MALIGNANT-MELANOMA - IMPACT OF SUPERFICIAL US ON MANAGEMENT

PURPOSE: To evaluate the impact of superficial ultrasonography (US) on clinical management of melanoma. MATERIALS AND METHODS: Superficial U S in areas at high risk for local recurrence or nodal metastases was p erformed in 33 patients with cutaneous melanoma. Impact categories wer e assigned to each US study (n = 55): category 3, US added information that altered clinical management; category 2, US added information th at did not change management; category 1, no added information and man agement unchanged; category 0, not helpful or was misleading. RESULTS: Twenty-two US studies (40%) were category 3: detection of nonpalpable metastases altered surgical therapy (n = 2), demonstration of pharmac odynamic response to chemotherapy (n = 5), and determination of benign ancy or malignancy (n = 15). Nine (16%) were category 2: identificatio n of nonpalpable metastases did not alter management. Twenty-two (40%) were category 1: supported clinical impression of no metastases (n = 18) or helped confirm cutaneous, subcutaneous, or nodal metastases (n = 4). Two (4%) were category 0: missed proved metastases. CONCLUSION: Superficial US affected management of melanoma by allowing detection a nd characterization of masses, guidance of biopsy, and assessment of p harmacodynamic response.