Melanoma

“Melanoma is a form of skin cancer that develops in cells called melanocytes. They make melanin, the pigment found in the skin.

Although melanoma represents less than 5 percent of the skin cancer cases diagnosed in the United States each year, it results in the most deaths. According to estimates from the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) Program, some 97,610 people will be diagnosed with melanoma in the United States in 2023 and about 7,990 are expected to die from it. The five-year relative survival rate for melanoma is estimated at 93.4 percent.

In addition to melanoma, there are also basal cell and squamous cell forms of skin cancer. Melanoma may also occur in mucous membranes – thin, moist layers of tissue that cover surfaces such as the lips. In addition to melanoma of the skin, this form of cancer can also occur in the eye and is called ocular or uveal melanoma.

When melanoma starts in the skin, the disease is called cutaneous melanoma. Melanoma is more aggressive than basal cell skin cancer or squamous cell skin cancer. Melanoma of the skin can occur anywhere on the body. Unusual moles, exposure to natural sunlight or artificial sunlight (such as from tanning beds) over long periods of time, and health history can affect the risk of melanoma.”

Source: https://www.aacr.org/patients-caregivers/cancer/melanoma/

FDG PET/CT (Melanoma) Treatment Response

FDG PET/CT exam findings Melanoma cancer at two timepoints. Initial staging shows a baseline PET/CT exam with recently diagnosed recurrent/metastatic melanoma involving the left groin and left thigh (arrowed). Restaging PET/CT were performed post immunotherapy (Keytruda) showing resolution of all the

NCCN Comments

“PET/CT scans can help to further characterize lesions found to be indeterminate on CT scan, and can image areas of the body not studied by the routine body CT scans (ie, arms and legs). A systematic review of 17 diagnostic studies documented PET sensitivity ranging from 68% to 87% and specificity ranging from 92% to 98% for stage III and IV melanoma compared to sensitivity ranging from 0% to 67% and specificity ranging from 77% to 100% for stage I and II melanoma. Another large meta-analysis suggested that PET/CT was superior to CT in detecting distant metastases. Other recent studies in patients with stage III or IV melanoma have reported similar results, and indicated that additional information provided by PET/CT may impact treatment decisions in up to 30% of patients, with the greatest impact seen in surgical management.”

Permission Pending from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Melanoma: Cutaneous Version 2.2023 —March 10, 2023. © National Comprehensive Cancer Network, Inc. 2023. All rights reserved. Accessed August 28, 2023 To view the most recent and complete version of the guideline, go online to NCCN.org.

Source: https://www.nccn.org/professionals/physician_gls/pdf/cutaneous_melanoma.pdf (Page MS-9 page 107/231)