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CLINICAL IMAGE
Year : 2013  |  Volume : 138  |  Issue : 3  |  Page : 370

Patellar metastasis of melanoma


Institute of Oncology, University of Istanbul Capa, 34390, Istanbul, Turkey

Date of Web Publication8-Oct-2013

Correspondence Address:
Faruk Tas
Institute of Oncology, University of Istanbul Capa, 34390, Istanbul
Turkey
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Source of Support: None, Conflict of Interest: None


PMID: 24135186

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How to cite this article:
Tas F, Keskin S. Patellar metastasis of melanoma. Indian J Med Res 2013;138:370

How to cite this URL:
Tas F, Keskin S. Patellar metastasis of melanoma. Indian J Med Res [serial online] 2013 [cited 2020 Feb 18];138:370. Available from: http://www.ijmr.org.in/text.asp?2013/138/3/370/119382

A 52-year old woman with histologically diagnosed melanoma presented to the Institute of Oncology, University of Istanbul, Turkey, for further management in June 2010. The patient had a history of a melanoma on her back, and had undergone wide excision of lesion followed by lymphadenectomy. Her disease stage was Stage III. PET/CT scan was performed to investigate metastatic areas. Increased 18 F-fluorodeoxyglucose accumulation in the posterior of patella was observed with SUVmax (standardized uptake rate) value 14.6 [Figure 1]. Diagnosis of melanoma metastasis to patella was confirmed by histologically. The patient was treated with single-agent temozolomide chemotherapy. No response to chemotherapy was found and she died due to progressive disease after 15 months. Primary intra-osseous lesions of the patella are rare [1] and account for 0.12 per cent of all primary bone tumours. Amongst the reported malignant lesions, haemangioendothelioma, lymphoma, osteosarcoma and metastasis are the most common tumours [1] . Metastasis to the patella is extremely rare in comparison with primary tumours of the patella because it has a relatively poor blood supply, consisting of a few nutrient branches from the collateral vessels of the knee [2] . Melanoma is well known for its ability to metastasize to virtually any organ or tissue, including some sites rarely seen with other solid tumours [3] . Similar to rare metastases to the heart, adrenal glands, pancreas, and kidneys, metastasis to patella was earlier detected infrequently (<1%), although these are now identified with much greater frequency with the use of CT scans and PET. In the literature, only a single case report was found [4] except our presentation.
Figure 1: A nodular lesion of soft tissue density on posterior of patella with high FDG uptake in PET images (arrow).

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   References Top

1.Singh J, James SL, Kroon HM, Woertler K, Anderson SE, Jundt G, et al. Tumour and tumour-like lesions of the patella - a multicentre experience. Eur Radiol 2009; 19 : 701-12.  Back to cited text no. 1
    
2.Lim CT, Wong AS, Chuah BY, Putti TC, Stanley AJ, Nathan SS. The patella as an unusual site of renal cell carcinoma metastasis. Singapore Med J 2007; 48 : e314-e9.  Back to cited text no. 2
    
3.Atkins MB, Hauschild A, Wahl RL, Balch CM. Diagnosis of Stage IV melanoma. In: Balch CM, Houghton AN, Sober AJ, Soong SJ, Atkins MB, Thompson JF, editors. Cutaneous melanoma, 5 th ed. St. Louis, Missouri, USA: Quality Medical Publishing, Inc.; 2009. p. 573-602.  Back to cited text no. 3
    
4.Jaeger HJ, Kruegener GH, Donovan AG. Patellar metastasis from a malignant melanoma. Int Orthop 1992; 16 : 282-4.  Back to cited text no. 4
    


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