Can a spot on the lung be melanoma if there’s no uptake on scans?

3mm is very small.  PET scans don't have great resolution so can miss small amounts of disease.  PET scans also have a significant false positive AND false negative rate. They are a tool, but they do not diagnose anything for certain.  It is very common to have benign lung nodules.  It seems unlikely to me that a 3mm nodule unchanged since March of 09 is melanoma.  I guess you can't say never, but given how common benign lung nodules are – when something doesn't change in that period of time, I'd be thinking benign.  Doctor's are always having to say "it's possible", but I'd say "not probable" in this instance.

Best wishes,

Janner

3mm is very small.  PET scans don't have great resolution so can miss small amounts of disease.  PET scans also have a significant false positive AND false negative rate. They are a tool, but they do not diagnose anything for certain.  It is very common to have benign lung nodules.  It seems unlikely to me that a 3mm nodule unchanged since March of 09 is melanoma.  I guess you can't say never, but given how common benign lung nodules are – when something doesn't change in that period of time, I'd be thinking benign.  Doctor's are always having to say "it's possible", but I'd say "not probable" in this instance.

Best wishes,

Janner

I had spots on my left lung for several years. I also had PET scans about every 4-5 months. There was no change; hence no worry. In 2008, one of the spots showed very slight growth. I had a needle biopsy and it turned out not to be melanoma but adenocarcinoma (lung cancer). I'm a non smoker. Had upper left lobe of lung removed. No further tretament required. It si important to have the spot measured after each PET scan. It is very small and is probably nothing but that's what I thought. Just watch, get regular scans and measure the spot. Best wishes.

I had spots on my left lung for several years. I also had PET scans about every 4-5 months. There was no change; hence no worry. In 2008, one of the spots showed very slight growth. I had a needle biopsy and it turned out not to be melanoma but adenocarcinoma (lung cancer). I'm a non smoker. Had upper left lobe of lung removed. No further tretament required. It si important to have the spot measured after each PET scan. It is very small and is probably nothing but that's what I thought. Just watch, get regular scans and measure the spot. Best wishes.

Hi Betsey,

Very good points by Janner and TAC.  CAT scans are generally the preferred diagnostic imaging tool for the lungs.  They can barely measure 25mm, so the resolution of the scan is an issue, as is the possiblilty of false positives.  No Doctor – Pulmonologist, Oncologist, or general surgeon – can say what the "spot" is unless a biopsy is performed (most Docs would prefer a slightly more medical sounding term of "nodule").  Geterally, a biopsy would be performed only it the nodules is showing growth AND is over 1cm.  This happened to me, by the way.

So the best course would be to scan at some regular interval, and not assume that the nodule is melanoma.  Of course, it cannot be said that the nodule is NOT melanoma either without a biopsy and testing, but the odds are very low if there is no growth.  Hope that helps.

Best Wishes,

Jim

Hi Betsey,

Very good points by Janner and TAC.  CAT scans are generally the preferred diagnostic imaging tool for the lungs.  They can barely measure 25mm, so the resolution of the scan is an issue, as is the possiblilty of false positives.  No Doctor – Pulmonologist, Oncologist, or general surgeon – can say what the "spot" is unless a biopsy is performed (most Docs would prefer a slightly more medical sounding term of "nodule").  Geterally, a biopsy would be performed only it the nodules is showing growth AND is over 1cm.  This happened to me, by the way.

So the best course would be to scan at some regular interval, and not assume that the nodule is melanoma.  Of course, it cannot be said that the nodule is NOT melanoma either without a biopsy and testing, but the odds are very low if there is no growth.  Hope that helps.

Best Wishes,

Jim

Betsy,

Over a year ago the PET scan lit up a node in my right chest area. When the tumor board looked back it had been there on several scans. They decided it was a false positive.  On my last scan it showed metabolic disease.  A biopsy was done and sure enough it was melanoma.  At the same time I could feel a lump on my arm. It did not show up on the scan. The fna showed to be melanoma.  Another scan done right before the surgery and this time it lit up.  It just wasn't large enough for the PET just 2 months earlier. 

I hope your husbands proves to be nothing. One of the many horrible things about this disease is the hurry up and wait feeling.  Just keep watching and hopefully it will prove to be nothing.

Linda

Stage IV NED 1 month

Betsy,

Over a year ago the PET scan lit up a node in my right chest area. When the tumor board looked back it had been there on several scans. They decided it was a false positive.  On my last scan it showed metabolic disease.  A biopsy was done and sure enough it was melanoma.  At the same time I could feel a lump on my arm. It did not show up on the scan. The fna showed to be melanoma.  Another scan done right before the surgery and this time it lit up.  It just wasn't large enough for the PET just 2 months earlier. 

I hope your husbands proves to be nothing. One of the many horrible things about this disease is the hurry up and wait feeling.  Just keep watching and hopefully it will prove to be nothing.

Linda

Stage IV NED 1 month

Betsy,

I have had a 6mm nodule in my right lung since my very first PET in july of 2008. at one point in mid- 2009 i was told this 6mm spot had grown to 6cm (in just 3 months with no uptake).  after meeting with a cardio-thorasic surgeon and scheduling a surgery date, i requested a chest CT – just to be sure. no biopsy was done due to placement of this spot and an artery – anyways…. CT showed that the spot was NOT growing. it was still 6mm – the reason i was given for the error was "breathing during PET vs. holding breath during CT".

nothing else has ever been done with my lungs and i am just fine. the spot is still there, unchanged, and everytime i get a scan i am told that it "could be" melanoma. however, i feel that because melanoma typically advances rapidly, that i just have a spot in my lungs. i worry about mel everyday, but dont allow myself to obsess about my lungs.

i hope you are able to get the answers you seek… and find peace in the "waiting" part of watch and wait.

DJpayn, IIIc, NED

Betsy,

I have had a 6mm nodule in my right lung since my very first PET in july of 2008. at one point in mid- 2009 i was told this 6mm spot had grown to 6cm (in just 3 months with no uptake).  after meeting with a cardio-thorasic surgeon and scheduling a surgery date, i requested a chest CT – just to be sure. no biopsy was done due to placement of this spot and an artery – anyways…. CT showed that the spot was NOT growing. it was still 6mm – the reason i was given for the error was "breathing during PET vs. holding breath during CT".

nothing else has ever been done with my lungs and i am just fine. the spot is still there, unchanged, and everytime i get a scan i am told that it "could be" melanoma. however, i feel that because melanoma typically advances rapidly, that i just have a spot in my lungs. i worry about mel everyday, but dont allow myself to obsess about my lungs.

i hope you are able to get the answers you seek… and find peace in the "waiting" part of watch and wait.

DJpayn, IIIc, NED