
- Giulio Cocco
- Unit of Ultrasound in Internal Medicine, Department of Medicine and Science of Aging, "G.D'Annunzio" University, Chiety, Italy.
| | - Andrea Delli Pizzi
- Department of Neurosciences, Imaging and Clinical Studies, "G.D'Annunzio" University, Chiety, Italy
| | - Raffaella Basilico
- Department of Neurosciences, Imaging and Clinical Studies, "G.D'Annunzio" University, Chiety, Italy
| | - Stefano Fabiani
- Unit of Ultrasound in Internal Medicine, Department of Medicine and Science of Aging, "G.D'Annunzio" University, Chiety, Italy
| | - Alessio Lino Taraschi
- Department of Neurosciences, Imaging and Clinical Studies, "G.D'Annunzio" University, Chiety, Italy
| | - Luca Pascucci
- Department of Neurosciences, Imaging and Clinical Studies, "G.D'Annunzio" University, Chiety, Italy
| | - Andrea Boccatonda
- Unit of Ultrasound in Internal Medicine, Department of Medicine and Science of Aging, "G.D'Annunzio" University, Chiety, Italy
| | | | - Cosima Schiavone
- Unit of Ultrasound in Internal Medicine, Department of Medicine and Science of Aging, "G.D'Annunzio" University, Chiety, Italy
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Van de Wiele C, Juanito G, Vander BK, Lawal I, De Spiegeleer B, Sathekge M, Maes A. Practical Considerations When Interpreting FDG PET/CT Imaging for Staging and Treatment Response Assessment in Melanoma Patients. Semin Nucl Med 2021; 51:544-553. [PMID: 34246450 DOI: 10.1053/j.semnuclmed.2021.06.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
While FDG PET/CT bears a high sensitivity and specificity for the staging of stage III and IV melanoma as well as for the purpose of melanoma recurrence detection, overall results tend to vary from one part of the body to another as well as for melanoma from cutaneous or choroidal origin. In this paper, organ or site-related differences in sensitivity and specificity in melanoma patients, both from cutaneous and choroidal origin, as well as their impact on clinical decision making are discussed. Furthermore, with the advent of immunotherapy for the treatment of malignant melanoma, post-treatment related potential false positive findings have emerged, the knowledge of which is essential for accurate treatment response assessment. These post-treatment related potential false positive findings are summarized in this paper so as to help the nuclear medicine physician in avoiding erroneous interpretation of acquired FDG PET/CT images in melanoma patients receiving immuntherapy.
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Affiliation(s)
- Christophe Van de Wiele
- Department of Nuclear Medicine, AZ Groeninge, Kortrijk, Belgium; Department of Diagnostic Sciences, University Ghent, Ghent, Belgium.
| | | | - Borght K Vander
- DRUQUAR, Laboratory of Drug Quality and Registration, Department of Pharmaceutical Sciences, University Ghent, Ghent, Belgium
| | - Ismaheel Lawal
- Department of Nuclear Medicine, University of Pretoria, Pretoria, South-Africa
| | - Bart De Spiegeleer
- DRUQUAR, Laboratory of Drug Quality and Registration, Department of Pharmaceutical Sciences, University Ghent, Ghent, Belgium
| | - Mike Sathekge
- Department of Nuclear Medicine, University of Pretoria, Pretoria, South-Africa
| | - Alex Maes
- Department of Nuclear Medicine, AZ Groeninge, Kortrijk, Belgium; Department of Morphological Sciences, University Leuven, Leuven, Belgium
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Barat M, Guegan-Bart S, Cottereau AS, Guillo E, Hoeffel C, Barret M, Gaujoux S, Dohan A, Soyer P. CT, MRI and PET/CT features of abdominal manifestations of cutaneous melanoma: a review of current concepts in the era of tumor-specific therapies. Abdom Radiol (NY) 2021; 46:2219-2235. [PMID: 33135115 DOI: 10.1007/s00261-020-02837-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 10/15/2020] [Accepted: 10/20/2020] [Indexed: 12/12/2022]
Abstract
Abdominal manifestations in patients with cutaneous melanoma include involvement due to metastatic spread and immune checkpoint inhibitor induced adverse events. The purpose of this review is to provide a critical overview of abdominal manifestations in patients with cutaneous melanoma and highlight the current imaging challenges in the era of tumor-specific therapies. Immune checkpoint inhibitors represent a treatment with demonstrated efficacy in the treatment of advanced cutaneous melanoma but are associated with several abdominal adverse events that must be recognized. CT has a role in the identification of colitis, enteritis and pancreatitis, whereas MRI has an important role in the diagnosis of autoimmune pancreatitis. Current evidence demonstrates that MRI should be the preferred imaging technique for the detection and characterization of hepatic and splenic metastases from cutaneous melanoma. The role of 18F-FDG-PET/CT should be further evaluated but current literature suggests an efficacy in the detection of pancreatic metastases not seen on CT and MRI.
