Metastatic melanoma to regional lymph nodes

There is an epidemic of melanoma in the United States and throughout most parts of the word. Recent advancements in the management of this disease has provided the patient with more options. The emerging technology of lymphatic mapping and sentinel node biopsy results in a more conservative, less morbid procedure to obtain nodal staging information. At the same time, providing the pathologist the 1-2 nodes from the basin most likely to contain metastatic disease, allows for a more detailed examination of the sentinel lymph node. This more detailed examination may include serial sectioning, immunohistochemical staining or even molecular biology techniques based on RT-PCR to provide more accurate staging. National trials are ongoing to examine the clinical relevance of the disease that is detected and the 'upstaging' that occurs with more sensitive assays for occult metastases.