THE ASSOCIATION BETWEEN MELANOMA, LYMPHOMA, AND OTHER PRIMARY NEOPLASMS

Background and Objective: Reports of multiple primary tumors are not n ew. However, we have no ted a disproportionate number of patients with melanoma in whom lymphoma develops and wanted to define the incidence of this association. Design: All 664 patients with melanoma treated a t Yale-New Haven Hospital, Conn, during the 5-year period from 1986 to 1991 were reviewed. The incidence of all the associated malignant neo plasms among our patients with melanoma was compared with the incidenc e that would be expected in the normal population adjusted for age, ra ce, and sex. Results: Among the 664 patients, 54 (8.1%) had one or mor e additional malignant neoplasms. Of the 10 different malignant tumor types recorded, lymphomas were the most prevalent. This incidence of l ymphoma among the melanoma patients was 12 of 664, resulting in an inc idence of 548 per 100 000 population, 16 times higher (P<.0125) than t he expected incidence (34 per 100 000) when adjusted for age, sex, and race. Conclusions: The incidence of a second malignant neoplasm in ou r patients with melanoma was 8.1%. Lymphoma was a particularly common type of second malignancy, showing an incidence more than 16-fold high er than that expected in the normal population. It is particularly imp ortant, from a clinical point of view, to be aware of this when clinic ally palpable lymph nodes develop in areas not normally the site of re gional lymphatic drainage of the primary melanoma.