Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
European Radiology
Published in: European Radiology 6/2016

01-06-2016 | Oncology

Metastatic patterns and metastatic sites in mucosal melanoma: a retrospective study

Authors: Gerd Grözinger, Steven Mann, Tarun Mehra, Bernhard Klumpp, Ulrich Grosse, Konstantin Nikolaou, Claus Garbe, Stephan Clasen

Published in: European Radiology | Issue 6/2016

Login to get access

Abstract

Objectives

Melanomas arising from mucosa are rare and associated with a poor prognosis. This study aims to provide an analysis of metastatic pathways, time intervals, factors influencing metastatic spread and organs for distant metastases.

Methods

A total of 116 patients with mucosal melanomas of different sites were included. The mean follow-up interval was 47 ± 52 months. Patients were assigned to two different metastatic pathways, either presenting loco-regional lymph node metastases as first spread or direct distant metastases. The distribution of distant metastases was assessed.

Results

Twenty-six patients presented with a pre-existing metastatic spread and were not assigned to pathways. Of the included patients, 44 developed metastases after treatment of the primary tumour; 25 patients directly developed distant metastases; 16 patients developed regional lymph node metastases prior to distant metastases. Location of the primary tumour in the upper airway or GI tract and advanced T stage were significant risk factors of direct distant metastases. Distant metastases are mainly located in the lung, the liver and non-regional lymph nodes.

Conclusions

Mucosal melanomas show a high rate of direct distant metastases rather than regional lymph node metastases. Thus the follow-up should always include a whole-body cross-sectional imaging in high-risk tumours.

