Differential Diagnosis of Malignant Melanoma and Benign Cutaneous Lesions by Ultrasound Analysis

Michael Hambardzumyan,A Hayrapetyan

doi:10.28991/scimedj-2020-0202-7

Abstract

Background: The purpose of the study is to evaluate the assessment of ultrasound analysis in the differential diagnosis of skin melanoma and benign cutaneous lesions. Objective: 61 patients (23 men and 38 women) between 17 and 87 years of age, with melanomas, atheromas, hemangiomas, keratoses, and naevi were studied. Methods: High-frequency gray-scale ultrasound analysis, color Doppler, power Doppler, advanced dynamic flow, strain Elastography, digital Dermoscopy were performed in all cases. Results: In malignant melanoma cases we have mainly: sharp margins, hypoechoic, homogenous structure, absent of posterior shadowing, central and disorganized circulatory pattern with multiple peduncles. In some benign pathology, several ultrasound criteria were exclusive: microcalcifications are only in atheroma, posterior shadowing, and circular rim - in keratosis. The incidence of other ultrasound criteria can vary in atheroma, hemangioma, keratosis, and nevus. Tumor longitudinal and thickness relation were higher (7.9±1.96) than in all benign pathologies (2.1-4.8). The Elastography stiffness of the 26 skin melanomas was 2.95±0.18 and was higher than the group of 35 patients with all benign skin pathology (0.96±0.59), including atheroma (2.0±0.78), hemangioma (0.55±0.21), keratosis (1.21±0.21) and nevus (0.78±0.45). Conclusion: Multimodal approaches to exploring high-frequency ultrasound analytic criteria can be helpful in the differential diagnosis of malignant melanoma and benign cutaneous lesions.

Highlights

Skin pathologies are mostly visible pathologies, the main efforts were focused on the different optical visualization methods, intended to improve the diagnostic accuracy of melanomas
Analyzing the ultrasound criteria in 26 patients with malignant melanoma, we registered a sharp margin with oval, jagged or linear shape (Table 1)
The mean number of melanoma lesions length and thickness ratio Longitudinal and Thickness (L/T) was 7.9±1.96 and it was higher than all benign pathologies, (2.14.8)

Summary

Introduction

Skin pathologies are mostly visible pathologies, the main efforts were focused on the different optical visualization methods, intended to improve the diagnostic accuracy of melanomas. The purpose of the study is to evaluate the assessment of ultrasound analysis in the differential diagnosis of skin melanoma and benign cutaneous lesions. Methods: High-frequency gray-scale ultrasound analysis, color Doppler, power Doppler, advanced dynamic flow, strain Elastography, digital Dermoscopy were performed in all cases. The Elastography stiffness of the 26 skin melanomas was 2.95±0.18 and was higher than the group of 35 patients with all benign skin pathology (0.96±0.59), including atheroma (2.0±0.78), hemangioma (0.55±0.21), keratosis (1.21±0.21) and nevus (0.78±0.45). Conclusion: Multimodal approaches to exploring highfrequency ultrasound analytic criteria can be helpful in the differential diagnosis of malignant melanoma and benign cutaneous lesions.

Objectives

Methods

Results

Conclusion