An unusual complication of axillary lymph-node clearance

Area of Science:

• Dermatology
• Oncology
• Surgical Pathology

Background:

• Cutaneous malignant melanoma with regional nodal metastases necessitates surgical intervention, including axillary lymph-node dissection.
• Axillary lymph-node dissection is a standard procedure for staging and treating melanoma spread to regional lymph nodes.
• Post-operative complications such as seroma formation can occur after lymph-node dissection.

Observation:

• Two elderly patients presented with a distinct skin eruption on the right chest wall 6 and 8 weeks post-right axillary lymph-node dissection.
• Both patients had undergone the procedure for malignant melanoma with nodal metastases and developed post-operative seromas, which were aspirated.
• Histological examination revealed extravasated red blood cells around dilated lymphatic vessels in one patient.

Findings:

• The observed skin eruptions in both patients resolved spontaneously within 4-8 weeks.
• The precise etiology of the eruption remains undetermined.
• Potential causes include bleeding into the seroma or a transient lymphovascular anastomosis.

Implications:

• This report highlights an unusual post-operative complication following axillary lymph-node dissection for melanoma.
• The spontaneous resolution suggests a self-limiting process, but the underlying mechanism requires further investigation.
• These cases represent the first documented instances of such eruptions in the medical literature, prompting consideration for differential diagnoses in similar clinical scenarios.