Laparoscopy in the Diagnosis of Liver Metastases in 80 Cases of Malignant Melanoma

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Abstract
Patients (80) with histologically proven malignant melanoma were submitted to laparoscopy. Of these, 44 had advanced disease and 36 were clinically locoregional (23 stage I, 13 stage IIb). Results of a liver scan and liver function tests were available before starting the procedure. Biopsies were obtained through the laparoscope using a Menghini liver biopsy needle, specimens being taken under visual control from the macroscopically suspected area. If no lesions were seen, 2 needle biopsies were taken at random from the anterior and posterior areas of both lobes. The liver was invaded in 11% of the patients with advanced disease, and in 23% of those with stage IIb. All the positive laparoscopies occurred when biochemistry and/or liver scan were also abnormal, and biopsies taken at random in normal-looking livers were all negatives. Benign tumors were found in 13% of the cases. Some of these were indistinguishable from metastatic melanoma on the basis of their macroscopic aspect alone.

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