Key points

• Mucosal melanomas show a high rate of direct distant metastases.
• T stage and primary location are predictors for direct distant metastases.
• Distant metastases were mainly found in lung, liver and lymph nodes.
• Follow-up of a high-risk mucosal melanoma should include whole-body imaging.
Appendix
Available only for authorised users
Literature
1.
Chang AE, Karnell LH, Menck HR (1998) The National Cancer Data Base report on cutaneous and noncutaneous melanoma: a summary of 84,836 cases from the past decade. The American College of Surgeons Commission on Cancer and the American Cancer Society. Cancer 83(8):1664–1678CrossRefPubMed
2.
Broomhall C (1967) Malignant melanoma of the oral cavity in Ugandan Africans. Br J Surg 54(7):581–584CrossRefPubMed
3.
Takagi M, Ishikawa G, Mori W (1974) Primary malignant melanoma of the oral cavity in Japan. With special reference to mucosal melanosis. Cancer 34(2):358–370CrossRefPubMed
4.
Gallagher RP, Lee TK, Bajdik CD, Borugian M (2010) Ultraviolet radiation. Chron Dis Can 29(Suppl 1):51–68
5.
6.
Zak FG, Lawson W (1974) The presence of melanocytes in the nasal cavity. Ann Otol Rhinol Laryngol 83(4):515–519PubMed
7.
8.
Curtin JA, Fridlyand J, Kageshita T, Patel HN, Busam KJ, Kutzner H, Cho KH, Aiba S, Brocker EB, LeBoit PE et al (2005) Distinct sets of genetic alterations in melanoma. N Engl J Med 353(20):2135–2147CrossRefPubMed
9.
Curtin JA, Busam K, Pinkel D, Bastian BC (2006) Somatic activation of KIT in distinct subtypes of melanoma. J Clin Oncol 24(26):4340–4346CrossRefPubMed
10.
Mihajlovic M, Vlajkovic S, Jovanovic P, Stefanovic V (2012) Primary mucosal melanomas: a comprehensive review. Int J Clin Exp Pathol 5(8):739–753PubMedPubMedCentral
11.
12.
13.
Alvarado GC, Papadopoulos NE, Hwu WJ, Bedikian AY, Homsi J, Myers JN, Bronstein Y, Bassett RL, Hwu P, Kim KB (2011) Pelvic computed tomography scans for surveillance in patients with primary melanoma in the head and neck. Melanoma Res 21(2):127–130CrossRefPubMed
14.
van Geel AN, den Bakker MA, Kirkels W, Horenblas S, Kroon BB, de Wilt JH, Eggermont AM, Mooi WJ, van der Aa MN (2007) Prognosis of primary mucosal penile melanoma: a series of 19 Dutch patients and 47 patients from the literature. Urology 70(1):143–147CrossRefPubMed
15.
Clark WH Jr, From L, Bernardino EA, Mihm MC (1969) The histogenesis and biologic behavior of primary human malignant melanomas of the skin. Cancer Res 29(3):705–727PubMed
16.
Balch CM, Gershenwald JE, Soong SJ, Thompson JF, Atkins MB, Byrd DR, Buzaid AC, Cochran AJ, Coit DG, Ding S et al (2009) Final version of 2009 AJCC melanoma staging and classification. J Clin Oncol 27(36):6199–6206CrossRefPubMedPubMedCentral
17.
Scrucca L, Santucci A, Aversa F (2007) Competing risk analysis using R: an easy guide for clinicians. Bone Marrow Transplant 40(4):381–387CrossRefPubMed
18.
Kim HS, Kim EK, Jun HJ, Oh SY, Park KW, Lim do H, Lee SI, Kim JH, Kim KM, Lee DH et al (2010) Noncutaneous malignant melanoma: a prognostic model from a retrospective multicenter study. BMC Cancer 10:167CrossRefPubMedPubMedCentral
19.
O'Regan K, Breen M, Ramaiya N, Jagannathan J, DiPiro PJ, Hodi FS, Van den Abbeele AD (2013) Metastatic mucosal melanoma: imaging patterns of metastasis and recurrence. Cancer Imaging 13(4):626–632CrossRefPubMedPubMedCentral
20.
Tas F, Keskin S, Karadeniz A, Dagoglu N, Sen F, Kilic L, Yildiz I (2011) Noncutaneous melanoma have distinct features from each other and cutaneous melanoma. Oncology 81(5–6):353–358CrossRefPubMed
21.
Meier F, Will S, Ellwanger U, Schlagenhauff B, Schittek B, Rassner G, Garbe C (2002) Metastatic pathways and time courses in the orderly progression of cutaneous melanoma. Br J Dermatol 147(1):62–70CrossRefPubMed
22.
Leiter U, Meier F, Schittek B, Garbe C (2004) The natural course of cutaneous melanoma. J Surg Oncol 86(4):172–178CrossRefPubMed
23.
Tas F, Keskin S (2013) Mucosal melanoma in the head and neck region: different clinical features and same outcome to cutaneous melanoma. ISRN Dermatol 586915
24.
Tas F (2012) Metastatic behavior in melanoma: timing, pattern, survival, and influencing factors. J Oncol 647684
25.
Francken AB, Accortt NA, Shaw HM, Wiener M, Soong SJ, Hoekstra HJ, Thompson JF (2008) Prognosis and determinants of outcome following locoregional or distant recurrence in patients with cutaneous melanoma. Ann Surg Oncol 15(5):1476–1484CrossRefPubMed
26.
Patel JK, Didolkar MS, Pickren JW, Moore RH (1978) Metastatic pattern of malignant melanoma. A study of 216 autopsy cases. Am J Surg 135(6):807–810CrossRefPubMed
Metadata
Title
Metastatic patterns and metastatic sites in mucosal melanoma: a retrospective study
Authors
Gerd Grözinger
Steven Mann
Tarun Mehra
Bernhard Klumpp
Ulrich Grosse
Konstantin Nikolaou
Claus Garbe
Stephan Clasen
Publication date
01-06-2016
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 6/2016
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-015-3992-9

Other articles of this Issue 6/2016

European Radiology 6/2016 Go to the issue

Chest

Prognostic impact of nomogram based on whole tumour size, tumour disappearance ratio on CT and SUVmax on PET in lung adenocarcinoma

Cardiac

Late gadolinium enhancement cardiac imaging on a 3T scanner with parallel RF transmission technique: prospective comparison of 3D-PSIR and 3D-IR

Neuro

Brain herniations into the dural venous sinus or calvarium: MRI findings, possible causes and clinical significance

Breast

Contrast-enhanced dual energy mammography with a novel anode/filter combination and artifact reduction: a feasibility study

Oncology

Comparison of contrast-enhanced modified T1-weighted 3D TSE black-blood and 3D MP-RAGE sequences for the detection of cerebral metastases and brain tumours

Magnetic Resonance

Accelerated magnetic resonance diffusion tensor imaging of the median nerve using simultaneous multi-slice echo planar imaging with blipped CAIPIRINHA