Pretreatment radiographic evaluation of patients with malignant melanoma.

During a four year period, 53 patients with malignant melanoma underwent extensive pretreatment radiographic evaluation for detection of occult extranodal metastatic disease. This included chest x-ray with tomography, upper G.I. series with small bowel follow through, barium enama, intravenous pyelogram, and radio-nuclide scans of the brain, liver and bone. All occult metastatic disease in asymptomatic patients was discovered on routine chest x-ray examination. There were three false positive examinations, which necessitated further diagnostic tests but there was no change in the final treatment decision. There was no alteration in the management of the remainder of the patients on the basis of the pretreatment radiographic evaluation.