Author/Editor		Brountzos, Elias; Panagiotou, Irene; Bafaloukos, Dimitrios; Kelekis, Dimitrios
Title		Bone metastases from malignant melanoma: a retrospective review and analysis of 28 cases
Translated title		Zasevki malignega melanoma v kosteh. Retrospektivni pregled in analiza 28 primerov
Type		članek
Source		Radiol Oncol
Vol. and No.		Letnik 35, št. 3
Publication year		2001
Volume		str. 209-14
Language		eng
Abstract		Background. The aim of the study was to evaluate the clinical characteristics, the radiological findings, and the treatment effect on the patients with bone metastases from malignant melanoma. Patients and methods. Retrospective review of 293 stage IV melanoma patients during a 15-year period was made. Results. Twenty-eight patients (9.5%) with bone metastases were identified; all patients had a thick or intermediate primary melanoma (Breslow 2.7-9.9). Most of the patients presented with multiple (95.6%, symptomatic (92.60 skeletal lesions. Imaging depicted 90 bone lesions. Axial metastases were more common (86%); 54% of them were located at the spine. Skeletal radionuclide scintigraphy was non-specific; radiographic and computed tomography was diagnostic. Typical bone metastases were osteolytic (92.5%). Sixty-six lesions were treated with radiotherapy; in 79% there was a palliative response. There was no correlation between total dose or fraction size and effective palliation. The skeletal lesions did not respond to concurrent chemotherapy and/or biphosphonates. Median response duration to treatment was estimated to 2.6 months and median survival to 4.7 months. Conclusions. Osseous metastases from malignant melanoma occur in the patients with more advanced primary lesions. They are most frequently osteolytic and located in the axial skeleton. Radiographij and computed tomography is diagnostic. Radiotherapy still remains the treatment of choice.
Summary		Izhodišča. Študijo smo izvedli z namenom, da bi ocenili klinične značilnosti, radiološke izvide in učinke zdravljenja bolnikov z zasevki malignega melanoma v kosteh. Bolniki in metode. V 15-letnem obdobju smo retrospektivno pregledali 293 bolnikov z melanomom stadij IV. Rezultati. Med pregledanimi primeri smo zasledili 28 bolnikov (9,5%) z zasevki na kosteh. Pri večffni bolnikov je bil primarni melanom z veliko ali srednje veliko globinsko invazijo (Breslow 2.7-9.9), kostni zasevki so bili večinoma multipli (95,6%) in simptomatski (92,6). S slikovno diagnostiko smo odkrili 90 zasevkov v kosteh. Bolj pogosti so bili zasevki v aksialnem skeletu (86%), kar 54% smo jih odkrili na hrbtenici. Radionuklidna scintigrafija skeleta ni bila dovolj značilna, da bi lahko z njo diagnosticirali zasevke melanoma v kosteh, tako smo naredili tudi rentgensko slikanje in računalniško tomografijo kosti. Najbolj tipični zasevki v kosteh so bili osteolitični (92,5%). Z radioterapijo je bilo zdravljenih 66 zasevkov; paliativen učinek smo dosegli pri 79%. Med velikostjo celokupne doze ali doze na frakcijo obsevanja ter paliativnim učinkom nismo našli korelacije. Če smo bolnike ob obsevanju zdravili tudi s kemoterapijo in/ali z bifosfonati, nismo dobili večjega učinka zdravljenja. Srednji odgovor na zdravljenje je bil 2,6 meseca, srednje preživetje pa 4,7 meseca. Zaključki. Zasevki malignega melanoma v kosteh se najpogosteje pojavljajo pri bolnikih z lokalno napredovalimi primarnimi tumorji. Največkrat so zasevki osteolitični in se najraje zasejejo v aksialni skelet. Diagnozo potrdimo z rentgensko preiskavo in računalniško tomografijo, najbolj priporočljivo zdravljenje pa je radioterapija.
Descriptors		MELANOMA BONE NEOPLASMS NEOPLASM STAGING NEOPLASM METASTASIS SURVIVAL RATE PALLIATIVE CARE TOMOGRAPHY, X-RAY COMPUTED