Scintiscans in the evaluation of patients with malignant melanomas.

In an attempt to define the role of scintiscanning in patients with a malignant melanoma, 349 liver, bone and brain scans in 136 patients have been reviewed. No patient with clinical Stage I or II disease was found to have occult metastases detected by scintiscans. All patients with proved positive scans demonstrated clinical symptoms consistent with the results of scintiscanning. Scintiscans in patients with a malignant melanoma are most effectively used to evaluate the symptomatic patient with Stage I or II disease and all patients with Stage III disease. Histologic verification of positive scans in patients with Stage I and II disease avoids unwarranted therapeutic decisions. There is, however, practical value in being able to predict accurately the absence of metastatic involvement. In only two of 249 examinations did the scans fail to detect metastases. A normal scan is a strong indicator of the absence of metastatic disease.