Cutaneous Delayed Hypersensitivity Reactions to Soluble Melanoma Antigen in Patients with Ocular Malignant Melanoma

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Abstract
We studied the cutaneous delayed hypersensitivity responses to a soluble melanoma antigen in 32 patients with the initial clinical diagnosis of ocular melanoma and in seven control patients. Eighteen out of 19 patients who had pathologically confirmed ocular melanomas were positive to this antigen, as were eight other patients clinically thought to have choroidal melanomas. All seven controls were negative on skin testing with this antigen, as were five patients who were initially thought to have ocular melanomas but who, on extensive work-up, were considered to have other, nonmelanoma, ocular lesions. Thus, patients with ocular malignant melanomas have cell-mediated immunity against an antigen common to systemic malignant melanoma. This delayed hypersensitivity assay may assist in the diagnosis of ocular melanoma, especially in patients with opaque media or those in whom ocular melanoma must be distinguished from metastatic lesions to the choroid. (N Engl J Med 291:274–277, 1974)