Augmented splenic uptake of 99mTc-sulfur colloid in patients with malignant melanoma

Paraneoplastic syndromes, tumor markers, and other unusual features of malignant melanoma

Malignant melanoma is a neoplasm associated with a wide variety of paraneoplastic syndromes. In this review the many paraneoplastic syndromes associated with malignant melanoma are critically reviewed. Unusual nonparaneoplastic associations with malignant melanoma and tumor markers for malignant melanoma are discussed.

The "hot spleen" phenomenon in metastatic malignant melanoma: its incidence and relationship with the immune system

Of patients with Stage II and III malignant melanoma, 34.7% display reversal of the liver-spleen ratio on technetium-99m-sulphur colloid isotope scans. Such an occurrence does not suggest a greater likelihood of relapse or a worse survival. The phenomenom is more common in female patients and there is a significant relationship between the presence of a "hot spleen" and a high IgM level. Patients with Stage II disease and high IgM levels have relapses more quickly than do those with normal IgM levels. Lymphopenia is common in patients with Stage II and III disease and the survival of these patients is worse than that of those with normal lymphocyte counts. In this report, the data are discussed together with results from other investigations, and a unifying hypothesis is presented which explains the phenomenon and relates it to increased activity of macrophages as a result of the presence of the tumor. The usefulness of isotope liver scanning in stage III malignant melanoma is also discussed.

Significance of 99mTc-sulfur colloid splenic image in malignant melanoma

To evaluate the clinical significance of 99mTc-sulfur-colloid (TsSC) spleen scan findings in patients with malignant melanoma, a retrospective study was undertaken. Eighty-one patients with histologically proven malignant melanoma who received treatment in Roswell Park during a five-year period were included in this study. The scans were analyzed for spleen size, differential uptake of the tracer in liver and spleen, and for the presence of metastases in these two organs. These data were compared with stage of disease, survival, and autopsy findings. Significant correlation was found between the splenic size as measured on the scintiscan and at autopsy examination. The spleen size was found to be normal in 92% of the patients in early melanoma. The median survival of patients who had a normal-sized spleen by scan criteria was found to be longer than those who had splenomegaly. No significant difference in survival was noted between the patients with and without augmented splenic uptake of TcSC. Only a small number (17.7%) of patients with augmented splenic uptake had splenic metastases; hence, the possible role of immunological factors was considered.