Hepatic Abnormalities Identified on Abdominal Computed Tomography at Diagnosis of Uveal Melanoma

Objective: To determine the prevalence of hepatic abnormalities identified during abdominal computed tomography (CT) performed within 1 month of the diagnosis of primary uveal melanoma. Methods: Retrospective review of CT reports generated within 1 month following diagnosis of uveal melanoma in 91 patients at Memorial Sloan-Kettering Cancer Center, New York, New York, from 2004 to 2009. Results: Of 198 patients reviewed, 91 (46%) had a CT scan within 1 month of uveal melanoma diagnosis; 1 or more hepatic abnormalities were identified in 50 of these patients (55%). Abnormalities included 38 focal (13 solitary, 25 multiple) and 15 diffuse (11 partial, 4 complete) lesions. Six patients had hepatic lesions suspected to be metastatic melanoma, but this was confirmed in only 3. Lesions suspected to be metastases were more likely multiple than solitary (P=.03). Thirty-nine patients had other lesions, most commonly lesions that were too small to be characterized, a fatty liver, and hepatic cysts. Lesions in 5 of 50 patients with abnormalities could not be classified. Neither the protocol (triphasic vs non-triphasic) nor the center where the scan was performed (Sloan-Kettering vs other) was significantly related to the likelihood of identifying hepatic abnormalities in a given patient (P=.46 and P=.1, respectively). Conclusion: Although hepatic abnormalities were frequently identified in patients who underwent CT within 1 month of uveal melanoma diagnosis, metastatic disease was confirmed only in the setting of multiple lesions in only a minority of patients.