Navigating the Rare: ¹⁸F FDG PET/CT Reveals Uterine Metastasis from Cutaneous Melanoma

Metastatic melanoma is the most life-threatening skin cancer due to its significant tendency to metastasize and its substantial resistance to therapeutic interventions. Melanomas spread aggressively, particularly to lymph nodes, the brain, and lungs, and can also involve the adrenal gland, liver, bones, and small intestine. Metastasis to the endometrium is exceedingly rare, with only a handful of documented cases. Fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) is an excellent modality for detecting metastases. A meta-analysis showed that PET/CT has superior diagnostic performance, with 88% sensitivity and 94% specificity, compared to other contemporary imaging techniques. We present a 55-year-old postmenopausal female, diagnosed with primary cutaneous melanoma of the right foot and initially treated with temozolomide. After 2 years, she presented with vaginal bleeding. Restaging with ¹⁸F FDG PET/CT revealed multiple nodal metastases with chest and abdominal wall deposits and confirmed uterine metastases.