An unusual case of metastatic melanoma in subcutaneous tissue presenting as a solitary cystic mass with fluid levels.

IF 1.3 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Journal of Ultrasound Pub Date : 2024-12-01 Epub Date: 2024-02-24 DOI:10.1007/s40477-023-00864-7
Catherine Cubitt, Sisith Ariyaratne, Sumathi Vaiyapuri, Vineet Kurisunkal, Rajesh Botchu
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Abstract

Malignant melanoma is a common and often aggressive neoplasm of the skin arising from melanocytes. Metastatic melanoma is known for its diverse clinical manifestations, and can present with atypical features prior to diagnosis of the primary lesion, which can pose a diagnostic challenge. We report a rare case of metastatic melanoma in a 67 year-old male who presented with a painless, enlarging mass in the right axilla over a 4 week period. Ultrasound and magnetic resonance imaging (MRI) scans revealed a well-defined solitary, cystic appearing lesion in the right axilla with a distinct fluid-fluid level. An ultrasound guided biopsy of the lesion diagnosed a metastatic melanoma. While haemorrhagic distant metastases are a well-recognised complication of malignant melanoma, particularly in the brain and lung, soft tissue metastases presenting with fluid-fluid levels is not well described in the literature. The case highlights the importance of considering the differential of melanoma metastasis when encountered with such a lesion and importance of ultrasound guided biopsy for histopathological confirmation, as the imaging features can mimic that of a haemorrhagic soft tissue sarcoma, the management of which differs substantially from that of melanoma.

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一例不寻常的皮下组织转移性黑色素瘤病例,表现为伴有液性的单发囊性肿块。
恶性黑色素瘤是一种由黑色素细胞引起的常见皮肤肿瘤,通常具有侵袭性。转移性黑色素瘤的临床表现多种多样,在确诊原发病灶之前可能表现出非典型特征,这给诊断带来了挑战。我们报告了一例罕见的转移性黑色素瘤病例,患者为一名 67 岁男性,4 周前出现右腋窝无痛性肿块增大。超声波和磁共振成像(MRI)扫描显示,他的右腋窝出现了一个界限清晰的单发囊性病变,并伴有明显的液-液水平。超声引导下的病灶活检诊断为转移性黑色素瘤。虽然出血性远处转移是恶性黑色素瘤公认的并发症,尤其是在脑部和肺部,但文献中对软组织转移出现液-液水平的描述并不多。本病例强调了在遇到此类病变时考虑黑色素瘤转移的鉴别诊断的重要性,以及在超声引导下进行活检以进行组织病理学确认的重要性,因为其影像学特征可能与出血性软组织肉瘤相似,而后者的处理方法与黑色素瘤有很大不同。
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来源期刊
Journal of Ultrasound
Journal of Ultrasound RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
CiteScore
4.10
自引率
15.00%
发文量
133
期刊介绍: The Journal of Ultrasound is the official journal of the Italian Society for Ultrasound in Medicine and Biology (SIUMB). The journal publishes original contributions (research and review articles, case reports, technical reports and letters to the editor) on significant advances in clinical diagnostic, interventional and therapeutic applications, clinical techniques, the physics, engineering and technology of ultrasound in medicine and biology, and in cross-sectional diagnostic imaging. The official language of Journal of Ultrasound is English.
期刊最新文献
Sonography of monkeypox: comment. Training and learning ultrasound: survey on a sample of Italian students, impact and role inside the core curriculum of degree courses in medicine and surgery. An unusual case of metastatic melanoma in subcutaneous tissue presenting as a solitary cystic mass with fluid levels. Microvascular imaging findings in infants with bacterial meningitis: a case series. Inflammatory bowel disease in children: finding the best diagnostic tool.
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