皮肤外黑色素瘤：放射科医生入门指南。
Extracutaneous melanomas: a primer for the radiologist.
作者信息
Keraliya Abhishek R, Krajewski Katherine M, Braschi-Amirfarzan Marta, Tirumani Sree Harsha, Shinagare Atul B, Jagannathan Jyothi P, Ramaiya Nikhil H
机构信息
Department of Imaging, Dana Farber Cancer Institute, Harvard Medical School, 450 Brookline Avenue, Boston, MA 02215 and Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA.
出版信息
Insights Imaging. 2015 Dec;6(6):707-17. doi: 10.1007/s13244-015-0427-8. Epub 2015 Sep 3.
OBJECTIVE
The purpose of this article is to provide a comprehensive review of the imaging features of extracutaneous melanomas.
CONCLUSION
Extracutaneous melanomas are clinically and biologically distinct from their more common cutaneous counterpart with higher frequency of metastatic disease and poorer overall prognosis. Complete surgical excision is the treatment of choice whenever possible; systemic therapy in the form of conventional chemotherapeutic agents as well as novel targeted agents is used for advanced/ metastatic disease. Multiple imaging modalities including US, CT, MRI and FDG-PET/CT play important roles in the evaluation of the primary tumour, assessment of metastatic disease and monitoring response to treatment. Radiologists should be aware of the typical imaging manifestations of extracutaneous melanoma, the distinct patterns of metastatic involvement as well as treatment response and toxicities associated with newer molecular targeted and immunotherapies to optimally contribute to patient management.
TEACHING POINTS
• Mucosal melanoma is clinically and biologically distinct from cutaneous melanoma. • Mucosal melanoma has a higher rate of metastatic disease than the cutaneous subtype. • Imaging is helpful in assessment of disease and response to treatment.
目的
本文旨在全面综述皮肤外黑色素瘤的影像学特征。
结论
皮肤外黑色素瘤在临床和生物学特性上与其更常见的皮肤黑色素瘤不同，其转移疾病发生率更高，总体预后更差。只要有可能，完整手术切除是首选治疗方法；对于晚期/转移性疾病，采用传统化疗药物以及新型靶向药物进行全身治疗。包括超声（US）、计算机断层扫描（CT）、磁共振成像（MRI）和氟代脱氧葡萄糖正电子发射断层显像/X线计算机体层成像（FDG-PET/CT）在内的多种成像方式在原发性肿瘤评估、转移疾病评估及治疗反应监测中发挥重要作用。放射科医生应了解皮肤外黑色素瘤的典型影像学表现、转移累及的不同模式以及与更新的分子靶向和免疫疗法相关的治疗反应及毒性，以最佳方式助力患者管理。
教学要点
• 黏膜黑色素瘤在临床和生物学特性上与皮肤黑色素瘤不同。• 黏膜黑色素瘤的转移疾病发生率高于皮肤亚型。• 影像学有助于疾病评估及治疗反应评估。
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