Metastatic melanoma

Case contributed by Dr Henry Knipe

Presentation

Metastatic melanoma

Patient Data

Age: 85
Gender: Female
X-ray

Chest

Multiple pulmonary masses/nodules throughout both lungs.

Cardiomediastinal contour is within normal limits allowing for calcified ectatic descending thoracic aorta. No bony abnormality noted. No free subdiaphragmatic gas.

CT

Chest, Abdomen/Pelvis

1.8 x 1.2cm well-circumscribed, slightly lobulated hypodensity in segment VIII of the liver. Further subcentimetre hypodensities in segments IVb/V and VI. Right adrenal body hypodense (25HU) nodule. Right hydroureteronephrosis with a transition to normal calibre posterior to the pancreatic head and in the region of dilated right ovarian vein. In the region of the ureteric calibre change, there is ovoid soft tissue density within the ureter. Multiple bilateral subcentimetre renal hypodensities. Pancreas, spleen and left adrenal gland have a normal appearance. Sigmoid diverticular disease. Bowel is otherwise unremarkable.

Hyperdense area of bladder wall thickening (up to 1.3cm) on the right. Right adnexal 5.9cm cystic lesion. No inguinal, pelvic or abdominal lymphadenopathy. Atherosclerotic calcification of the aorta and iliac arteries. No suspicious bony lesions.

Case Discussion

This case demonstrates proven melanoma metastases to:

  • lung
  • liver
  • right ureter (likely)

Incidental findings include:

  • left ovarian cyst (possible neoplastic in this age group)
  • simple renal cysts (likely)
  • sigmoid diverticular disease
  • hyperdense bladder wall - may be due to contrast mixing
  • right adrenal lesion (metastases vs. adenoma)
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Case information

rID: 26686
Case created: 3rd Jan 2014
Last edited: 22nd May 2016
Inclusion in quiz mode: Included

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