¹⁸F-FDG PET-CT for Staging of Conjunctival Melanoma

Abstract

The value of F-18 fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET-CT) for the evaluation of cutaneous melanoma has been demonstrated previously. However, there are few reports regarding the use PET-CT for the staging of conjunctival melanoma (CM). We report here a case, a 34-year-old male with a six-month history of a pigmented nodule at the palpebral conjunctiva of the left eye, and a firm left preauricular lymph node detected on physical examination. Biopsy of the ocular lesion confirmed CM, and fine needle aspiration cytology of the preauricular node was positive for malignancy. CT showed three pulmonary nodules. An 18F-FDG PET-CT was performed to restage the patient. The study showed hypermetabolic lesions in the left eye, and in the left preauricular node. The scan was negative for metastasis. These findings were important in guiding management of the disease in this patient. Future prospective studies should further evaluate the role of 18F-FDG PET-CT for the staging of CM.

Advances in the management of conjunctival melanoma

“…PET-CT scanning may be useful in detecting regional lymph nodes and distant metastases, allowing proper staging and treatment. [21, 77] Given the propensity of conjunctival melanoma for brain, liver and lung metastases, baseline liver imaging (CT, MRI, or ultrasound), brain MRI, and chest CT or PET-CT scanning should be considered. [90]…”

“…[34] Adjuvant cryotherapy has been shown to be superior in preventing the tumor recurrence than surgical excision alone. [20, 21, 22, 23, 28] as 52% of patients initially treated with excisional biopsy alone developed a local recurrence, compared to 18% of patient initially treated with excisional biopsy with cryotherapy. [20]…”

Management of conjunctival malignant melanoma: a review and update

“…PET/CT scans, commonly used to detect metastasis in other malignancies may potentially be used for CMM. However, the current literature is sparse, and further studies are required to truly assess their efficacy [142,143]. …”

Can 18F-FDG PET/CT findings be used to predict orbital tumor histology?

“…Therefore, 18 F-FDG PET/CT is now considered a non-invasive imaging tool for regional lymph node assessment. Damian et al have reported their favorable experience with 18 F-FDG PET/CT in the evaluation of local, regional and systemic spread of conjunctival melanomas [33].…”