Computed tomography for the detection of neck node metastases in melanoma patients.
OBJECTIVE
To assess the value of CT scanning for detection of lymph node metastases in the neck.


METHODS
The appearance and site of the metastases was studied, as well as the sensitivity and specificity of CT.


RESULTS
Nodal metastases did not always show a high contrast uptake and nodal density therefore cannot be used as a criterion for metastasis. Irregular contrast enhancement was seen in seven of the 21 tumour-positive necks. Frequently, metastases in the parotids, superficial nodes in the neck and in the posterior triangle were seen. The sensitivity and specificity of palpation and CT scanning were 87 and 100%, respectively.


CONCLUSIONS
However, because small, clinically occult, melanoma metastases were frequently overlooked on CT, the role of this imaging modality in assessing occult metastases remains limited. Based on recent data from literature it is reasonable to speculate that ultrasound guided fine needle aspiration cytology (FNAC) will prove to be more effective than a non-invasive staging procedure of the neck in melanoma patients.
van den Brekel
M W
MW
Department of Otolaryngology/Head & Neck Surgery, The Netherlands Cancer Institute (Antoni van Leeuwenhoek Huis), Amsterdam, The Netherlands.
Pameijer
F A
FA
Koops
W
W
Hilgers
F J
FJ
Kroon
B B
BB
Balm
A J
AJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging; D008297:Male; D008545:Melanoma / Q000000981:diagnostic imaging* / Q000556:secondary*; D008875:Middle Aged; D009333:Neck / Q000000981:diagnostic imaging*; D012680:Sensitivity and Specificity; D012878:Skin Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D014057:Tomography, X-Ray Computed