Letter: Splenic lymphoma in a patient treated with interleukin-2 and dacarbazine for metastatic melanoma

We have recently encountered an unusual case which we would like to report. A 38 year old male underwent a wide excision of a primary cutaneous nodular malignant melanoma in June 1987 in the left flank (Breslow 1.5 mm). A palpable lymph node was detected in the left groin in November 1987 and left ileoinguinal dissection was performed. One of 15 lymph nodes was found to be involved by melanoma. Ten months later (September 1988) the patient presented with right inguinal lymphadenopathy and underwent superficial groin dissection. Three of the 11 excised nodes were infiltrated by melanoma. Subsequent CT scan and ultrasound performed in November 1988 revealed 2 filling defects in the spleen that were not evident in earlier studies. No attempt to achieve tissue diagnosis was made at that time and combined chemo-immuno therapy was started. Between December 1988 and April 1989 he received 4 courses of treatment, consisting of a single IV bolus injection of Dacarbazine (850 mg/m²) followed by 2 cycles of Interleukin-2 (IL-2) given continuouslly IV for 5 consecutive days each, (18 × 10⁶ IU/m²/24 h) with a rest period of 10 days between cycles.