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Sentinel nodes outside lymph node basins in patients with melanoma
G K Roozendaal1, J D de Vries, D van Poll
1Department of Surgery, Netherlands Cancer Institute, Amsterdam, The Netherlands.
The British Journal of Surgery
|February 13, 2001
Summary
Abnormally located sentinel lymph nodes are found in 5% of melanoma patients. These aberrant nodes can harbor metastasis and should be investigated in late scintigraphy images.
Area of Science:
- Oncology
- Nuclear Medicine
- Surgical Pathology
Background:
- Lymphoscintigraphy in melanoma patients can reveal "hot spots" outside typical lymph node areas.
- Evaluating these unusual findings is crucial for accurate staging and treatment.
Purpose of the Study:
- To investigate the significance and patterns of abnormally located "hot spots" identified during lymphoscintigraphy in melanoma patients.
Main Methods:
- Prospective study of 379 patients with clinically localized cutaneous melanoma.
- Sentinel node biopsy performed using vital blue dye and a gamma ray detection probe following lymphoscintigraphy.
Main Results:
- "Hot spots" outside regional lymph node basins were observed in 6.6% of patients.
- Aberrant sentinel nodes were identified in 4.7% of patients, with four cases showing metastasis.
- Lymphangioma was identified as the cause in two instances of abnormal hot spots.
Conclusions:
- Sentinel nodes can be located outside conventional lymph node basins in approximately 5% of melanoma cases.
- Specific lymphatic drainage patterns contribute to these aberrant findings.
- Investigating these aberrant sites in late scintigraphy is recommended as they may represent the sole sites of melanoma metastasis.