Multi-nodal basin drainage in lower limb melanoma

Area of Science:

• Oncology
• Dermatology
• Surgical Pathology

Background:

• Lymph node status is a critical prognostic indicator in melanoma patients.
• Limb melanomas typically exhibit predictable lymphatic drainage to ipsilateral inguinal nodes, with rare popliteal involvement.

Purpose of the Study:

• To report a unique case of lower limb melanoma with unusual lymphatic spread.
• To highlight the importance of comprehensive clinical examination in melanoma patients due to atypical nodal basin involvement.

Main Methods:

• Case report detailing a patient with lower limb melanoma.
• Sentinel lymph node biopsy and pathological examination.
• Clinical assessment of lymphatic drainage patterns.

Main Results:

• The patient presented with a lower limb melanoma.
• Sentinel lymph nodes were identified and metastatic spread was confirmed in both ipsilateral and contralateral inguinal lymph node basins.
• This finding deviates from the expected predictable drainage patterns.

Conclusions:

• Lower limb melanoma can exhibit non-predictable lymphatic drainage to contralateral lymph nodes.
• Clinical examination of melanoma patients requires meticulous assessment beyond typical drainage pathways.
• This case underscores the need for vigilance in evaluating all potential nodal basins.