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CC BY 4.0 · World J Nucl Med 2023; 22(03): 244-247
DOI: 10.1055/s-0043-1771280
Case Report

Role of 18F-FDG PET-CT in Urethral Malignant Melanoma and Analysis of the UK Guidelines on Ano-uro-genital Melanomas

Abhishek Mahato 
1   Department of Nuclear Medicine, Command Hospital, Lucknow, Uttar Pradesh, India
,
Anurag Jain
1   Department of Nuclear Medicine, Command Hospital, Lucknow, Uttar Pradesh, India
,
M.G. Manoj
2   Department of Pathology, Command Hospital, Lucknow, Uttar Pradesh, India
,
Richa Joshi
3   Department of Oncosurgery, Command Hospital, Lucknow, Uttar Pradesh, India
› Author Affiliations Funding None.
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Abstract

Urethral melanomas are a rare subtype of noncutaneous melanomas. The disease has a tendency to have skip lesions and early metastases as compared with cutaneous melanomas. The role of fluorine-18 fluorodeoxyglucose (18F-FDG) positron emission tomography computed tomography (PET-CT) is well established in cases of cutaneous melanomas and is recommended by the National Comprehensive Cancer Network (NCCN) for stage IIB to IV cancer. There are no established guidelines on the management of noncutaneous melanomas; however, a recently published United Kingdom national guideline aims to streamline the management of ano-uro-genital melanomas. The guideline describes a very limited role in the use of 18F-FDG PET-CT in this case scenario. The tendency to skip lesions, early metastases, involvement of brain parenchyma, and finally the usage of anti-PD-1 medications are key areas where 18F-FDG PET-CT has shown superiority over CT scan. With this case report, we aim to highlight the strength of 18F-FDG PET-CT in the management of urethral melanomas, which can be extrapolated to other ano-uro-genital melanomas.

Keywords

ano-uro-genital melanoma - FDG PET-CT - mucosal melanoma - UK guidelines - urethral melanoma


Publication History

Article published online:
06 September 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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  • References

  • 1 Murphy G, Hussey D, Metser U. Non-cutaneous melanoma: is there a role for (18)F-FDG PET-CT?. Br J Radiol 2014; 87 (1040): 20140324
    CrossrefPubMedGoogle Scholar
  • 2 Reinhardt MJ, Joe AY, Jaeger U. et al. Diagnostic performance of whole body dual modality 18F-FDG PET/CT imaging for N- and M-staging of malignant melanoma: experience with 250 consecutive patients. J Clin Oncol 2006; 24 (07) 1178-1187
    CrossrefPubMedGoogle Scholar
  • 3 Subesinghe M, Marples M, Scarsbrook AF, Smith JT. Clinical impact of (18)F-FDG PET-CT in recurrent stage III/IV melanoma: a tertiary centre Specialist Skin Cancer Multidisciplinary Team (SSMDT) experience. Insights Imaging 2013; 4 (05) 701-709
    CrossrefPubMedGoogle Scholar
  • 4 Patrick RJ, Fenske NA, Messina JL. Primary mucosal melanoma. J Am Acad Dermatol 2007; 56 (05) 828-834
    CrossrefPubMedGoogle Scholar
  • 5 Piura B. Management of primary melanoma of the female urogenital tract. Lancet Oncol 2008; 9 (10) 973-981
    CrossrefPubMedGoogle Scholar
  • 6 Gupta R, Bhatti SS, Dinda AK, Singh MK. Primary melanoma of the urethra: a rare neoplasm of the urinary tract. Int Urol Nephrol 2007; 39 (03) 833-836
    CrossrefPubMedGoogle Scholar
  • 7 Oliva E, Quinn TR, Amin MB. et al. Primary malignant melanoma of the urethra: a clinicopathologic analysis of 15 cases. Am J Surg Pathol 2000; 24 (06) 785-796
    CrossrefPubMedGoogle Scholar
  • 8 DiMarco DS, DiMarco CS, Zincke H. et al. Outcome of surgical treatment for primary malignant melanoma of the female urethra. J Urol 2004; 171 (2, Pt 1): 765-767
    CrossrefPubMedGoogle Scholar
  • 9 Watanabe K, Hasegawa G, Kashima K, Sato Y, Hara N, Nishiyama T. Primary malignant melanoma of the female urethra: a case report. Urol Case Rep 2020; 34: 101493
    CrossrefPubMedGoogle Scholar
  • 10 Safadi A, Schwalb S, Ben-Shachar I, Katz R. Primary malignant urethral melanoma resembling a urethral caruncle. Urol Case Rep 2017; 15: 28-29
    CrossrefPubMedGoogle Scholar
  • 11 Comploj E, Palermo S, Trenti E. et al. Unexpected long survival in primary malignant melanoma of the male urethra. Case Rep Dermatol 2009; 1 (01) 93-99
    CrossrefPubMedGoogle Scholar
  • 12 Smith HG, Bagwan I, Board RE. et al. Ano-uro-genital mucosal melanoma UK national guidelines. Eur J Cancer 2020; 135: 22-30
    CrossrefPubMedGoogle Scholar
  • 13 El-Safadi S, Estel R, Mayser P, Muenstedt K. Primary malignant melanoma of the urethra: a systematic analysis of the current literature. Arch Gynecol Obstet 2014; 289 (05) 935-943
    CrossrefPubMedGoogle Scholar
  • 14 Acikalin A, Bagir E, Karim S, Bisgin A, Izol V, Erdogan S. Primary melanoma of the urinary tract; clinicopathologic and molecular review of a case series. Pathol Res Pract 2020; 216 (09) 153095
    CrossrefPubMedGoogle Scholar
  • 15 Kaunitz GJ, Cottrell TR, Lilo M. et al. Melanoma subtypes demonstrate distinct PD-L1 expression profiles. Lab Invest 2017; 97 (09) 1063-1071
    CrossrefPubMedGoogle Scholar
  • 16 Hou JY, Baptiste C, Hombalegowda RB. et al. Vulvar and vaginal melanoma: a unique subclass of mucosal melanoma based on a comprehensive molecular analysis of 51 cases compared with 2253 cases of nongynecologic melanoma. Cancer 2017; 123 (08) 1333-1344
    CrossrefPubMedGoogle Scholar
  • 17 Guo J, Si L, Kong Y. et al. Phase II, open-label, single-arm trial of imatinib mesylate in patients with metastatic melanoma harboring c-Kit mutation or amplification. J Clin Oncol 2011; 29 (21) 2904-2909
    CrossrefPubMedGoogle Scholar
  • 18 Sachpekidis C, Kopp-Schneider A, Pan L. et al. Interim [18F]FDG PET/CT can predict response to anti-PD-1 treatment in metastatic melanoma. Eur J Nucl Med Mol Imaging 2021; 48 (06) 1932-1943
    CrossrefPubMedGoogle Scholar