E. Alexiev 1, K. Guirov 2, A. Mihova 3, B. Guirova 4, E. Titianova 5,6
1 University Hospital for Active Treatment in Maxillo-Facial Surgery, Medical University – Sofia,
2 Clinic of Vascular Surgery and Angiology,
3 Department of Pathomorphology,
4 Military Medical Detachment for Emargency Response,
5 Clinic of Functional Diagnostics of Nervous System, Military Medical Academy – Sofia,
6 Faculty of Medicine, Sofia University St. Kliment Ohridski – Sofia, Bulgaria

Objective: To demonstrate the diagnostic abilities of multimodal ultrasound imaging and its correlation to clinical, intraoperative, histological and CT imaging in a rare case of facial malignant melanoma.

Materials and Methods: A 39-year-old man with a tumor formation in the left facial half was evaluated preoperatively with clinical, CT and multimodal (2D/3D/4D) ultrasound imaging with B-flow. The data were compared with the intraoperative and histological findings.

Results: The tumor infiltrated the soft tissue of the whole left facial half and was with sandglass-shape. It did not involve the facial bones. CT showed tumor formation with dense structure and weak vascularization. The multimodal ultrasound imaging presented heterogenic structure, part of which was less vascularized, with a distinct capsule and pseudocysts areas. The histological diagnosis was advanced malignant melanoma. A high correlation between ultrasound pattern and tumor histology was established before and after surgery.

Discussion: The multimodal ultrasound imaging is a reliable non-invasive method for facial tumor diagnosis providing additional information for tumor morphology and vascularisation. It could be used for intraoperative navigation to reduce possible perioperative complications.

Key words: facial melanoma, ultrasound imaging.

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