Solitary pulmonary metastatic nodule in a patient with
malignant melanoma.
Pulmonary metastases clinically present as a
Solitary Pulmonary nodule.
Similar to other Solitary Pulmonary nodular lesions, these are detected by routine chest x-rays.
Of
the Solitary Pulmonary nodular lesions, solitary metastases accounts for less than 3% of cases.
Colon, chest,
sarcoma, melanoma and genitourinary malignancies account for 79% of such instances.
Solitary metastatic lesion can precede, follow or appear concomitantly with the
malignancy.
Diagnostic strategy
When it appears concomitantly or following definitive therapy of the primary,
thin needle aspiration of the lesion is probably the best procedure to establish the
nature of the lesion.
CT scans are superior to whole lung tomograms in evaluating the
presence of other occult metastatic lesions.
When the solitary pulmonary metastasis precedes clinical recognition of the
primary, standard management of the Solitary Pulmonary nodular lesion should follow.
This clinical presentation
accounts for less than 1% and routine search for primary is not recommended.
Treatment
Surgical resection of single metastasis should be considered
when the primary
tumor is resectable.
No other organ metastasis is evident
and no effective alternate
therapy is available
Surgical resection of solitary lung lesions occurring a few years
following curative resection of primary have a better prognosis than the lesions that
manifest concomitantly with the primary tumor.