whole body imaging in melanoma staging

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1、ChoyLewis,HMSIIIGillianLieberman,MDWholeBodyImaginginMelanomaStagingChoyLewis,HarvardMedicalSchoolYearIIIGillianLieberman,MDChoyLewis,HMSIIIJan2006GillianLieberman,MDOutline•PatientIntroduction•OverviewofMelanoma•ImagingModalitiesUsed•RevisitourPatient2ChoyLewis,HMSIIIJan2006GillianLieberma

2、n,MDPatientMW•54yoFwhohasotherwisebeenhealthyp/wlarge,malodoroursleftfacialmass•Started4yrsagocrustedfelloff•Recurredayragoincreaseinsizew/brownishdischarge,occasionalbleeding,andpain•PMH:Severalbenignmolesremovedfrombackin19753ChoyLewis,HMSIIIJan2006GillianLieberman,MDPatientMW2•FH:Gra

3、ndmotherw/skinCAbutnotmelanoma•PE:Unremarkableexceptfor9x12cmfungating,malodorous,leftfacialmass(inareaofParotidgland)withbrownishdischarge4ChoyLewis,HMSIIIJan2006GillianLieberman,MDDdxforFacialMass•FacialNerveSchannoma•Hemangioma•Lipoma•Parotidglandtumor•Melanoma•SquamousCellCA•Metastases•

4、LymphEdema•OtherNon-malignantProcesses5ChoyLewis,HMSIIIJan2006GillianLieberman,MDMalignantmelanoma•Arisesfrommelanocytes•Caninvolveanyorgansystemhttp://www.the-reference-desk.com/images/skin.jpg6ChoyLewis,HMSIIIJan2006GillianLieberman,MDEpidemiology110MostFrequentCancersinUSMenandWomenfrom1

5、995-1999http://www.cnn.com/interactive/health/0205/cancer.statistics/content.2.html7ChoyLewis,HMSIIIJan2006GillianLieberman,MDEpidemiology210MostFrequentCancersResultinginDeathinUSMenandWomenfrom1995-1999http://www.cnn.com/interactive/health/0205/cancer.statistics/content.2.html8ChoyLewis,H

6、MSIIIJan2006GillianLieberman,MDTypesofMelanoma•SuperficialSpreading•Acrallentiginous•Nodular•LentigoMaligna•Other9ChoyLewis,HMSIIIJan2006GillianLieberman,MDDiagnosisPathological10ChoyLewis,HMSIIIJan2006GillianLieberman,MDAWordonLymphoscintigraphy•?NodalInvolvement•Usesaradionuclidetracer+/-

7、isosulfanbluetoidentifylymphdrainageforthelesioninquestion•Worksgreatforlesionsoftheextremity•Notasgoodforaxial&headandnecklesionsCleanSLNisnotequivalenttonoMetsespeciallyforthickerlesionsandlesionsofthehead,neck,andtrunk11http://www.melanomahopenetwork.