The role of ultrasound in the evaluation of metastatically involved regional lymph nodes in cutaneous melanoma: Clinical cases

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Objective. To demonstrate, using clinical cases, the diagnostic value and the role of ultrasound in assessing metastatic involvement of superficial regional lymph nodes (LN) in patients with cutaneous melanoma. Materials and Methods. Two clinical cases of patients with cutaneous melanoma and regional lymph nodes metastatic involvement are presented. Results of superficial lymph nodes ultrasound were compared with data of radiological methods (contrast-enhanced CT and SPECT) and verified by histopathological examination of surgical specimens. Results and Discussion. Case No.1 demonstrates the classic ultrasound features of lymph-node malignancy: a polycyclic outer contour, loss of corticomedullary differentiation, and a peripheral type of vascularization. In contrast, Case No. 2 shows poor ultrasound features: a rounded LN shape, focal cortical thickening, and hypoechoic areas with a few vascular loci, which are also indicative of secondary involvement. Conclusion. Ultrasound allows to suspect the secondary metastatic lymph nodes changes by the detection of a set of relevant signs in melanoma patients. It may be used as a first-line diagnostic modality to guide further diagnostic workup and treatment planning in patients with cutaneous melanoma.

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