Although metastatic pulmonary and pleural melanoma has previously been noted, primary pleural melanoma has not been reported. In addition, an extracutaneous response to Adriamycin chemotherapy by melanoma is documented. The patient demonstrated a continued objective response and remained in remission for 10 months. His death was not related to the tumor, and at autopsy there was no gross or microscopic evidence of other organ involvement or origin. Previously reported unusual primary sites associated with this tumor are reviewed, and the established criteria for determination of a primary site in the lung are reiterated. Possibilities of prior unrecognized presence of a primary site are discussed. After having reviewed pertinent literature regarding this intriguing case, we believe that all necessary criteria for proof of a first report have been met.
Attending Physician, Section of Medical Oncology and Hematology; Clinical Associate Professor, Michigan State University, College of Osteopathic Medicine.