CTICasesMetastatic Melanoma of the Lung from Unknown Primary
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Imaging findings
A large, right apical, heterogeneously enhancing mass is noted, exhibiting a cervical-thoracic sign that suggests a posterior mediastinal or extrapleural origin. Subtle calcifications are present. Despite initial consideration of a nerve sheath tumor, biopsy confirmed metastatic melanoma from an unknown primary, with high attenuation areas potentially representing hemorrhage.
Key takeaways
Melanoma can metastasize to the lung and present as a solitary mass, even in the absence of a known primary cutaneous lesion. The imaging characteristics, including heterogeneous enhancement, calcification, and hemorrhage, can be non-specific. Biopsy is essential for diagnosis, as metastatic melanoma from an unknown primary is a recognized but challenging clinical entity.
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