Cutaneous melanoma follow-up: appropriateness of requests for ultrasound tests – the S.Gallicano National Referral Centre Experience

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BackgroundAt skin level, a cancerization field (CF) indicates some chronically photoexposed areas in which, besides a primary tumor, histological or biomolecular modifications without clinical signs are present. Active telethermography (ATT) allows us to observe the imaging of a hyperthermic halo (HH) surrounding the tumor . The Authors hypothesize HH as a possible expression of CF.ObjectivesThe aim of this study were to verify whether HHs have the same histological or immunohistochemical characteristics as the CF and, secondly, to evaluate the efficacy of a device containing the enzyme photolyase in modifying thermographic parameters in these area.MethodsThe study included 30 patients affected by actinic keratosis, evaluated clinically and by ATT at time 0 and after 3, 6 and 9 months.ResultsThe ATT showed the presence of HHs in all the patients and, after the treatment, a significant modification of both the extension of these areas and the thermal parameters. In 5 patients for whom, while operated, two other biopsies were performed, respectively on the HH and on a perilesional non-hyperthermic area, in the HH, we detected a p53 and Ki 67 over-expression.ConclusionsOur results indicate that ATT could represent a useful paraclinic method in identifying CFs in subjects at risk.

Section: Introductionmentioning

confidence: 99%

The efficacy of a photolyase-based device on the cancerization field: a clinical and thermographic study

Laino

Elia

Desiderio

et al. 2015

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“…Also, it has to be underlined that the series was collected in a recent period using high resolution ultrasound systems which improved both diagnosis and follow-up of several conditions [22,[24][25][26]. To date, the knowledge on US presentation of MTC is poor, and the present data strongly improve the literature on this matter.…”

Section: Discussionmentioning

confidence: 69%

Ultrasound features of medullary thyroid carcinoma correlate with cancer aggressiveness: a retrospective multicenter study

Trimboli

Giovanella

Valabrega

et al. 2014

“…Over the past several years the incidence of cutaneous melanoma has rapidly increased (incidence ranging from 2 to 20%) with about 60,000 new cases diagnosed every year in Europe [1][2][3]. Five-year survival rate varies in a wide range (10-70%, depending on many variables) and it is reported to be much lower in patients with cutaneous metastases [4][5][6][7][8]. Cutaneous metastases from melanoma are very frequent and related to different risk factors and clinical parameters of which the most relevant are high thickness and number of mitoses, all determining tumor stage and consequently different patient management [9,10].…”

Section: Introductionmentioning

confidence: 99%

HF ultrasound vs PET-CT and telethermography in the diagnosis of In-transit metastases from melanoma: a prospective study and review of the literature

Solivetti

Desiderio

Guerrisi

et al. 2014

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BackgroundOver the past several years the incidence of cutaneous melanoma has rapidly increased. This tumor develops often in-transit metastases that significantly reduce patient survival at 5 years. To improve prognosis and quality of life in patients with melanoma metastases, a mini invasive procedure like electrochemotherapy (ECT) is adopted to remove superficial tissue lesions. To detect the melanoma metastases, high frequency (HF) ultrasound (US) is used. This technique, though, can be time-consuming and it needs an expert operator and a high performing machine. Therefore, we asked whether the US could be replaced or integrated with other less time-consuming techniques such as 18-FDG positron emission tomography/computed tomography (PET-CT) and telethermography (TT).MethodsFifteen patients (4 males and 11 females - age range: 63–91) affected whit advanced stage melanoma were enrolled. They presented 52 in-transit metastases as detected by the three techniques used, HF-US, PET/CT and TT within 30 days before ECT.ResultsAll the 52 lesions were detected by HF-US (100%), 24/52 were detected by PET-CT (42,6%) and 15/52 were detected by TT (27,7%). PET-CT reported 3.7% false positives, while no false positive were reported by TT.ConclusionsAs US detected 100% lesions, compared to the other two techniques used, US, along with clinical examination, has still to be considered as gold standard in the diagnosis of metastatic lesions. US, associated with an exhaustive anamnesis and accurate clinical examination, cannot be replaced by either PET-CT or TT. When US performing devices and experienced operators are not available, though, it is highly recommended to integrate US with at least one of the other techniques. Under certain circumstances, as in the case of obese and non-collaborating patients or in patients with lymphatic stasis, these techniques should be integrated to obtain exact in-transit metastases evaluation.