Laboratory tests and imaging studies in patients with cutaneous malignant melanoma - 09/09/11
Abstract |
Laboratory tests and imaging studies are often ordered for asymptomatic patients with malignant melanomas (MMs) in an effort to detect subclinical metastatic disease. However, their sensitivity and specificity for detecting cryptic metastases are not well established. A review of the literature on laboratory tests and imaging studies for MM metastases was undertaken to address the usefulness of such investigations in asymptomatic patients with MM in AJCC (American Joint Committee on Cancer system of classification) stages I, II, and III. A review of the pertinent literature since 1966 was conducted through MEDLINE, Medica, and Cancerlit. Laboratory tests and imaging studies revealed occult MM metastases in only a small number of the thousands of reported patients with putative AJCC stage I, II, and III MM. However, for those diagnosed with limited metastases, surgical removal with or without immunotherapy, chemotherapy, or radiotherapy can lead to long-term remissions in some patients. For patients with asymptomatic AJCC stage I or II disease, chest roentgenograms (CXR) and blood lactic dehydrogenase (LDH) levels may be obtained at low cost and prove to be of benefit if metastases are identified. For patients with AJCC stage III disease, computed tomographic (CT) scans of the thorax, abdomen, and pelvis (especially when the primary cutaneous site of the melanoma is below the waist) may be considered for detecting metastatic MM. Other tests, such as magnetic resonance imaging (MRI) scans of the brain, may be ordered based on symptoms or physical findings. In the future, technologically improved techniques and newer methods may prove cost-effective for detecting treatable asymptomatic MM metastases. Furthermore, improvement in treatments will also influence the indications for the search for occult MM metastases. At this time there is a need for an international consensus conference on laboratory tests and imaging studies for occult melanoma metastases. (J Am Acad Dermatol 1998;39:451-63.)
Le texte complet de cet article est disponible en PDF.Plan
Supported by The Ronald O. Perelman Department of Dermatology, New York University School of Medicine; the Department of Dermatology, State University of New York at Stony Brook; the Joseph H. Hazen Foundation; the Niarchos Fund of the Skin Cancer Foundation; the Mary and Emanuel Rosenfeld Foundation; and the Kaplan Comprehensive Cancer Center (Cancer Center Support Core Grant No 5P30CA-16087-18). |
|
Reprints are not available from the authors. |
|
0190-9622/98/$5.00 + 0 16/1/91564 |
Vol 39 - N° 3
P. 451-463 - septembre 1998 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?