Altered lymphatic circulation at the site of melanoma excision

Local excision of malignant melanoma promotes both disruption and regeneration of regional lymphatics. These disturbances in local lymphatic drainage favor escape of residual melanoma cells either locally or in transit from more distal sites. Accordingly, a wide tridimensional resection to eradicate all local tumor and circumvent interstitial entrapment and migration of melanoma cells is still advocated. Changes in lymph vessels after excision also demand caution when distal endolymphatic isotopes are administered. Lymph leakage and trapping with overconcentration of the isotope may result in excess local irradiation and skin breakdown.