Abstract
Background: Primary pulmonary malignant melanoma (PMM) is an extremely rare disease entity. There are limited published data on primary pulmonary malignant melanomas. The clinical manifestations and imaging features are non-specific. The imaging features of pulmonary melanoma have been described in previous reports, but it is still challenging to diagnosis it radiologically. Case presentation: A 66 years old male presented with productive cough and back pain. His chest computed tomography (CT) scan revealed homogenous mass with higher density in left hilum with metastatic nodules in lungs. The metastatic lesions in vertebra on magnetic resonance imaging (MRI) were hyper-intense on T1WI and hypointense on T2WI. Further evaluation and immunohistochemical examination confirmed the diagnosis of primary pulmonary malignant melanoma with metastasis to vertebral bodies, liver, adrenal and lungs. He received 2 cycles of chemotherapy and died one month after initial diagnosis of the disease. Conclusion: We have described pulmonary melanoma as bilateral homogenous nodules and mass with a higher computed tomography value. Although CT value has not been described in all literatures, many cases displayed higher density masses. So, clinicians should consider primary lung melanoma as a differential diagnosis for patients with such higher density mass in CT scan and hyper-intensity on T1WI and hypo-intensity on T2WI on MRI.
Highlights
ConclusionWe have described pulmonary melanoma as bilateral homogenous nodules and mass with a higher computed tomography value
Melanoma, a malignant neoplasm of melanocytes, is one of the most aggressive cancers
We have described pulmonary melanoma as bilateral homogenous nodules and mass with a higher computed tomography value
Summary
We presented a case of pulmonary malignant melanoma with metastasis and had a poor prognosis, and summarized the key aspects of this rare disease based on the available published literatures. We suggest, when encountered with homogenous nodules or masses with higher CT value in lung and metastases, and on MRI hyper-intensity on T1WI and hypo-intensity on T2WI, with the exception of hemorrhage, PMM should be taken into consideration as a differential diagnosis
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