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Affiliation(s)
- Maxime Barat
- Department of Abdominal & Interventional Radiology, Hôpital Cochin, AP-HP, 27 Rue du Faubourg Saint-Jacques, 75014, Paris, France
- Université de Paris, Descartes-Paris 5, rue de l'Ecole de Médecine, F-75006, Paris, France
| | - Sarah Guegan-Bart
- Université de Paris, Descartes-Paris 5, rue de l'Ecole de Médecine, F-75006, Paris, France
- Department of Dermatology, Hôpital Cochin, AP-HP, 27 Rue du Faubourg Saint-Jacques, 75014, Paris, France
| | - Anne-Ségolène Cottereau
- Université de Paris, Descartes-Paris 5, rue de l'Ecole de Médecine, F-75006, Paris, France
- Department of Nuclear Medicine, Hôpital Cochin, AP-HP, 27 Rue du Faubourg Saint-Jacques, 75014, Paris, France
| | - Enora Guillo
- Department of Abdominal & Interventional Radiology, Hôpital Cochin, AP-HP, 27 Rue du Faubourg Saint-Jacques, 75014, Paris, France
| | - Christine Hoeffel
- Department of Radiology, Hôpital Robert Debré, 11 Boulevard Pasteur, 51092, Reims, France
| | - Maximilien Barret
- Université de Paris, Descartes-Paris 5, rue de l'Ecole de Médecine, F-75006, Paris, France
- Department of Gastroenterology, Hôpital Cochin, AP-HP, 27 Rue du Faubourg Saint-Jacques, 75014, Paris, France
| | - Sébastien Gaujoux
- Université de Paris, Descartes-Paris 5, rue de l'Ecole de Médecine, F-75006, Paris, France
- Department of Abdominal Surgery, Hôpital Cochin, AP-HP, 27 Rue du Faubourg Saint-Jacques, 75014, Paris, France
| | - Anthony Dohan
- Department of Abdominal & Interventional Radiology, Hôpital Cochin, AP-HP, 27 Rue du Faubourg Saint-Jacques, 75014, Paris, France
- Université de Paris, Descartes-Paris 5, rue de l'Ecole de Médecine, F-75006, Paris, France
| | - Philippe Soyer
- Department of Abdominal & Interventional Radiology, Hôpital Cochin, AP-HP, 27 Rue du Faubourg Saint-Jacques, 75014, Paris, France.
- Université de Paris, Descartes-Paris 5, rue de l'Ecole de Médecine, F-75006, Paris, France.
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Christou D, Katodritis N, Decatris MP, Katodritou A, Michaelides I, Nicolaou N, Kounoushis M, Hadjicostas P. Melanoma of the gallbladder: appropriate surgical management and review of the literature. Clin Case Rep 2014; 2:313-8. [PMID: 25548636 PMCID: PMC4270716 DOI: 10.1002/ccr3.121] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Accepted: 06/28/2014] [Indexed: 12/23/2022] Open
Abstract
KEY CLINICAL MESSAGE Melanomas of the gallbladder (GB) are extremely rare with a very poor prognosis. They feature in the literature as a few case reports and the method of their management is not clear. We report a case of patient with metastatic cutaneous melanoma to the GB, and our treatment suggestion.
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Affiliation(s)
- Demetris Christou
- Department of General Surgery, Larnaca General HospitalLarnaca, Cyprus
| | - Nicos Katodritis
- Department of Radiation Oncology, Bank of Cyprus Oncology CentreNicosia, Cyprus
| | - Marios P Decatris
- Department of Medical Oncology, Bank of Cyprus Oncology CentreNicosia, Cyprus
| | | | | | - Nicolaos Nicolaou
- Department of General Surgery, Larnaca General HospitalLarnaca, Cyprus
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Choi WS, Kim SH, Lee ES, Lee KB, Yoon WJ, Shin CI, Han JK. CT findings of gallbladder metastases: emphasis on differences according to primary tumors. Korean J Radiol 2014; 15:334-45. [PMID: 24843238 PMCID: PMC4023052 DOI: 10.3348/kjr.2014.15.3.334] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Accepted: 03/15/2014] [Indexed: 12/22/2022] Open
Abstract
Objective To describe computed tomography (CT) features of metastatic gallbladder (GB) tumors (MGTs) from various primary tumors and to determine whether there are differential imaging features of MGTs according to different primary tumors. Materials and Methods Twenty-one patients who had pathologically confirmed MGTs and underwent CT were retrospectively enrolled. Clinical findings including presenting symptoms, type of surgery, and interval between primary and metastatic tumors were recorded. Histologic features of primary tumor and MGTs including depth of invasion were also reviewed. Imaging findings were analyzed for the location and morphology of MGTs, pattern and degree of enhancement, depth of invasion, presence of intact overlying mucosa, and concordance between imaging features of primary and metastatic tumors. Significant differences between the histologies of MGTs and imaging features were determined. Results The most common primary tumor metastasized to the GB was gastric cancer (n = 8), followed by renal cell carcinoma (n = 4) and hepatocellular carcinoma (n = 3). All MGTs (n = 21) manifested as infiltrative wall thickenings (n = 15) or as polypoid lesions (n = 6) on CT, similar to the features of primary GB cancers. There were significant differences in the morphology of MGTs, enhancement pattern, enhancement degree, and depth of invasion according to the histology of primary tumors (p < 0.05). Metastatic adenocarcinomas of the GB manifested as infiltrative and persistently enhancing wall thickenings, while non-adenocarcinomatous metastases usually manifested as polypoid lesions with early wash-in and wash-out. Conclusion Although CT findings of MGTs are similar to those of primary GB cancer, they are significantly different between the various histologies of primary tumors.
