Two synchronous lung metastases from malignant melanoma: the same patient but different morphological patterns

Abstract

Malignant melanoma is an aggressive cancer with a high metastatic potential. Among the multiple sites of metastatic disease, the lung is one of the most frequently involved sites. Typically, pulmonary metastases from malignant melanoma occur as solid nodules. Rarely, pulmonary involvement in metastatic melanoma occurs as subsolid nodules. The present article describes an unusual case of a patient with malignant melanoma that developed two synchronous pulmonary metastases with two different densities on CT images (one solid and the other subsolid) and different morphological patterns on histologic images. The radiologic-pathologic correlation of these two patterns of presentation was also reported.

Pulmonary metastases from malignant epithelioid schwannoma of the arm presenting as fast-growing subsolid nodules: Report of an unusual case

“…Based on these published data and previous articles, the SSN appearance of pulmonary metastases is most frequently observed in patients with malignant melanoma [[5], [6], [7], [8], [9]]. Infrequently, this presentation pattern may be observed in pulmonary metastases from spindle cell carcinoma of the kidney [20], cholangiocarcinoma [21], prostate cancer [22], choriocarcinoma and angiosarcoma [23].…”

“…In a literature search of the PubMed database for publications from the past 15 years using the key words metastasis/metastatic and SSN/ground-glass nodule, we identified eight English-language case reports in which pulmonary metastases presenting as SSNs were described (Table 1) [[5], [6], [7], [8], [9],[20], [21], [22]].…”

“…Infrequently, this presentation pattern may be observed in pulmonary metastases from spindle cell carcinoma of the kidney [20], cholangiocarcinoma [21], prostate cancer [22], choriocarcinoma and angiosarcoma [23]. While in choriocarcinoma and angiosarcoma SSN appearance is due to the fragility of the metastatic neovascular tissue [23], the SSN appearance of the pulmonary metastases from melanoma, spindle cell carcinoma, cholangiocarcinoma and prostate cancer reflects the partial effacement of the alveolar architecture by the neoplastic tissue [[5], [6], [7], [8], [9],[20], [21], [22]].…”

“…This type of lesion may remain stable for years or show heterogeneous growth patterns with a trend toward a progressive increase in size over time [[1], [2], [3]]. More rarely, malignant SSNs may be the manifestation of primitive pulmonary lymphomas [4] or metastases from extrapulmonary malignancies, most often from malignant melanoma [[5], [6], [7], [8], [9]].…”

What’s New on Quantitative CT Analysis as a Tool to Predict Growth in Persistent Pulmonary Subsolid Nodules? A Literature Review

“…Malignant SSNs usually represent the histologic spectrum of pulmonary adenocarcinoma with lepidic growth pattern, including pre-invasive (adenocarcinoma in situ) and invasive lesions (minimally invasive and lepidic-predominant adenocarcinoma) [16]. Very rarely, malignant SSNs may be the manifestation of primitive pulmonary lymphomas [17] and pulmonary metastases from extrapulmonary malignancies [18,19].…”