Intracranial metastatic melanoma: correlation between MR imaging characteristics and melanin content.

Işıklar, I.; Leeds, Norman E.; Fuller, Gregory N.; Kumar, Ashok J.

doi:10.2214/ajr.165.6.7484597

Cited by 153 publications

(110 citation statements)

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“…The higher the melanin content of the tumor, the more intense is the signal intensity on T1-weighted and the lower is the signal intensity on T2-weighted images. [7][8][9][10][11][12] As stated previously, our 2 patients showed similar MR imaging appearances, which indicated melanotic melanoma. Conversely, amelanotic melanoma will generally demonstrate hypointensity on T1-weighted and hyperintensity on T2-weighted images and thus is not easy to diagnose on the basis of the MR imaging alone.…”

Section: Discussionsupporting

confidence: 70%

“…Conversely, amelanotic melanoma will generally demonstrate hypointensity on T1-weighted and hyperintensity on T2-weighted images and thus is not easy to diagnose on the basis of the MR imaging alone. 7,8 On the basis of these 2 cases, we believe that there are indications other than just signal intensity to aid in detecting melanoma of this region: brown-or gray-black color, ellipsis shape, and submucosal development toward the middle ear along the eustachian tube, accompanied by homolateral serous otitis media.…”

Section: Discussionmentioning

confidence: 97%

“…7,8 Because of the paramagnetic characteristics of melanin, melanotic tumors may be detected by using MR imaging. Key observations are hyperintensity on T1-weighted and hypointensity on T2-weighted images.…”

Section: Discussionmentioning

confidence: 99%

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MR Imaging Features of Primary Mucosal Melanoma of the Eustachian Tube: Report of 2 Cases

Yang¹,

Wang²,

Jian³

et al. 2008

AJNR Am J Neuroradiol

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SUMMARY:We observed 2 cases of malignant melanoma arising from the eustachian tube with MR imaging. In this region, we explored further characteristics of primary mucosal melanoma. We discuss the value of using MR imaging to diagnose and treat patients with melanoma in the eustachian tube. In addition, we introduce the key points to differentiate melanoma from some common diseases in the region. Malignant melanoma primarily affects the skin, rarely the mucosa. Melanoma of the upper airway mucosa constitutes approximately 1% of the total melanoma of the head and neck.1 Primary melanoma of the eustachian tube is even rarer. In a series of 158 cases of mucosal melanoma of the upper airway, only 2 cases were located at the eustachian tube orifice in the nasopharynx.2 To the best of our knowledge, only 6 cases of primary melanoma of the eustachian tube have been reported in the literature to date [2][3][4][5] ; unfortunately, the corresponding MR imaging findings were not described effectively. During the past 5 years, melanoma of the eustachian tube in the nasopharynx has been positively proved through histopathology in 2 patients at our hospital. These 2 patients underwent MR imaging. Case Reports Case 1A 75-year-old man with mild hypertension and an intermittent epistaxis for the past 20 days was examined. An otorhinolaryngologic examination showed serous otitis media of the left ear and a brownblack soft-tissue mass with surface irregularity in the left nasopharynx. The pharyngeal orifice of the left eustachian tube was obstructed. MR imaging revealed an elliptic well-defined 1.2 ϫ 2.0 ϫ 1.4 cm mass in the left nasopharynx, arising from the left eustachian tube. The lesion showed signal intensity hyperintense to gray matter on T1-weighted images and hypointense signal intensity on T2-weighted images with moderate homogeneous contrast enhancement following the administration of contrast material (Fig 1A-C). The timeintensity curve of dynamic contrast-enhanced (DCE) MR imaging was a rapidly enhancing and rapid washout type (Fig 1D, -E). The lesion was complicated with serous otitis media of the left ear, which showed hypointense signal intensity on T1-weighted images and hyperintense signal intensity on T2-weighted images without significant contrast enhancement. Neither an enlarged retropharyngeal node, evidence of head and neck melanoma, nor systemic abnormalities were observed. A surgical specimen of the brown-black mass in the left eustachian tube was histopathologically proved to be malignant melanoma. On immunohistochemistry, tumor cells were strongly positive for S-100, vimentin, and melanoma antibody HMB45. Case 2A 35-year-old woman with no significant medical history presented with a 2-year history of hearing decrease and with a 1-month intermittent epistaxis. An otorhinolaryngologic examination revealed serous otitis media of the left ear and an irregular coarse friable grayblack soft-tissue mass occupying the whole pharyngeal orifice of the left eustachian tube in the nasopharynx. MR imaging showed an el...

