The patient is a 55-year old female with a history of an intermediate thickness melanoma (Clark's level IV) on the left chest wall. The patient has undergone wide resection of the primary melanoma. CT scans of the neck, chest, abdomen and pelvis were interpreted as normal. The patient presented for staging by PET scan.

The PET scan demonstrated hypermetabolic foci within the left chest wall, right upper lateral thigh, both adrenal glands and the left ventricle (arrows).

Biopsy and echocanliography confirmed PET findings. The patient was begun on aggressive Interferon and Interleukin therapy for one year.

Melanoma has the highest glycolytic rate of any neoplasm in humans and has the ability to metastasize to any tissue.

In this patient, whole body PET scanning demonstrated unsuspected hypermetabolic melanoma metastases leading to early implementation of therapy.