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Affiliation(s)
- Won Seok Choi
- Department of Radiology, Seoul National University Hospital, Seoul 110-744, Korea
| | - Se Hyung Kim
- Department of Radiology, Seoul National University Hospital, Seoul 110-744, Korea
| | - Eun Sun Lee
- Department of Radiology, Seoul National University Hospital, Seoul 110-744, Korea
| | - Kyoung-Bun Lee
- Department of Pathology, Seoul National University Hospital, Seoul 110-744, Korea
| | - Won Jae Yoon
- Department of Internal Medicine, Inje University Seoul Paik Hospital, Inje University College of Medicine, Seoul 100-032, Korea
| | - Cheong-Il Shin
- Department of Radiology, Seoul National University Hospital, Seoul 110-744, Korea
| | - Joon Koo Han
- Department of Radiology, Seoul National University Hospital, Seoul 110-744, Korea
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Sanli Y, Ozkan G, Yegen G, Turkmen C, Mudun A. Metastasis of Malignant Melanoma to Common Biliary Duct Demonstrated With F-18 FDG PET/CT. Clin Nucl Med 2011; 36:470-2. [DOI: 10.1097/rlu.0b013e31820ade2e] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Alimova E, Gorin I, Gressier L, Hugol D, Bouillot JL, Cavalcanti A, Terrier-Lacombe MJ, Blondet C, Franck N, Morini JP, Dupin N, Avril MF. [Metastatic melanoma of the gallbladder: two cases]. Ann Dermatol Venereol 2009; 136:368-70. [PMID: 19361709 DOI: 10.1016/j.annder.2008.11.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2008] [Accepted: 11/21/2008] [Indexed: 11/26/2022]
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Marone U, Caracò C, Losito S, Daponte A, Chiofalo MG, Mori S, Cerra R, Pezzullo L, Mozzillo N. Laparoscopic cholecystectomy for melanoma metastatic to the gallbladder: is it an adequate surgical procedure? Report of a case and review of the literature. World J Surg Oncol 2007; 5:141. [PMID: 18072972 PMCID: PMC2233626 DOI: 10.1186/1477-7819-5-141] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2007] [Accepted: 12/11/2007] [Indexed: 11/15/2022] Open
Abstract
Background Only 2% to 4% of patients with melanoma will be diagnosed with gastrointestinal metastasis during the course of their disease. The most common sites of gastrointestinal metastases from melanoma include the small bowel (35%–67%), colon (9%–15%) and stomach (5%–7%), with a median survival of 6–10 months after surgery, and 18% survival at five years. Metastatic melanoma to the gallbladder is extremely rare and it is associated with a very poor prognosis. Case presentation We report a case of a 54-year old man presented to observation with diagnosis of 6.1 mm thick, Clark's level IV, ulcerated melanoma of the trunk, developing in the course of the disease metastatic involvement of the gallbladder as first site of recurrence, treated by laparoscopic cholecystectomy. To date only few cases of patients with metastatic melanoma of the gallbladder treated by this surgical procedure have been reported in literature. Conclusion Gallbladder metastasis represents a rare event as a first site of recurrence. It must be considered a possible expression of systemic disease also despite radiological absence of other metastatic lesions. Laparoscopic approach has a possible therapeutic role, but open surgery has also a concomitant diagnostic purpose because gives the possibility of manual exploration of abdominal cavity, useful particularly to reveal bowel metastatic lesions, not easily identifiable by preoperative imaging examinations.
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Affiliation(s)
- Ugo Marone
- Department of Surgical Oncology "B", National Cancer Institute of Naples, Italy.
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Núñez R, Yeung HW, Swanston NM, Macapinlac HA. Captación de fluordesoxiglucosa en la vesícula biliar en la PET y la PET-TAC de tres pacientes oncológicos. ACTA ACUST UNITED AC 2007; 26:234-6. [PMID: 17662192 DOI: 10.1157/13107977] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- R Núñez
- Servicio de Medicina Nuclear, Centro Oncológico MD Anderson, Houston, Texas, USA.
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