The metastatic pattern and causes of death were analyzed by autopsy of 216 patients with histologically proven advanced malignant melanoma. These cases constituted 3 per cent of all the autopsies done for cancers from 1959 to 1954 at Roswell Park Memorial Institute, Age range was from six to eighty-six years, with a median value of 49.5 years. Male to female ratio was 1.5:1. Multiple organ metastases were present in 95 per cent of the patients. The most common organs involved were lymph nodes (73.6 per cent), lungs (71.3 per cent), liver (58.3 per cent), brain (49.1 per cent), bone (48.6 per cent), heart (47.2 per cent), adrenal glands (46.8 per cent), and gastrointestinal tract (43.5 per cent). Single organ metastasis was extremely uncommon in malignant melanoma of cutaneous origin. The incidence of histologically different, second primary cancer was 7.4 per cent. The most common cause of death was respiratory failure because of massive involvement of lungs in addition to pleura. The second leading cause of death was complications of brain metastases (increased intracranial pressure and hemorrhage). The median survival was twenty-four months. It appears that this is a selected group of patients with a worse prognosis than expected overall.
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