Malignant Melanoma

Aída Ortega Candil,Cristina Rodríguez Rey,José Luis Carreras Delgado

doi:10.5402/2012/308279

Malignant Melanoma

Aída Ortega Candil, Cristina Rodríguez Rey + Show 1 more

Open Access

https://doi.org/10.5402/2012/308279

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Journal: ISRN dermatology	Publication Date: Dec 4, 2012
Citations: 10	License type: CC BY 3.0

Affiliation: Hospital Clínico San Carlos

Abstract

Nuclear medicine plays an essential role in the correct staging of patients suffering from melanoma. Both sentinel lymph node biopsy (SLNB) and positron emission tomography (PET) represent its main diagnostic tools. SLNB is the choice procedure for lymphatic regional staging of these patients, including the result of this technique in the 2002 American Joint Cancer Committee melanoma staging. SLNB sensitivity is superior than PET/CT for the detection of lymphatic micrometastases in early stages of the disease. PET/CT is mainly used in confirming clinical metastases suspected, detection of recurrences, and recurrence restaging. PET/CT has also shown superiority against conventional diagnostic methods in the detection of distant metastases, being able to detect illness even six months earlier than those methods.

Highlights

Cutaneous malignant melanoma (CMM) is the fifth most common cancer in men and the seventh in women and is one of the most deadly cancers [1]
Because only approximately 20% of patients with an intermediate-thickness primary are expected to have metastases in the regional nodes, 80% of patients undergoing elective lymph node dissection (ELND) are at the risk for acute wound problems and the chronic morbidities of lymphedema, nerve injury, and anesthetic complications without actual survival benefit
In 2009, the American Joint Committee on Cancer (AJCC) made a new revision in the staging of melanoma that included a third category, the rate of mitosis, which was added to the existing tumour thickness and ulceration

Summary

Introduction

Cutaneous malignant melanoma (CMM) is the fifth most common cancer in men and the seventh in women and is one of the most deadly cancers [1]. The prognostic factors of CMM include the thickness or Breslow index, Clark level, presence of ulceration, mitotic index, tumour location (located in the trunk and upper extremities have worse prognosis), the pattern of growth, histological type, age and sex, and involvement of regional lymph nodes. Of all of these parameters, the state of the first node draining from the tumour (called “sentinel node”) represents the most important prognostic factor in patients with melanoma in early stages [4]. Sentinel lymph node biopsy (SLNB) and positron emission tomography/computed tomography (PET/CT) represent its main diagnostic tools

Sentinel Lymph Node Biopsy

PET Technique

Findings

Conclusions