FDG PET for mucosal malignant melanoma of the head and neck

Objectives/Hypothesis: To evaluate imaging findings using positron emission tomography (PET) and 18F-fluorodeoxyglucose (FDG) in mucosal malignant melanoma (MMM) of the head and neck. Study Design: Retrospective evaluation. Methods: Eighteen PET examinations were performed for initial staging and/or follow-up in 10 patients with MMM. Medical records of 6 male and 4 female patients (age range, 43-81 y, mean, 67 y) were reviewed retrospectively with regard to the patients' history, symptoms, and clinical course. Primary melanoma elsewhere in the body was excluded at the time of diagnosis. Results: All MMM were visible in staging PET examinations, but FDG uptake depended on lesion size and anatomic site. Big lesions with a nodular growth, as seen in pathologic specimens, were better visible compared with lesions with a more superficial spread within the mucous membranes. Lesions in the anterior part of the nasal cavity were more difficult to detect than those in the posterior sinonasal complex because of possible interference with nonspecific uptake in muscles of the mouth and pronounced appearance of the skin when imaging was performed using filtered back projection without attenuation correction. Conclusion: We found that MMM of the head and neck can be visualized using FDG PET. Furthermore, locoregional and distant metastases can be evaluated much like those of cutaneous malignant melanoma. Therefore, PET may be suitable for the staging and/or restaging of these patients. Further studies have to elucidate the potential role of FDG PET in patient management.