BACKGROUND. The early detection and treatment of tumor recurrences in melan
oma patients is dependent on reliable, sensitive, and specific techniques t
o verify suspected tumor metastases. As of fine-needle aspiration cytology
(FNAC) has yet to establish itself in the routine follow-up of melanoma pat
ients.
METHODS. FNAC procedures were performed in melanoma patients with palpable
tumors or nonpalpable, ultrasonigraphically suspicious lesions. Cytodiagnos
tic evaluation of fine-needle samples obtained from suspicious lesions was
performed morphologically. Findings were validated either by histopathologi
c diagnosis or prolonged clinical follow-up.
RESULTS. The cytologic examination of 739 FNACs from 330 melanoma patients
was conducted within 1 day of sampling. Complications were not observed. Th
is study showed a sensitivity of 97.9% and a specificity of 100.0%. Moreove
r, in 158 FNACs derived from lesions with a diameter less than 1 cm a sensi
tivity of 94.6% was achieved. Diagnosis of metastatic melanoma with unknown
primary tumor was established in 20 cases.
CONCLUSIONS. FNAC is very reliable for the early detection of melanoma meta
stases. FNAC is a swift method free of complications and is able to replace
diagnostic surgery completely for nonmalignant lesions in a large number o
f patients. Moreover, FNAC is especially useful in combination with ultraso
und in melanoma follow-up and can enable diagnosis of lesions smaller than
1 cm without impairment of sensitivity or specificity. (C) 2000 American Ca
ncer Society.