MALIGNANT-MELANOMA AND GRANULOMATOSIS

Sarcoidosis or granulomatous reactions have rarely been reported in as sociation with malignant melanoma (MM). We describe seven patients who presented with both granulomatous disease and MM, and discuss the phy siopathological and prognostic significance of this association. In th ree patients, the granulomatosis was diagnosed as true sarcoidosis and in one patient, as tumour-associated granuloma. In three cases, desig nated here as atypical tumour-associated granulomatoses, the presence of clear-cut pulmonary granulomatous nodules was typical neither for s arcoidosis nor for tumour-associated granuloma and was highly suggesti ve of melanoma metastases. Mediastinal lymphadenopathy was present in every patient. In all seven patients, the question of mediastinal or p ulmonary involvement or relapse of the MM was raised, but could be con firmed in only one patient. MM can be associated with granulomatous di sease. Knowledge of this association has implications in the managemen t of patients with MM.