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Evaluation of sentinel lymph node status in spindle cell melanomas
M C Thelmo1, R W Sagebiel, P A Treseler
1Department of Surgery, University of California, San Francisco Medical Center at Mount Sinai and UCSF Comprehensive Cancer Center, 94115, USA.
Journal of the American Academy of Dermatology
|February 24, 2001
Summary
Sentinel lymph node (SLN) biopsy is rarely positive in spindle cell melanoma and desmoplastic malignant melanoma (DMM), suggesting a low risk of metastasis for these rare melanoma types.
Area of Science:
- Oncology
- Dermatology
- Surgical Pathology
Background:
- Spindle cell melanoma and desmoplastic malignant melanoma (DMM) have a low propensity for lymph node metastasis, even with significant tumor depth.
- Limited data exists regarding the sentinel lymph node (SLN) status in these specific melanoma subtypes.
Purpose of the Study:
- To investigate the SLN status in patients diagnosed with spindle cell melanoma and DMM.
- To assess the metastatic potential of these rare melanoma variants through SLN analysis.
Main Methods:
- Retrospective review of patient records from 1993 to 1999.
- Inclusion of patients with tumors >1 mm or <1 mm with high-risk features.
- Preoperative lymphoscintigraphy, selective SLN dissection, and wide excision were standard management.
Main Results:
- Out of 29 patients with spindle cell melanoma and DMM, 28 had negative SLNs.
- One patient experienced distant metastases (splenic, bony, brain).
- Mean follow-up was 16.5 and 11 months, indicating sustained disease absence in most.
Conclusions:
- SLNs in spindle cell melanoma and DMM rarely contain micrometastasis, despite tumor thickness.
- Further multicenter studies are needed to fully elucidate the biology of SLNs in this melanoma variant.
