The Tail and the String Sign: New Sonographic Features of Subcutaneous Melanoma Metastasis

Antonio Corvino, Fabio Corvino, Orlando Catalano, Fabio Sandomenico, Antonella Petrillo

Research output: Contribution to journalArticlepeer-review


No highly specific sonographic imaging findings to evaluate melanoma spread along the lymphatic vessels have ever been described. Between January 2009 and December 2012, a consecutive group of 531 melanoma patients at their initial stage or during follow-up for nodal or extra-nodal superficial metastasis were evaluated retrospectively to assess the presence of two sonographic findings demonstrating superficial lymphatic metastasis: a “tail” sign (a thin hypoechoic prolongation from one or both poles of a superficial metastasis) and a “string” sign (multiple in-transit lesions connected to each other in a rosary image). The total number of superficial metastatic lesions was 222. The tail sign was seen in 13 of the 222 lesions (5.9%). The string sign was detected in four patients (4.5%). These signs showed a low sensitivity with a very high specificity (100%). Tail and string signs may represent an additional finding of high specificity to be employed in the differential diagnosis of melanoma patients.

Original languageEnglish
Pages (from-to)370-374
Number of pages5
JournalUltrasound in Medicine and Biology
Issue number1
Publication statusPublished - Jan 1 2017


  • High-resolution ultrasound
  • Lymph node metastasis
  • Melanoma
  • Metastasis
  • Subcutaneous tissue

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Biophysics
  • Radiology Nuclear Medicine and imaging


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