Neopterin in patients with choroidal melanoma

Neopterin excretion in urine and the serum concentrations of neopterin were compared in 101 patients with a malignant melanoma of the choroid and in a matched group of healthy volunteers. The majority of cases (n = 99) presented an untreated (n = 20) or treated and either partially (n = 33) or completely regressed (n = 47) melanoma of stage I-III without signs of extraocular manifestation at the time of analyses. The incidence of elevated neopterin concentrations in all melanoma patients beyond the upper limit (mean + 2 S.D. of healthy controls) was 16% for both serum and urine. In patients with critical events, for example orbital infiltration or delayed metastatic disease during the subsequent follow-up period (at least 14 months), the neopterin concentrations were at the higher end of distribution. One patient with verified metastatic disease at the time of analysis presented extremely elevated neopterin concentrations in serum (82.3 nmol/l) and urine (1608 mumol/mol creatinine). It seems that the results of neopterin analyses are informative as a prognostic factor for the follow-up of patients with a malignant melanoma of the choroid.