Fine needle aspiration biopsy of metastatic melanoma

Abstract

In 1930 Martin and Ellis published, in The Annals of Surgery, the description of a procedure whereby a needle attached to a syringe was inserted into a neoplastic mass for the purpose of aspirating cells for tumor diagnosis [1], This procedure, although modestly invasive, rapid, and accurate, was largely ignored for approximately 30 years. Major credit must be given to the Scandinavians for its revival in the 1960s. Since that time fine or thin needle aspiration biopsy (FNAB), as the procedure has come to be known, has become widely recognized and used in major hospitals and clinics throughout the world. The subject has been well summarized recently [2]. In addition to its usefulness in the diagnostic approach to primary tumors, it has significantly altered the management of patients with established cancer and suspected metastatic disease. Introduced at Duke University Medical Center (DUMC) in 1972, diagnostic FNAB has expanded to the extent that currently more than 1,700 patients per year are being evaluated with this procedure. FNAB was introduced into the melanoma clinic for the major purpose of aiding in the documentation of metastatic melanoma in this clinic population [3, 4]. The purpose of this chapter is to review a recent 10-year experience at DUMC with this procedure in melanoma patients.