Noninvasive screening tests for metastatic melanoma: rationale and results

When melanoma metastasizes to distant organs, the most common sites of involvement are lung, liver, bone and brain. In addition to conventional x-ray and radioisotopic studies, ultrasonography and computed tomography are being utilized in increasing frequency. The yield and reliability of these noninvasive tests among patients with various stages of melanoma are presented. Other than chest x-rays, the routine use of such tests to screen patients with early melanoma for occult lesions of the liver, bone and brain is not indicated. Even among patients with advanced melanomas, such tests should be used for staging purpose only in patients with symptoms or specific indications.