Department of Radiology, Royal Marsden Hospital, London, UK.
Department of Medical Oncology, Royal Marsden Hospital, London, UK.
Oral Maxillofac Surg. 2024 Mar;28(1):363-372. doi: 10.1007/s10006-023-01150-w. Epub 2023 Apr 5.
Awareness of head and neck mucosal melanoma (HNMM) is important, as incorrect work-up can impact on the investigation and management of this rare and aggressive cancer. Following on from the 2020 HNMM UK guidelines, we set out the imaging recommendations and their rationale. To illustrate the key imaging characteristics, we also include a case series from our centre.
All HNMM cases managed at our institution from January 2016 to January 2021 were identified, and the available imaging for each patient was reviewed. For each patient, the age, gender and location of primary tumour was recorded together with key staging and diagnostic imaging parameters.
A total of 14 patients were identified. The median age was 65 years with a female to male ratio of 1.33:1. Primary tumours were sinonasal in location in 93% of cases, with 7% of patients having metastatic neck nodes at presentation and 21% of cases having distant metastatic disease at presentation.
This data set is in general concordance with other published series regarding the sinonasal origin of the vast majority of HNMM tumours along with the proportion of patients with metastatic neck nodes and distant metastases at presentation. We recommend dual-modality imaging with computed tomography (CT) and magnetic resonance imaging (MRI) of primary tumours whenever possible. In the systematic staging of HNMM, positron emission tomography (PET)-CT should be strongly considered, together with MRI of the brain. Pre-biopsy imaging of HNMM tumours is advisable whenever possible.
了解头颈部黏膜黑色素瘤（HNMM）很重要，因为不正确的检查可能会影响对这种罕见且侵袭性癌症的调查和管理。继 2020 年英国 HNMM 指南之后，我们提出了影像学建议及其原理。为了说明关键的影像学特征，我们还纳入了来自我们中心的一系列病例。
确定了 2016 年 1 月至 2021 年 1 月在我院管理的所有 HNMM 病例，并对每位患者的可用影像学资料进行了回顾。对于每位患者，记录了原发肿瘤的年龄、性别和部位，以及关键分期和诊断影像学参数。
共确定了 14 例患者。中位年龄为 65 岁，女性与男性的比例为 1.33:1。原发肿瘤位于鼻旁窦的占 93%，有 7%的患者在就诊时存在颈部淋巴结转移，21%的患者在就诊时存在远处转移。
与其他已发表的系列研究相比，本数据集在大多数 HNMM 肿瘤的鼻旁窦起源、就诊时存在颈部淋巴结转移和远处转移的患者比例方面基本一致。我们建议尽可能对原发肿瘤进行 CT 和 MRI 双模态成像。在 HNMM 的系统分期中，强烈考虑 PET-CT 与脑 MRI。建议在可能的情况下对 HNMM 肿瘤进行活检前影像学检查。