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Section: Discussionsupporting

confidence: 70%

Section: Discussionmentioning

confidence: 97%

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MR Imaging Features of Primary Mucosal Melanoma of the Eustachian Tube: Report of 2 Cases

Yang¹,

Wang²,

Jian³

et al. 2008

AJNR Am J Neuroradiol

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“…As a result, the expected signal pattern for melanotic melanoma is hyperintensity in relation to cortex on T1 -weighted images, hypointensity in relation to cortex on T2-weighted images, and isointensity or hypenintensity in relation to cortex on proton density-weighted images. The expected signal pattern for amelanotic melanoma is similar to that for other brain tumors: hypointensity or isointensity in relation to cortex on T1 -weighted images and hyperintensity on isointensity in relation to cortex on T2-weighted images 2 .…”

Section: Discussionsupporting

confidence: 53%

A cystic amelanotic melanoma metastasis to the brain: case report

et al. 2008

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SummaryAs far as we know, cyst formation in intracranial melanoma is rare, and only 15 cases of intracranial amelanotic melanoma have been reported until now. A yellowish mass was observed in the frontal lobe. The content of the cyst consisted of old hematoma, xanthochromic fluid and necrotic tissue, was evacuated and the cyst wall was totally resected. No abnormal pigmentation was noted in the cyst wall and surrounding brain tissue. The imaging features of metastatic melanomas are distinctive due to the presence of melanin and the propensity for hemorrhage. Both hemorrhage and melanin can produce T1-weighted hyperintensity and T2-weighted signal intensity loss.KEY WORDS: Melanoma. Brain metastases. Brain abscess. Metástasis cerebral de un melanoma amelanótico quístico ResumenQue sepamos, la formación quística de un melanoma intracraneal es rara y sólo se han descrito 15 casos de melanoma intracraneal amilanocítico. Se observó una masa amarillenta en el lóbulo frontal. El contenido del quiste consistía en un hematoma antiguo, con líquido xantocrómico tejido necrótico que se evacuó, con resección total de la pared del quiste. No se encontró ninguna pigmentación anormal en la pared ni en el tejido cerebral adyacente. Las imágenes de los melanomas metastásicos son muy peculiares, debido a la presencia de melanina y a la propensión a la hemorragia. Ambos, hemorragia y melanina pueden producir hiperseñal en T1 e hiposeñal en T2.

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“…For example, melanomas have a short T1, and accumulation of the ASL signal can be attenuated. 31 Furthermore, flow in regions with reduced activity due to radiation or vascular disease may be underestimated by ASL due to delayed arrival of arterial blood. Such underestimation might be addressed by newer ASL techniques that can label for longer and also measure the arterial transit delay.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Accuracy of PET, SPECT, and Arterial Spin-Labeling in Differentiating Tumor Recurrence from Necrosis in Cerebral Metastasis after Stereotactic Radiosurgery

Lai

Mahadevan

Hackney³

et al. 2015

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE:Radiographic assessment of cerebral metastasis after stereotactic radiosurgery remains a major challenge in neuro-oncology. It is often difficult to distinguish tumor progression from radiation necrosis in this setting using conventional MR imaging. The objective of this study was to compare the diagnostic sensitivity and specificity of different functional imaging modalities for detecting tumor recurrence after stereotactic radiosurgery.

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Intracranial metastatic melanoma: correlation between MR imaging characteristics and melanin content.

Cited by 153 publications

References 1 publication

MR Imaging Features of Primary Mucosal Melanoma of the Eustachian Tube: Report of 2 Cases

MR Imaging Features of Primary Mucosal Melanoma of the Eustachian Tube: Report of 2 Cases

A cystic amelanotic melanoma metastasis to the brain: case report

Diagnostic Accuracy of PET, SPECT, and Arterial Spin-Labeling in Differentiating Tumor Recurrence from Necrosis in Cerebral Metastasis after Stereotactic Radiosurgery

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