1. The Tail and the String Sign: New Sonographic Features of Subcutaneous Melanoma Metastasis 
Antonio Corvino, Fabio Corvino, Orlando Catalano, Fabio Sandomenico, Antonella Petrillo 
Ultrasound in Medicine and Biology 
Volume 43, Issue 1, Pages (January 2017)
DOI: /j.ultrasmedbio
Copyright © 2016 World Federation for Ultrasound in Medicine & Biology Terms and Conditions

2. Fig. 1
Drawing of loco-regional spread of cutaneous melanoma. Melanoma metastasis is described as satellite metastasis when found within 2 cm from the primary tumor (or its scar) and as in-transit metastasis if the lesion is located at a greater distance.
Ultrasound in Medicine and Biology  , DOI: ( /j.ultrasmedbio )
Copyright © 2016 World Federation for Ultrasound in Medicine & Biology Terms and Conditions

3. Fig. 2
(a) The drawing illustrates the tail sign, seen as a small prolongation seen on one or both poles of the nodule. (b) High-resolution ultrasound image shows a melanoma in-transit metastasis in the inguinal region with the tail sign at one pole of the nodule (arrowheads).
Ultrasound in Medicine and Biology  , DOI: ( /j.ultrasmedbio )
Copyright © 2016 World Federation for Ultrasound in Medicine & Biology Terms and Conditions

4. Fig. 3
(a) The drawing illustrates the string sign, seen as a band connecting two or multiple nodules. (b) High-resolution ultrasound image, longitudinal view, shows melanoma in-transit metastasis of the axillary region with the string sign.
Ultrasound in Medicine and Biology  , DOI: ( /j.ultrasmedbio )
Copyright © 2016 World Federation for Ultrasound in Medicine & Biology Terms and Conditions

5. Fig. 4
High-resolution ultrasound image, longitudinal view. Left image: Melanoma in-transit metastasis in the inguinal region which shows the tail sign (arrowhead). Right image: Directional color-Doppler image rules out the possibility of a vessel (arrow).
Ultrasound in Medicine and Biology  , DOI: ( /j.ultrasmedbio )
Copyright © 2016 World Federation for Ultrasound in Medicine & Biology Terms and Conditions

6. Fig. 5
Differential diagnosis between tail sign and lymphatic edema. High-resolution ultrasound image longitudinal view. The image shows two in-transit nodules of the thigh (between calipers) surrounded by lymphatic edema (arrowheads), due to a previous radical inguinal lymphadenectomy. The thin hypoechoic lines due to the accumulated fluid simulate the tail sign.
Ultrasound in Medicine and Biology  , DOI: ( /j.ultrasmedbio )
Copyright © 2016 World Federation for Ultrasound in Medicine & Biology Terms and Conditions

7. Fig. 6
Differential diagnosis between the string sign and a venous thrombosis. High-resolution ultrasound, longitudinal view, with the use of extended field of view scan. The image shows an in-transit melanoma nodule (arrow) grown adjacent to an external saphenous vein filled with echoic material (arrowheads) due to thrombosis.
Ultrasound in Medicine and Biology  , DOI: ( /j.ultrasmedbio )
Copyright © 2016 World Federation for Ultrasound in Medicine & Biology Terms and Conditions