Metastatic malignant melanoma of unknown primary origin: a study of 30 cases

Thirty patients with metastatic malignant melanoma of unknown primary origin treated at Emory University Clinic between 1940 and 1975 are presented. This group represents the 4.4% of all melanomas treated during the same period of time at Emory. Nineteen (63.3%) patients had nodal metastases only, and they were handled by radical lymphadenectomy of the involved area. The remaining 11 patients presented with lung or widespread subcutaneous metastatic disease and treated with biopsy and radiotherapy or chemotherapy. The former group experienced 28.6% five- and ten-year actuarial survival while patients with lung metastases succumbed within four months after diagnosis. Spontaneous regression of a typical melanoma skin lesion has been reported in three patients prior to development of metastatic disease.