Melanoma

HISTORY: Known melanoma, rule out metastasis.

 

FINDINGS: Images 1-3 are scans of the liver demonstrating multiple

hypoechoic lesions.  Notice in Image 1 the target appearance of the

lesions.  Note in Image 2 there is slight distal enhanced through-sound

transmission from the metastasis.  Images 4 and 5 are high-resolution

linear array scans of the right axilla demonstrating enlarged axillary

lymph nodes.

DIAGNOSIS: Metastatic melanoma to the liver and axillary lymph nodes.

DISCUSSION: Sonography clearly identified hepatic and axillary nodal

metastases in this patient.  Because of widespread involvement

(adrenals, GI tract, etc.), CT is the imaging method of choice to

evaluate for abdominal metastasis from melanoma.  The target appearance

(as noted in Image 1) in this case is non-specific and can be seen with

metastatic adenocarcinoma and fungal microabscesses.  Enhanced through-

sound transmission is not uncommon with metastatic melanoma as

demonstrated on Image 2.