Thoracic metastasis in malignant melanoma. A radiographic survey of 65 patients

Sixty-five patients with malignant melanoma metastatic to the thorax were evaluated retrospectively. Chest x-ray films showed abnormalities in 63 patients and provided the first evidence of dissemination in 42 of the 62 with widespread metastasis. Frequent radiographic follow-up evaluations of patients with primary melanoma is necessary to detect metastasis at an early stage. Pulmonary metastasis was seen radiographically in almost 90 percent of the patients. Snowstorm metastasis denotes a poorer prognosis than other patterns of pulmonary involvement. Enlargement of mediastinal lymph nodes, bronchial obstruction with atelectasis, pleural effusion, bone metastasis with an extrapleural mass, and cardiomegally were also seen. Follow-up chest x-ray films are of limited value in evaluating patients once they are found to have thoracic metastasis. The rate of growth of metastatic lesions or the regression of the metastasis does not correlate with survival.