Sixteen hundred and seventy-seven melanoma patients were treated at Duke
University Medical Center from 1956 to 1976. Osseous metastases were more
common than previously reported and occurred in 116 patients (6.9 per
cent), most often in the axial skeleton. Diagnosis was made by
roentgenogram, bone scan, or both in the symptomatic patient. Seventy-five
patients sustained pathological fractures, most of which were successfully
treated conservatively. Nine of the ten patients with neurological symptoms
were improved by laminectomy. The grave prognosis for melanoma patients
with osseous metastases (mean survival, 3.6 months) led to conservatism
even for an impending pathological fracture. Unstable pathological
fractures of long bones were treated by internal fixation and
irradiation.